I have been an LPN since 1990, and an RN since 2003. In 2004, I was involved in a motor vehicle accident in which I was rear-ended by a drunk driver at 60 mph while I was stopped at a red light. I sustained two herniated discs in my neck, which required me to have an anterior cervical discectomy and fusion from C4 through C7. I also sustained herniated discs at l4-L5 and L5-S1. I have seen several surgeons who have advised that I am not a surgical candidate because of the extent of my injuries.
I was referred to a pain management specialist, and I have been under care for almost five years. During this time, I was able to continue to practice safely, although at times I was in pain, and I never had a problem during annual job performance reviews.
In February, I reinjured my lower back at work and developed a left-sided foot drop. I continued working until April, when I was placed on medical disability because of the foot drop, as I was beginning to trip and drag my foot. At some point during these last few months, someone at work reported me to an impaired nurse program because they thought I was impaired, because I was unsteady at times. I underwent an impaired nurse evaluation and was recommended to attend an intensive outpatient program, as I had admitted that I had previously misused my medication because of the pain. However, the program physician never asked me about my previous injuries, nor why I was taking pain medication.
I have agreed to cooperate and attend the intensive outpatient program; however, the physician is demanding that I stop taking any pain medication, which, according to my pain management physician, is a ridiculous notion. I have tried to explain to the program physician that it not possible for me to stop taking my medication, just as it would not be possible for an insulin-dependent diabetic to stop taking insulin. The physician is demanding that I go on Suboxone, which is not FDA-approved for the treatment of chronic pain.
I have run out of options and have nowhere to turn.
Nancy Brent replies:
Your unfortunate series of events is difficult, at best, to endure as is the reaction from the physician at the impaired nurse program in which you are participating. Although the continued use of controlled substances for pain is an important issue in any recovery program, your pain management physician is the expert in this specialty. A coordinated approach of your program with your pain management physician would be in everyones best interest. There also are recovery programs that focus on pain management as part of the overall treatment in a recovery plan.
It is important for you to retain a nurse attorney or attorney in your state who works with nurses and others who are facing treatment and licensure issues and can advise you about your rights. You can locate an attorney through any professional nursing association to which you belong, contact a state bar association referral service, or go to The American Association of Nurse Attorneys Web site (Taana.org) and click on the Need a Lawyer? link. The association has members in most states and hopefully can provide you with the names of several nurse attorneys near you.