So many takeaways from this interview. Bridget was confronted with her substance use disorder 24 years ago. She will tell us about what led to her addiction, her intervention, her reintegration back into the OR, what her message is to new OR health professionals and so much more. You don’t want to miss this interview. For more information on drug diversion and resources: https://www.rxpert.solutions/ https://zcu.io/XbZ2
Terri: Welcome back everyone, my guest today is Bridget Petrillo. She is a CRNA who has lived the recovery process and she’s willing to share her story today. I don’t ask people like Bridget on here so they can relive their stories in vain; I asked them so that you can hear their stories in hopes that it will humanize substance use disorders in healthcare professionals. I’m going to tell you in all honesty when I first got involved with monitoring for diversion, for me it was all about the hunt and patient safety – which is very important – but I gave little thought to the health care professional – after all, they were guilty of theft, working impaired and putting patients lives in danger, so why would I have empathy for them? They should have known better, and if they knew that they were addicted they should have known better to ask for help. Now, I’m still concerned about patient safety but I am much more empathetic toward the healthcare professional after speaking with people, learning more about the disease – and that is why I invite people like Bridget to the podcast. She has a story to tell and I hope that it will open your eyes further to the disease, so welcome Bridget, please share your story with us.
Bridget: Hi Terri, hi everyone, thank you so much for giving me this opportunity. I’m really flattered after listening to many of your podcasts, so yeah, what you said about should have known better – that was definitely something that was going through my mind my first day of recovery. If you can imagine a suitcase full of self-hatred that I was carrying around, because of thoughts like that, I had no idea that becoming a drug addict was an occupational hazard of the job of working in anesthesia, and I really thought that people who were drug addicts were morally inept, that it was a choice, and you know, I despised them and so, of course, I had to then despise myself for what I assumed was falling down this hole or tripping or whatever it was. Like many other anesthesia providers, I sustained an injury, I was skiing probably under the influence of alcohol quite honestly, and tore my ACL and needed surgery. Back in the 90s, they were giving out Oxys like they were candy and you know, even if they hadn’t it was just very quickly after that that I became addicted to the feeling. I mean the medicine took the pain away but it made me feel normal, it took away a lot of my anxiety and initially it gave me more energy. I got really, you know, revitalized from it and I felt more even to have those medicines, and you know, I likely went back to work too early. You know, I was Superwoman and I thought, you know, my job can’t live without me, and there’s always a shortage of Health Care Providers anywhere at any time. Everybody says, oh, there’s such a shortage right now; I have never worked in medicine that there hasn’t been a shortage of staff – always a shortage, so you know I had this perfect storm I like to call it: I had a family history of alcoholism and mental illness, I had a grandfather who died of alcoholism, I had a job that put me at risk, and then I had this exposure right, so that’s my perfect storm. And then in addition to the job which is your expertise, is that the medical management by the pharmacy and the hospital was very loose as far as the waste record keeping, was incredibly loose, and so it made it that much easier for me to take the leftover waste instead of putting it in the garbage. It was a clear liquid that was witnessed, okay here you go, and then I could take that because I was in so much pain, I was in emotional pain and physical pain. I told myself it was physical pain but in many years of retrospect I know that it was the emotional pain that I was in, and this was 24 years ago so my date of sobriety is 12/7/99.
Terri: Congratulations on that – that’s great. Now was it the hospital that finally said something to you or was it someone else that confronted you, that started your journey of recovery?
