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MARGARET THOMPSON MARGARET THOMPSON PMHCNS –NP, BC PMHCNS –NP, BC
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MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Dec 29, 2015

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Page 1: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

MARGARET THOMPSONMARGARET THOMPSONPMHCNS –NP, BCPMHCNS –NP, BC

Page 2: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Understand the disease model of addiction

Identity risk factors for healthcare professionals

Review enabling behaviors Recognize behaviors that accompany

increasing Alcohol / Drug usage Review legal implications and treatment

resources

Page 3: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 4: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 5: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 6: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

To feel good

To do better

Because everyone else is taking them

Curiosity

Page 7: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Experience of pleasure / award

Involved in reinforcement of basic instincts

Drugs / intoxicants over-stimulate this system

Page 8: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

The award system if modified

Memory systems are modified

Higher brain functions are impacted, resulting in behavior of addiction

Page 9: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 10: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Drugs effect other neurotransmitters

GABA

Dopamine

Endorphins

Norepinephrine

Page 11: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Chronic relapsing disorder Progressive - serious detrimental health outcomes.

Characterized by frequent episodes of intoxication / highs

Preoccupation with usage

Page 12: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Usage despite adverse consequences

Compulsion to seek and consume Loss of control in limiting intake

Emergence of a negative emotional state in the absence of the drug

Page 13: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Tolerance

Withdrawal

Legal Problems

Black Outs

Page 14: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 15: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

NursesPsychologyCounselorsPhysiciansDentistryPharmacyChiropractorOther Health Professions

Page 16: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Same Prevalence as the General Population

Inability to Practice

State Monitoring Programs

Page 17: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Providers well-being affects safety of the community

High level of denial

Difficulty with self-observation

Fearful of the consequences on professional lives

Taught to feel Unique – “grandiosity”

Page 18: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Long work days Fatigue Problems balancing career and

family Low self esteem Emotionally charged patient

situations

Page 19: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Control Issues Increased risk of becoming

cross addicted Death and Illness are ever

present Staff Shortages / Mandatory

overtime Unnatural work shifts

Page 20: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Demands of practice Lack of time for leisure, family and

self Perfectionism Excessive dedication to work Guilt The beeper and the telephone Preoccupation and emotionally

unavailable

Page 21: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

BurnoutCompassion Fatigue

Page 22: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

One study has shown that up to 80% of nurses come from

families with at least one alcoholic member

Page 23: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Highly caring by nature Caretaking: Highly emotional and draining

Superhero role Unique draw of profession

Page 24: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Professional Risks - Physicians

Page 25: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Final decision maker Medicine often dictates workaholics

Sense of control Ego

Professional Risks - Physicians

Page 26: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Training that workplace is sacred

Office / hospital last place that addiction manifests itself

Hospital setting remains protected

The Medical Marriage

Professional Risks - Physicians

Page 27: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

PHARMACOLOGIC OPTIMISM

Page 28: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Self Prescribing Behavior

Page 29: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

ACCESS AND KNOWLEDGE

Page 30: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Geographic Mobility

Page 31: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Myth of Immunity

Page 32: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Myth of Entitlement

Page 33: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

REFERS TO THOSE REACTIONS OR BEHAVIORS OF FAMILY MEMBERS, FRIENDS,

INSTITUTIONS, OR PEERS OF ADDICTS THAT SHIELD THEM

FROM EXPERIENCING THE HARMFUL CONSEQUENCES OF

THEIR ALCOHOL OR OTHER DRUG USE

Page 34: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Denial Family Secrets Maintain image of stability Loyalty Motivation Rationalization Ultimatums

Page 35: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Humanistic and Caretaking Missions Dedication / Commitment Common bond Alignment – Extended Family Shared Experiences Secrets unknown to laymen Graveyard Humor

Page 36: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Face Uncertainly and Death Excessive time Together / Long

Hours Professional Family Membership : Legal

Documentation / Licensure Maintain image of Prestigious Group Protection

Page 37: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 38: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

FACT: Any Addict is a Potential Suicide

Page 39: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Appearance

Absenteeism

Difficulty concentrating

Confusion

Memory problems

Lability of mood / Irritability

Page 40: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

POOR DOCUMENTATION RELATED TO WASTING / ADMINISTRATION

UNOBSERVED WASTE WITHOUT SIGNATURES

ERRORS IN ADMINISTRATION

EXCESSIVE WASTE, SPILLAGE, BREAKAGE OF CONTROLLED SUBSTANCES

Page 41: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Signs out more controlled drugs then anyone else

Volunteers for additional shifts and work on unfamiliar units

Medicates other’s patients while they are on break

Patients being cared for report ineffective efficacy of pain medications

Page 42: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Seeks out MD on Duty for Personal Complaints of Pain

Doctor Shopping

Always Uses IM or IV and Maximum Dosages

Diversion

Page 43: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Possession

Possession

SaleSale

Manufacture

Manufacture

Distribution and Trafficking

Distribution and Trafficking

ForgeryForgery

Prescription Fraud

Prescription Fraud

Page 44: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Tool to assist prescribers in making more informed dispensing decisions

Law enforcement - assists with investigations of drug abuse and diversion

Covers schedule ii-iv controlled substances dispensed prescriptions

24/7 access within minutes

Page 45: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Thorough assessment Specialty treatment Aftercare Monitoring High accountability

Page 46: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Legislated in 1998 as an alternative to disciplinary action

Monitoring services Operated by Virginia Commonwealth

University department of psychiatry, under contract with department of health professions

Eligibility Nature of impairments

Page 47: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Strong peer group setting board involvement Drug testing Licensure restrictions

Page 48: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

Contract Abstinence Practice Restrictions Individualized drug screening

protocol Peer monitoring 12 step meetings Caduceus

Page 49: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 50: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 51: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 52: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 53: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 54: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 55: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 56: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 57: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 58: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.
Page 59: MARGARET THOMPSON PMHCNS –NP, BC. Understand the disease m odel of addiction Identity risk f actors for healthcare p rofessionals Review enabling.

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