Our Guest: Melissa Owens, BSN, RNRN | Care management – WICT/SSI Health Plan
Melissa, a nurse in recovery, tells all. She is candid about what it’s like to be a new nurse and all its challenges. She exposes attitudes within nursing that are unhealthy and while she does not blame her substance use disorder on any one thing, listening to her gives us insights into how things can stack up. You will hear about her journey into addiction, how her diversion started and how she was caught, her attempts to get help and ultimately a successful recovery which she has maintained for years.
For more information on Drug Diversion mitigation and resources, visit: https://www.rxpert.solutions/
Transcript
Terri
Hello, everybody. My guest today is Melissa Owens. Melissa is a nurse in recovery, and I recently read her story in a feature article. Her story was moving as really all stories of substance use disorder and recovery are. But what I really appreciated was the way she put into words how she got where she ended up, going straight to the ICU as a new grad, the specific pressures of the job, the culture, and her exposure to opioids and the use of alcohol. So I want to welcome you, Melissa. Thank you very much for being with us today and being willing to share your story.
Melissa
Well, thanks so much for having me. And like I mentioned to you before, I’m just so grateful to have this platform to be able to discuss this big important topic.
Terri
Yes, and you had shared in your story that somebody else’s story really helped you. And so that’s one of the goals here is to reach out, touch people, to help them give them hope. And then also, as I mentioned to you, one of my goals is to humanize this disease for those who are in positions like myself being the diversion specialist, who’s monitoring and watching for this kind of activity in their facilities. So let’s start with your story. Talk us through your leading up to graduating as a nurse and how you entered that field and how it all impacted you.
Melissa
Sure. I think my story as far as how I got into nursing is similar to many other nurses that I feel like nursing kind of chose me. I think I mentioned in my article, I didn’t seek this out for the fame and fortune at a very early age, was kind of delegated to help aging family members and kind of keep them busy in the summers and so forth. And that turned into a really obvious sense of direction for me that this is really where I found this is where my passion lied still to this day. In fact, I was just explaining to one of my children that filling up other people’s cups is the best way that I fill up my cup. So it became evident very early on for me, upon graduation from high school, I didn’t really have an idea of where I wanted to go and seek an education and so forth.
Melissa
And I took time off, did some traveling around the world, around the country, I should say, and moved to several different places and ultimately ended up in Eugene, Oregon, and started working at a nursing home as a nursing assistant. And that just further drove home the fact that this is exactly where I need to be putting my focus. Ultimately moved back and went to college for nursing. And throughout the nursing college experience, we have clinicals in various different areas, specialty areas. And I think if there was one that I leaned most towards, it was OB. And then when I did my OB clinical. And the very first day, I was pulled into a live birth and told to just stand in the corner and just observe. I was that nurse in the corner crying. And the parents are probably looking at me like, who is this?
Melissa
What is wrong with this girl? And after that whole experience, I thought, well, I definitely don’t want to do OB, because I don’t think I can handle that. But still didn’t really know. But then approaching graduation, I just kind of put feelers out there and got a lot of options. But one of my really good friends was offered a job in the exact same hospital, in the same intensive care unit that I was as well. So it just seemed like a good fit to do this with her. We both felt like we didn’t know what were going to be doing, what were getting ourselves into, so we might as well just try it together and try to hold each other up. So that’s where I found myself, was in a fresh out of nursing school in a 15 bed general medical ICU. The hospital is a level two hospital and just clueless, scared, but eager and just so proud to be a nurse. So proud to be a nurse. I just couldn’t wait.
Terri
That’s a little tough. The ICU. We have good friends of ours whose daughter is a nurse as well, and she started in the ICU, and she came in right at the time of COVID and she eventually left to the ICU. It was just too much. But even under other circumstances, no COVID. The ICU is a really tough place, I think, to get your feet wet.
Melissa
I would agree. And I think when the pandemic started, we kind of said to each other in the hospital, that what the public doesn’t realize, is that every day in a hospital and so here we are with a pandemic on top of day to day operations. Like there’s a pandemic. I personally know of a couple of other new graduates who unfortunately started their career during COVID and it’s led to them really questioning the profession. And I don’t discourage them from feeling that way. It’s a very overwhelming thing. But you’re right. I mean, ICU just in general is overwhelming, and I had no idea what I was getting myself into. And like I said, I think that was important to have a support there a friendly face from nursing school, so we could both just cry in the bathroom together. Like, should I be doing this?