Bridget: It was my co-workers: my very best friend was a perfusionist that I worked with; it was an Anesthesia Tech that was in recovery from alcoholism; it was two other nurse anesthetists, and they, you know, I was unique – I don’t know whether I was unique but I was blessed, let’s just say I was blessed -my friends and family knew each other, my friends would come for Christmas, they knew my family, they had their phone numbers. I have a sister who’s a little bit older than me, but we would pal around with my friends and so they all knew each other and so they were able to collaborate and hire an Interventional doctor and then they had an intervention. So at 5 am on 12/7/99, I had eight people show up at my house and say, we have a bed for you, we’re going to take you to treatment because they realize that the hospital and the Administration wasn’t doing anything to help me – they knew, they absolutely knew – they didn’t know what to do and my friends didn’t know what to do but they figured it out, and so they got me help, they packed a bag for me, they watched me take a shower they – just like in the movies, I didn’t want to go – one of the moments I like to discuss when I tell my story at AAA meetings is I’m sitting there in Connecticut, it’s January, it’s cold, on the ground it’s probably 30 degrees and I’m in my pajamas, and there’s a sliding glass door behind me and my family is in front of me and they’re reading the letters just like they do on TV, and telling me, you know, the facts, and I’m thinking to myself I could run out this back door and I could run down the Boston Post Road and nobody will ever know. And I wanted to run so badly and yet you know because my brain had been hijacked, I don’t know what made me stay there but that’s what I thought, that to solve my problem I could run out the sliding glass door in my bare feet, in my pajamas, and walk down the road and be done with them. And so instead I got in the car with them and drove to a treatment facility and I stayed there for two weeks, then I did intensive outpatient for eight weeks and then counseling and AAA.
Terri: Okay, so a couple of things that you talked about, so it was friends and family, they saw a change in you I’m guessing, and those that were at the bedside with you were watching that change, in addition to social interactions. And so that’s important, right, that’s a lot of what we need to look for – the fact that the pharmacy wasn’t looking – that’s the data piece of it so maybe they would have said, “Whoa Bridget is, you know, wasting quite a bit of stuff” but they weren’t looking, so we really depend on the peers and this is – I mean if peers knew what to look for and took it seriously you almost wouldn’t need any of this other stuff – because, right, they’re the ones watching. Now you talked about your brain being hijacked and you know you were thinking, if I could just get out the door this could be over – is there more about that you can tell us, like what is it like – I’m guessing that there were other times before the intervention where it was just not reality, but you felt that it was?
Bridget: Yeah, it is the worst feeling in the world. I tell people I have lived through hell because that knowledge of knowing that I was a criminal and doing something that I had no control over it but I wanted to control, but I thought that I could control it by stopping, and then once I realized I couldn’t control it and I couldn’t stop, I thought about suicide all the time, all the time – probably 24/7 I thought about suicide, and being in the anesthesia business, we have access to incredible amounts of strong drugs that I could do, so you know I was really really holding on, that was going to be my answer, you know, if if I didn’t get help. And I’m so blessed you know with the fact that my friends and family saw that there was something wrong and they had the knowledge to do something. I had that change in behavior, I stopped calling, I didn’t answer the phone, I turned all my lights out, I would make plans with people and never show up – I mean I did all the classic things that we learn about now. Back then we didn’t you know necessarily learn about all that, but those are that’s one of the things that I teach – I now teach a lot of the anesthesia students and the residents, and I teach them, you know, find a tribe, find somebody you could be accountable to and tell them, if I’m starting to act funny you need to do something, like just if you had a mole on your face that looked cancerous that you can’t see but somebody says, gee that mole looks suspicious, maybe you should get that checked out.
Terri: Okay yeah, no very true, I think when you told me your story originally, this group of family and friends, they did the one day at a time thing, right, like just go for one day and if you don’t want to stay you can leave. Which yes, you know wasn’t true necessarily unless you ran out the back door in your slippers.
Bridget: But when I showed up at the treatment center, even though it’s funny, back then they never knew what you know, they didn’t know what fentanyl was. When I sat down and they said what’s your drug choice, and I said fentanyl, they go, What’s that? They don’t say that anymore unfortunately, but I thought, what the heck, they’re not going to be able to help me, and my friend said you know, please be open, they can help you, and they said they could help me, and they did. And I don’t know why I believe them, I don’t know why, that’s where I say it was the grace of God that kept me there, that allowed me to listen to these people and say, yeah it’s no big deal, we’re going to help you, you’re going to be fine, you’re going to get this treatment, you’re going to get out of here and you may even give anesthesia again because I really thought my life was over.
Terri: Right, okay, so after 24 years, another congratulations by the way, would you say that your recovery is complete?
Bridget: No, because it’s always ongoing – it’ll be complete when I die I think, but you know, it is constantly ongoing, I’m constantly learning about the disease of addiction and recovery and that’s the beauty of it, really, is that it’s never complete.
Terri: Okay and you still attend meetings and you’re involved and those types of things.
