Imagine if you had no place to turn.
Caught in addiction but too afraid to seek help. Scared of the repercussions that that might have.
In the fourth contribution to our No left Turn series, our good friend Tiff Swedeen looks at addiction stigma from a nurses point of view.
The fear, the implications and the postulations that reinforce stigma – and prevent nurses from seeking and receiving help.
It’s Nurses’ Day on May 12th, and I’m indebted to Tiff for writing such a personal, challenging and, frankly, eye-opening account.
Thank you Tiff, as always.
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Addiction doesn’t discriminate.
No population or demographic is exempt.
Not even a profession that is known for its caring, ethical attributes.
According to Forbes, nurses are the #1 trusted profession in America.
Our title and job description infer we adhere to scrupulous morals, possess exceptional coping skills, and are immune to afflictions that trouble the general population.
The archetype makes sense, considering a nurse is the person you call when you need someone to care for you. You wouldn’t want to call someone who’s anything less than healthy, strong, knowledgeable, and capable. A nurse needs to be able to manage the suffering of others with ease; he or she shouldn’t be suffering themselves. We feel pressed to uphold a facade of invincibility.
But nurses aren’t immune, and these are dangerous postulations that reinforce stigma and prevent nurses from asking for and receiving help.
They’re especially damaging when a nurse won’t ask for help with their addiction.
A nurse who believes they’re supposed to be super-human but finds themselves dependent on alcohol or pills won’t reach out – even if their life depends on it.
Statistically speaking, approximately 10% of nurses suffer from substance use disorder (1). But that’s just the reported number… imagine the actual scope of the problem.
I don’t need to imagine it; I’m living proof.
When my use of opiates and alcohol spiralled out of control I knew I needed guidance and support, but I was paralysed by shame and stigma. Though desperate to get clean, I was even more desperate to maintain anonymity. My priority seeking treatment wasn’t to find the best resources, it was to devise a way to get sober without telling a soul.
I’d heard of nurses in similar circumstances over the years, and they weren’t talked about kindly. Many seemed to simply disappear from the workplace, but gossip would linger.
Treatment programs are available in most states specifically for healthcare professionals, but those aren’t discussed either, except maybe to say, “So and so ended up in ‘the program’.”
Nurses who are questioning their use of alcohol, or at risk of abusing prescriptions are left completely in the dark. Not to mention terrified to lose their job and licenses. I was horrified to be considered “one of those nurses” who were “in the program”.
As an overachieving caregiver, it felt a fate worse than death to be thought of as weak, vulnerable, or susceptible to disorders that should only affect our patients.
So I tiptoed around the subject, feeling out who I might trust or where I might find relief. Comments by well-meaning friends, family and coworkers supported my anxiety and compelled me to stay secretive.
- “Nurses who divert (steal) medications from work are the worst of their kind.”
- “No nurse should ever get to that point. They should just know better. They don’t deserve the license if they do.”
- “I drink after work all the time, but I’d never let myself become an alcoholic. Nurses know better than that.”
- “But you don’t drink that much at all! You’re fine!”
- “At least as a nurse you know how to safely take medications.”
- “Whatever you do, don’t tell ANYBODY. Nobody should know this about you.”
- “You should be able to moderate your drinking yourself. You can’t risk your job by going to a meeting and getting recognised.”
It was suggested I seek an expert’s opinion.
I chose a local PhD level chemical dependency therapist and researcher who came highly recommended and esteemed by colleagues in the field.
Of course, I paid out of pocket so as not to tip off my insurance and accidentally out myself to my employer.
The lengths I went in order to protect my integrity, and therefore protect my disorder, are incomprehensible. After examination and analysis, the specialist’s conclusion was this:
“Sounds like you’re functioning quite well. You’re a professional, you’ll get this figured out. I don’t think you’re too bad off at all.”
Deep in my soul, I knew he was very wrong, but my search for help ceased.
For two years, I withdrew further into the abyss of addiction. I escalated from pills to injecting IV narcotics and was often drinking throughout the day.
Eventually I reached what I consider both a rock bottom, and my saving grace.
I diverted (stole) medications from work and my employer caught me. This was the lowest, most contemptible moment in my career.
But there was redemption; instead of being fired, I was given an opportunity to go to treatment. Since then, I’ve been on a mostly forward trajectory of recovery.
It’s had its own cadence of ups and downs but life consistently improves as I move toward balance and spiritual wholeness.
I wonder though: how much sooner could I have found my way to sobriety? How much more willing would I have been to admit I was in trouble if having addiction wasn’t viewed as being weak, damaged or inferior? What if I’d been welcomed and congratulated when I opened up, instead of being “shushed” or minimised as “not that bad”?
Speculation won’t change my story, but I can use the past to make a difference for others.
The recovery community is making strides towards becoming more accessible and acceptable. But as my life of substance abuse fades farther into the distant path, I’m shocked to find stigma still prevails.
Since embarking on this journey, I’ve met many sober nurses, and many who have considered it. But our conversations are held in dark corners and in hushed tones.
Recently, a colleague told me “I’m thrilled with my new life of sobriety, but there’s no way I’m telling anyone at work. You know how people are. I’m just going to being judged.”
While that’s not exclusively true – I live sober out loud and have often encountered compassion and acceptance- she was mostly right.
I’ve had to work hard to fight past the disparaging remarks, the questioning looks, the awkward conversations. But it’s been worth it.
Every time I choose to proudly and publicly state that I’ve battled addiction, it’s a chance to proudly and publicly state I’ve overcome it, and more importantly that it’s possible for others to do the same.
It’s a chance for me to be a glimmer of light in what might be someone’s darkest moment. When that light shines, stigma shrinks beneath it.
I’m not advocating for every nurse or person who’s struggled with substances to break their anonymity. I’m not saying it’s necessary to reveal these parts of ourselves to just anyone.
But as a nurse who lost almost everything based on society’s expectations, self-loathing, fear, and shame, I am saying that for prevention and treatment of addiction to be attainable for all, stigma has to end.
Addiction doesn’t discriminate.
No one person, industry, religion, or society is exempt.
We’re all capable of actions that lead to guilt and regret. But we’re also all capable of recovery and redemption. Let’s start viewing each other that way.
Let’s spend less time finding reasons to judge and criticise, and more time breaking down walls, creating safe spaces where honesty and acceptance flow freely.
(1) Substance Use Disorder in Nursing (2011), National Council of State Boards of Nursing
[Ed] The title of this piece is a quote from Florence Nightingale
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About our author, Tiff Swedeen.
Tiffany has lived a series of experiences that many would call mistakes, but she considers practice.
As a nurse and certified life & recovery coach, Tiffany writes about her adventures as a part of her healing journey, in hopes to empower others.
Travelling as much as possible in her VW camper van, Tiffany aims to conquer the world with compassionate mindfulness.
She lives in a small town with her beloved canine Cassie the Wonder Dog, and is mother to one magnificent daughter who’s trying out the big wide world for herself.
You can catch more from Tiffany on her website, or follow her on IG/Twitter @scrubbedcleanrn