Melissa
I’m never going to figure this out. And eventually, a year later, it was just like riding a bike. It was like just a transition walking in there one day, and it was like everything just fit. And I could finally start operating as though I was confident and comfortable, and I had a very wonderful preceptor and a manager, and it was a very supportive place to start off my career, but I was not prepared for well, I wasn’t prepared for the nursing aspect of it. First of all, I don’t think you can ever really prepare for the actual thing, but I wasn’t prepared for everything that came along with being an intensive care nurse, and that is something that definitely affected me very early on.
Terri
Okay, what were some of those things that you weren’t prepared for that come along with that?
Melissa
Yeah. First and foremost, the personal side of the people that we are caring for. It was really difficult for me to witness a lot of the things that I was witnessing early on. I had never had exposure to people dying to death and let alone in a very tragic way, most of the people that I cared for were in there due to some sort of pretty sudden tragedy. And so it wasn’t just about managing this patient who was struggling to were struggling to keep them alive, but it was caring for their family there, too, who was going through the worst possible time in their life. And it was just a heaviness that I didn’t know how to not carry that around, and I don’t think I still do. But that combined with just the overall stress of the job and managing one sick patient, let alone the long hours, twelve hour shifts that turn into 16 hours, no breaks, no lunch, constantly on your feet, that all was just very lot.
Melissa
And it was just a feeling that it was a sink or swim. In fact, my preceptor actually mentioned something like that. I don’t know the exact quote that she made. And I wouldn’t try to say something because I don’t know the exact quote, but she did mention the fact that this is going to be something that you either are going to get swallowed up by or you’re going to just get through the day with, like, a nice hard pat on the back. It wasn’t like nobody was holding my hand, like, in nursing school trying to get me to put that IV in. So it was very eye opening.
Terri
Yeah. And those types of hours and that type of pace, it doesn’t really give you an opportunity for any kind of self care. You keep going because you have to keep going. But we do need to take care of ourselves. But that type of physician doesn’t allow you to do that. Like you said, no breaks and no I was in a hospital recently doing a gap analysis for them, and I’m carrying my water around. Some of the people that were escorting us, when they said, do you need some water? It’s like, oh, I have some. I need a refill, though. But they were like, oh, yeah, I haven’t had anything to drink. I’m just used to it. Nurses, we don’t drink throughout the day.
Melissa
You don’t have to go to the bathroom, right?
Terri
That’s right. Well, yeah, exactly. You don’t do one, don’t do the other. You’re not allowed to keep your drinks in an area where there’s patient care, so you don’t have time to run someplace else and take a swig. And so you just don’t do it and you don’t take care of yourself.
Melissa
No.
Terri
In your article, you mentioned the toxic culture. Tell us a little bit about that.
Melissa
Sure. I will also add that the self care piece, that is not something that we’re even taught at all in nursing school. And that’s unfortunate because I wasn’t taught that in any other education system either. And unfortunately, now it’s something I’m trying to learn now, 18 years into my career. But either way, yes, the toxic culture, I think, yes, that was another piece that I wasn’t aware of and I wasn’t prepared for, and I really didn’t know how to manage it. Still don’t, but like I said, my preceptor was wonderful, but very this is matter of fact, this is how it is. I’m not going to hold your hand if you don’t get it, you shouldn’t be here. This is life or death, and you’re kind of responsible for that. And I appreciated that. I didn’t probably need a handholder, but there were times I may have wanted a shoulder to cry on.
Melissa
But what I started noticing very early on was and hearing rumblings about nurses eat their young, that sort of quote, and then just experiencing that with some not even older nurses, but I guess more senior nurses that had been in the position 510 years before I came in. They didn’t throw a party for me when I got there. There really wasn’t a lot of warm gossip time or anything. I felt very alone. I felt like if I asked for help, it was kind of questioned, like, didn’t you learn this? Or do you really need help? It kind of made me want to just pull away and kind of try to do things myself, which I also didn’t feel comfortable doing. So that was my early on taste to it, is that it just kind of was a sink or swim and there wasn’t this camaraderie and this unified team.
Melissa
It was really like you just kind of had to watch who you were asking for help because they might just maybe mention to your preceptor later that you don’t know what you’re doing because you asked XYZ question. Those were the little things I was noticing early on, but again, just realized I was new in this position. This was my first career job. I’m coming into somebody else’s territory. Like, this is how it was a tight group of coworkers. Maybe it’s going to take me a while to break that barrier, but in various jobs, I started experiencing what is very well documented and researched about this lateral violence in nursing. It’s been studied and there’s plenty of research papers that have been written about it that it does exist in this field. And I can’t say that I haven’t played a part in some of it as well because it is kind of like that locker room type of mentality in a sense that I’ve been in positions where I felt if I wasn’t contributing to some of the behavior, then I was going to be on the other end of it as well.