Bridget: Yes I enjoy going to meetings, I have worked all of the 12 steps, I sponsor people, I have a sponsor, and I’m involved in the American Association of nurse anesthetists, their peer support network. We have a group called Anesthetist in Recovery, we call ourselves AIR. I’m also involved in IDAA which is the International Doctors of Alcoholics Anonymous – they have meetings, they have conferences and I am part of those groups, so that keeps me learning and helping other people. And the thing about helping other people, you know, don’t drink, go to meetings, do your meditation, do your prayer, make amends, work all the steps, I can’t tell them to do that if I’m not doing it myself.
Terri: Yeah, that makes sense, so you’re back in the OR – there are those who feel very strongly that people should not go back into the OR specifically because it is so dangerous and you have a lot of autonomy, you’ve got all those meds right there in front of you – obviously you are a success story but there are some that say don’t even take the chance because the risk of relapse and potentially death is so high, so what are your thoughts on that?
Bridget: Yes, and not only that, it’s the patient safety thing like you said, so you know I believe people are entitled to their opinion, and based on their experience and I have seen more people succeed than not succeed in going back to the head of the bed, however, I would never be able to do this unless I was firmly grounded in recovery, and I didn’t have the support of at the time my counselor. So when I left my treatment center that day in February two weeks after the intervention, I said I’m never going back to anesthesia, and I am never going back to that hospital, and my counselor said, well, one day at a time, why don’t you see what happens? And my road got very narrow for what was good for me, so I can speak for me – I know that my recovery is the most important thing in my life, I will always put my recovery before my job and I know the the warning signs for impending relapse, and I have people who support me and that I can talk to about that, and I don’t trust myself, I don’t trust my future-self in that way, so I can really only speak for myself, and know that this is my path, and this is a God-given path for me, and when people ask if they should go back to Anesthesia I say well you know that’s going to be up to you, I mean I gave anesthesia four years before I became a drug addict so I have a history of giving anesthesia without diverting drugs, and I know that a lot of the literature says if you’re a resident or a student and you have a problem and you know maybe this isn’t the right career for you because it’s early enough in your life and your training that you can change places – it’s easier for a resident I think than a nurse anesthesia student because anesthesia for advanced nursing is so specific. I can’t just go do some other kind of advanced nursing, I need a whole other degree, whereas you know a resident is already but they can go get another residency, but I can’t speak for other people. I can say that it is possible if somebody is grounded in recovery and that’s the most important thing. I can’t work at every single hospital, I can’t work in all the settings that are available, I need to be in a place where they’re comfortable having me, that they’re keeping an eye on me where I work, right now they test the waste, it’s the best system possible. At the Mayo Clinic you know we test the waste, they’re very strict on monitoring our usage and so you know it’s really hard for me to say but I can tell you it’s possible, yeah to recover and to work, and you know I’m a really good resource to have because if there’s a problem you know to come find me. I’ll tell you whether I think that these are signs of something and also I can say, I can sit in the room with my provider and say hey look, I’ve been where you are, this is how I got help and I’m back giving anesthesia, so I can offer and I’ve been involved in those situations where I’ve had to with another surname to supervise her and do an intervention. And you know I think that that’s a gift that I can give to the place where I work.
Terri: Absolutely, yeah again you’ve touched on several things; I guess one of the big things is knowing your limits and being honest with yourself; only the self can know whether you’re being honest, right, so somebody could be saying, nope, I’m ready, I’m grounded, I’m in my recovery but you know they know they’re not quite there and there’s nothing we can do about that, right, so you really do have to be very, very honest with yourself. Maybe in the future, you could get back, but right now you’re just truly not ready, you’ve got more healing to do so people need to be honest with themselves, but I think you’ve also touched on something which is important and it’s a message that I’m trying to get out there too, and that is that culture of ‘we accept you, we’ll work with you,’ because what that does for the facility is, once that word is out then others know that and if someone else has a problem they could come to you in confidence. And hey, you know what, like you said you’re involved in those interview interactions with suspicious diversion cases and you can share your story and give them some hope which is extremely important for those confrontations with people, so I think those are all fantastic things. What do you think is a good approach to bringing somebody back to work, I mean how do you combine the monitoring without reminding them on a daily basis what their past was, or is it good to remind them on a daily basis because that helps keep them you know potentially more on the straight and narrow? What kind of reintegration process do you think works best?
