Catch me, if you can.

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1 Catch me, if you can. Addictions at the Workplace, the Risk to ALL

2 Introductions Rigo Garcia Claudia Garcia Background Background APN-BC, CRNA, MSN, MBA MBA, BSN, RN-BC, LAC, CADAC II Parkdale Center for Professionals, Parkdale Center for Professionals, Chief Executive Officer Great Lakes Anesthesia, Chief Anesthetist Husband & Father Chief Operating Officer Licensed and Certified Alcohol and Addiction Counselor Wife, Mother &

3 Program Objectives Objective 1 Upon completion of this activity the learner will be able to List 3 predisposing factors of the impaired profession. Objective 2 Upon completion of this activity the learner will be able to identify 3 obstacles facing nurses wishing to re-enter practice. Objective 3 Upon completion of this activity the learner will be able to list at least 3 proposed solutions to remedy the current situation.

4

5 Addiction, The ties that bind 1:3 People personally know an addict 1:10 People live with an addict 1:15 People Are addicts

6 A Game of Chance

7 David Kwiatkowski X-Ray Technician-Phoenix On Friday, diverted medication left out unattended, overdosed at work No hospital prosecution Monday, started new job 9 years, 19 hospitals, 8 states and 12,000 pts: 40 cases of HEP C identified and one death. 39 years in Prison 15 minutes too long

8 5 factors of chance 1. Characteristics 2. Accessibility & Necessity 3. Enabling & Misdiagnosing 4. Inadequate Intervention 5. Expert Knowledge

9 #1 Characteristics More than meets the eye

10 The Addict Disheveled Unemployed Irresponsible Degenerate Criminal Dirty

11 Addict Intelligent, top 25% of class Well liked and Respected Supervisors and Manager Advanced Degrees Top performers Charming Polite Gentetic Predisposition

12 #2 Accessibility & Necessity Although the initial act of consumption is voluntary, cessation of the addiction, on will power, alone is not Dr. Bernadette Roche Author- Substance Abuse Polices in Anesthesia

13 Accessibility FACTS Addictions are estimated to cost U.S. employers Addictions are estimated to cost U.S. employers more than $300 billion a year. more than $350 billion a year. 76%, of people with a drug or alcohol Addictions 76%, of people with a drug or alcohol Addictions are currently employed. are currently employed. Substance Abuse and Mental Health Services Administration (SAMHSA)

14 I think I can * I think I can * I think I can * I think I can

15

16 #3 Enabling & Misdiagnosing Commitment Potential loss Hesitation to change

17 Commitment to negative Behaviors

18 Potential Loss (ponzi)

19 Gangs Treatment Education Reentry M.A.T Aftercare Support Monitoring Just Say No Borders System Strain Incarceration & Prosecution

20 Enabling at It s Finest

21 #4 Inadequate Intervention Despite best intentions

22 Fate of the Nurse Board of Nursing Attorneys General Legal State Assistance Programs Employers Employers health coverage NBCRNA Credentialing NPDB OIG NCSBN Treatment Centers

23 By the Numbers

24 Physician/ Nurse Assistance Program for Addiction

25 Journal of Nursing Regulation

26 State Monitoring Programs A initial assessment is required A list of treatment providers is given The list of provider meets agreed upon standards If treatment is required, it is mandatory Confirmation of the treatment provider is obtained before the meeting? (why is this important?) Treatment provider is forwarded OAG, BON, or Employer complaints?

27 #5 Expert Knowledge One step behind

28

29 While You Were Sleeping

30 One step Ahead (always) UDS- Tampering U47700 Policy & Procedure Propofol Testing Schedule- Panel Mass Spectrometry

31 What Now?

32 Proposed Solutions 1. Characteristics --- Accept Different Similarities 2. Accessibility & Necessity --- Consider the Compulsion 3. Enabling & Misdiagnosing --- Utilize Objective Parameters 4. Inadequate Intervention --- Oligopolize the Market 5. Expert Knowledge --- Learn More

33 Many small people in many small places doing many small things can change the face of the world.

34

35 Questions? Thank you for your attention.

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