Melissa
I didn’t write any of the research papers so I don’t want to speak as to what my opinion on all that is. But that became something that I grew a lot of distrust for the coworkers who I really should have been united with. And I think that often leads to I just know personally I’ve experienced other nurses that has led to a lot of errors that happen because people are afraid to ask for help and it just shouldn’t be that way. But I felt that very early on.
Terri
Wow, that’s interesting, that’s very sad. And you’re right, if you don’t feel comfortable asking somebody a question, then that’s when you’re going to make your own decision, which might not be right. And so I know I’ve always worked really hard in Pharmacies where I’ve had any management responsibility to try to build that culture of hey, we’re in this together. Do not hesitate to ask even if you think it’s stupid. And those of you that get asked, you need to be open and have the right attitude, I guess. I don’t know, maybe they feel that I went through the sink or swim and so now you are too. I made it and this is what toughened me up and it’s just part of the process and so if I did it, you did it. Plus if you don’t have time to self care for yourself then I don’t have time to care for the newbie that’s on the floor either because we’re all doing our thing.
Melissa
Well, you’re right, it is sad and I think there’s a lot of things that contribute to it and I think one of them is this like, well, this is how it was for me, so why don’t we just keep perpetuating the problem? But it’s also because it’s a high burnout job and if you’re not doing self care then you’re pretty jaded and you’re not really enjoying your job. And unfortunately that exists in a lot of workplaces, not just nursing, but that is prevalent later on when I became a preceptor and started orienting new employees to the unit and so forth in various other positions. I did tell them right away that I really welcome your questions. I want you to ask questions because quite honestly, the new nurse who comes in here and doesn’t ask any questions, I’m very worried about because if you’re not asking questions then I’m just assuming you’re doing what you think is what you should do.
Melissa
But nobody expects you to know how to do this yet there’s a reason why our orientation is like a six month orientation, right?
Terri
Absolutely.
Melissa
Don’t feel bad and find your trusted person and go to them with questions.
Terri
Right? Absolutely.
Melissa
Okay.
Terri
So you mentioned you were a preceptor. I think you were pretty much a high achiever, right. Once you got there, you escalated up into the chain of command, shall we say. Is that how you had always been even prior to graduating from nursing school? Or did some of that overachieving high achieving? Was that a function of the disease that eventually came and an attempt to outperform the disease, so to speak?
Melissa
That’s a great question. I can answer that. I was not a high achiever prior to graduating nursing school. In nursing school, you have to be a high achiever. Essentially. If you don’t have a B average, then you’re not going to get through it. So that was definitely a step up from where I came from high school, I played sports, so as long as I could get by so I could still play the sport, that was enough for me. School was never enjoyable for me. You were one of those that was president of every organization and volunteering and AP classes and overachiever?
Melissa
Yeah. No, unfortunately, I think my greatest achievement was I was secretary of the student council in fifth grade. Other than that, my mom was so grateful the day I graduated and was like, okay, well, let’s just move on, let’s try another chapter. But I learned very different, and I had to learn that in college. I had to have tutors because I learned very different than how the average well, how school is designed for children to learn. Kids to learn. So yes, no, it wasn’t an overachiever. And I think you bring up a good point that I think it was part of the disease and becoming hyper focused on I should just back up just a little bit. I quickly found my niche in ICU. As much as it was hard and it was grueling and it was stressful, I settled in really quickly and it just felt like this is where I belonged.
Melissa
So I was very passionate and I was very patient centered, and I just wanted to do the most I could in the twelve hour period, which went by in a blink of an eye. So I became very involved in the work, I think. Yeah. A combination of that and just the functioning of the disease, ultimately, which I wasn’t realizing for many years into my career.
Terri
Right. Yeah. And we’ll get to that disease in a bit. But I do have one more question. You mentioned debriefing in your article. What is that? That was a term I wasn’t I mean, I can kind of guess, but what is debriefing?
Melissa
Yeah. So a debriefing is essentially a lot of paramedics or EMTs have after they witness a traumatic event or go to a call that something traumatic has happened, they can come back. And there’s oftentimes facilities have teams available for these debriefings. And there are people that are specialized in trauma response or other things, counseling type of specialties. But it often consists of the team that has cared for this individual or the case that has happened and then some of the people that are just designated to this debriefing team. And then you can just kind of talk about what you just witnessed because like I said, I didn’t have this background of a previous life of ICU nursing or something comparable to that. So all of a sudden I’m just this average girl getting thrown into a situation and seeing these things that are just not I just don’t think everybody’s made to see all those things, but in the meantime, I’m seeing all these things.