Bridget: Well, first, I don’t need a reminder from anyone that I’m in recovery, I start out my day every day with gratitude for being alive and sober and I was very blessed, so I did actually go back to my to the hospital where I had diverted from three years sober; I went back to work three and a half years and they were very amazing, so I was under contract with the Board of Nursing and so my job could say okay well, we know that the Board of Nursing is monitoring you there, I’m getting urine drug screens which I think are extremely important. They said, Gee, it’s not a good idea for you to work overtime, don’t take call, don’t work overtime, let’s just start you out at 40 hours a week, regular shifts, like not night shift or anything like that, so my job could say, okay well we know that the Board of Nursing has you covered we’re just going to keep an eye on you like we would any other employee. We’ll do monthly reports, your counselor will check in with us, we’ll check in with your counselor – they had each other’s phone numbers so they could check in – so it was very friendly. I had people who knew my story who would also keep an eye on me, and you know the Board of Nursing asked me before they granted me my license back, you know I had lost everything and I had to gain it back but they said well how will we know, how will your co-workers know if you relapse? I said they’re going to know in a minute because that’s the way this disease is. I just knew that if I relapse I would live a day, and so I had people keeping an eye on me, so a recovery-friendly workplace is really important, it’s important for there to be non-judgmental people who say, hey, how are you doing? I noticed that you called in sick last week, you know, is everything okay? Did you go to a meeting? – you know that kind of thing, somebody who kind of understands and then to have, you know, judgment-free work zone, and maybe people did judge me when I came back, but when I did come back I got a lot of hugs from people and they said we’re so happy you’re back we’re so glad that you’re okay, we thought you had bulimia, we thought you had cancer, we thought, you know, a million things. They were just welcoming me with open arms, telling me that, and here’s the other crazy thing the hospital said: they were sorry – they’re like, hey we’re really sorry about what we did, and we’ve changed everything and again, so their drug screens, the monitoring from another person, and then also having a pharmacy department that is better at testing the waste and keeping more of an eye on things. They had changed all that, so all of those things, it’s like, you bake a cake, you put flour, sugar, eggs, butter – if you leave out the butter it’s not going to taste so good – so kind of like I feel like a return to work is a lot of different things to make it really good, right, and like you said, people check in on you – it’s not something we’re just not gonna talk about because that’s, you know, embarrassing for you, but we’re gonna throw it out there like, hey you called in sick, what’s up? You know, how are you doing?
Terri: Yes okay, interesting, you mentioned that you do education for the new grads and one of the messages was developed – that group that is watching you, are there any other messages that you want to make sure that they get out of their time with you?
Bridget: Basically that help is available if it comes to that point where you find yourself down a road that you didn’t really plan on going, that you know help is available and hope is possible and I advertised a lot for the – AA has a helpline so the American Association of nurse anesthetists realizes that an occupational hazard is substance use disorder and we have a 100 helpline that’s manned by our friend Rigo Garcia, and he’s a good friend of mine and they monitor, they take those phone calls, and they just help people get an evaluation for getting help so that’s one of the things I tell the students – I even tell the anesthesia residents, the doctors, like yeah, this is a CRNA helpline but you can call it too, and if you’re an X-ray tech or you have a family member you can call that number too, and it’s confidential, and that’s the thing that’s very important about that moment of like clarity where you might want to get help and you’re not sure. I remember that I wanted to protect my anonymity so much now it’s less important to me but that anonymity that confidentiality, it’s like it feels so important at the time, and like I want to get my job back, I don’t want to be reported, I don’t want to go to jail, I have a family, I have all this, yes it’s all possible and it sucks at the moment but it’s possible and I also just teach them, keep an eye on your brothers and sisters, like keep an eye on your tribe, if you notice, like you know there’s a lamb outside, right – that’s a big analogy you know the sheep and then there’s a sheep or a lamb heading for the cliff it’s like go, get that person, bring them back and you’ll feel better about yourself if you take care of people. You know we’re nurses, we love to take care of people – even doctors, we all like to take care of people, we want people to do well and so keep an eye on your brothers and sisters, stay well, you know if you’re feeling like your life is a little bit out of control and you’re a little over your skis because of family, whatever, working too hard, you know take a break it’s really okay to take a break, take a step back before it gets to that point of your life being out of control and you’re in so much pain that you can’t – that your only solution is to, you know, find a drug.
Terri: Right yeah, all good points. I do know that procedural areas or the staff are very much a team and very dedicated to each other, so much so that an outsider coming in to observe or potentially to do an audit on something the workflows – they don’t like it, it’s like what are you doing, I mean they can be a little bit hostile right because it’s like we don’t need you we got this this is our place but I think adding on to that is the message that substance use disorders are there and diversion is real and that’s fine, look after each other, that’s fantastic but you have to also know when to speak up and when to do something, you’re not protecting your colleague by not saying anything, right, it’s that team thing needs to take a different look when there is a concern – continue to be a team, but know that you need to speak up and say something.
Bridget: For sure, yes, having that conversation and not having it be like in the old days. We used to speak cancer – you always have to whisper cancer – and I really hope that someday we don’t have to whisper, you know, drug addiction or diversion or any of those things – that it’s a reality and it’s ugly and you know if if if you know if you see something do something you know uh that’s also one of our mottos, at the AANA – it’s not it will reveal itself eventually and what we don’t want is for somebody to be found in the bathroom overdosed or dead.
Terri: Exactly, yeah, and I think another takeaway from this conversation for me is for facilities in addition to whatever they’re doing which you know hopefully they’re monitoring and doing all these things as you said you know you were enabled to some extent, right, putting out the resource information if somebody has that moment of okay you know, this is it, I gotta do something so those places where they can go and still keep their anonymity and report themselves and talk to somebody, and at that moment if I’m guessing at that moment if you have a moment of clarity of, I need help, but you don’t know where to go, that moment could pass pretty quickly and maybe not come for a long time. But if that number is front and center and quickly available to you then, you know, you might take advantage of it in that moment, that you have that clarity.
Bridget: Yeah, absolutely 100%, and you know to have somebody on the other line who says yeah I’ve been where you have and I’m human and you know it’s unfortunate that this is how my life has turned out, I didn’t choose necessarily, I never said when I wanted to become a nurse anesthetist that I wanted to become a drug addict, I never said that, I never believed it not in a million years. I probably would have bet millions of dollars to the opposite and you know for that, so yeah I do appreciate you bringing the human side to a lot of these stories
Terri: Yeah well, I think it’s important, definitely, and it helps us. Is there anything that you think can be said by those who haven’t been there in a confrontation of somebody, essentially a stranger, or if the manager is in the room that has some relationship with them and I’m sure it’s different for each person depending on where they are in their denial or you know the process but is there any particular message you think that should be incorporated into every confrontation with somebody that we suspect that something is going on and you know we’re not friends family that type of thing we’re just we’re doing our job we’ve spotted something and we’re confronting.
Bridget: I think I hated myself so much at that moment of my intervention and you know even somebody telling me they loved me was so painful and I didn’t believe it because I had been hijacked but somebody did say to me you’re worth it, this is worth it, you are a worthy human being and you’re worth getting the help and that help is possible and help is available I think those are the key things in talking to somebody that getting help is worth it. My best friend who was eight and a half months pregnant in the intervention said to me, I don’t care if you never talk to me again, I don’t care if you hate me for the rest of your life and my life, but you are going to get help today and that was really powerful that she was willing to put that on the line, so I think even a stranger or an employer or a supervisor, if they’re willing to put something out there on the line, whether it’s taking care of the flight to get to treatment or give them the time off, or say we’re going to keep your benefits for you because you know financial worries are enormous, and it’s so tied up, our addiction is so tied up in our disease so but really and truly, you’re worth it, you are 100% worth getting help.
Terri: Okay I like that, all right thank you for these excellent takeaways, Bridget, and thank you for being willing to come and share your story I really appreciate it.
Bridget: Thank you, Terri, thanks for taking the time to search me out, and have a really happy New Year by the way.
Terri: Yes, thank you too. All right, you have a great rest of your day.
Bridget: Thank you.