Melissa
But my job is to not see those things, but to focus and see exactly what needs to be done and to just get through it. And oftentimes the stressful situations of a code when somebody is actively dying and we’re trying to resuscitate them, that is a very intense and stressful time period because everybody is doing their own job. But at the same time, you’re involved in a situation that is very traumatic and uncomfortable. There’s just a lot that goes and then ultimately those situations end very fast, whether it’s the patient, unfortunately expires or they’re stabilized, but the team is gone and you’re there alone to clean up the mess. But it’s in those moments then when the event has ended that you’re just kind of processing this. And I mean, there has to be some sort of a release for that. And we didn’t have that, I should say never.
Melissa
I think I had an informal debriefing happen one time and that was because a physician kind of said, I’m really bothered by this. And we just kind of grouped together. There was no team. There was nothing like that. But I had to just kind of process those things on my own. I had to take those things home even though I’m not supposed to take those things home. It’s like, how do you not I’m human. And that became very hard for me, very heavy. And I think that was a huge weight. And unfortunately, that’s something that was happening daily in the ICU. It’s pretty much daily that kind of situation is unfolding.
Terri
Yeah. No, I hear you. And like you said, nothing in school prepares you for that. And I still remember the first time where I had a patient expire on the table and it was exactly that, a code. And as a pharmacist, depending on where you’re working, you may not see much of that, but when you carry that code pager, then you’re the one. And I remember it very vividly. My first time an Ed code, and all of a sudden the physician is saying, all right, I’m going to call it. Does anybody have anything else that they? Is everyone good with this? And I’m like, oh my gosh.
Melissa
That’S the worst 5 seconds. Because in your head you’re just thinking, what did I do wrong leading up to this? This was my patient, they were just fine. And everybody’s thinking that, looking at each other like, there’s got to be something else we can do. But yeah, that’s not the reality and that’s it.
Terri
So it always made me very mindful for pharmacists, but it should be the same for everyone. Is that then throughout my career where I would have a new pharmacist that then experienced it’s like, okay, let’s take a moment to talk about this because this is not normal.
Melissa
Right. You pointed out something very important, though, because it quickly becomes normal. At least I think we’re forced to make it normal because it’s our job. But when you have a new person there that is turning white and is about to pass out, you really realize that like, okay, I’m getting kind of used to this and hardened by some of this. And so, yes, we do need to be mindful that we shouldn’t be so used to this that we don’t have feelings anymore.
Terri
Right, exactly. Okay, so tell us about the progression of your disease and then how it led to diversion. How did this kind of I mean, there’s probably no definitive starting point. All of this was kind of leading up and contributing to things. But let’s talk about that progression of your disease.
Melissa
Sure, yeah. I think first and foremost the absence of the debriefing. I found a way to debrief on my own, and that was through the substances. And I just want to start with that. But it started early for me. So, like I said, started this job in the ICU straight out of nursing school, right before I graduated nursing school. Maybe two or three months before that, I started developing these headaches that were the worst headaches I’ve ever had in my life and found out through my primary care provider at that time that it was likely migraines. But he knew I was about to be embarking on my new career and job and that I would have insurance and I could go see a neurologist and kind of spread my wings like that. But he just in the meantime told me, take some ibuprofen and just try to mandate go in a dark room.
Melissa
Well, that’s great, but I can’t always do that. And especially when I was a nurse, it was quickly realizing that where was I going to escape to? I still had eleven and a half hours left in my shift, so I did get a new primary doctor and saw her and told her about these and they were very debilitating migraines, very debilitating. And so the only first and only thing she offered me was a prescription for 75 Vicinin per month. And she said 75? Yeah. I mean, there’s no way anybody would do that anymore. But 75 and never asked me, have you had this stuff before? And I still to this day try to think about, did I? Because I know I had something when I had my wisdom teeth because it just knocked me out. But I don’t remember anything beyond that. I was not subjected to this type of medication ever.
Melissa
So she gave me a prescription for 75 Vicinin. I just thought, wow, that’s heavy. But okay, I’ll have these for years. And then a week or so later, whenever it was that I ended up getting a headache, I took one tablet and I was at home, luckily. And I just noticed that not only did my headache go away, but, man, I was like, jumped off the couch and I was like, okay, I’m feeling pretty light here and I’m feeling like I’m ready to just tackle some things. Everything just kind of went everything like this heaviness. It just always seemed to exist inside me and around me and follow me. And I wasn’t overly depressed most of my life, but there was just always a heaviness, and I couldn’t escape something. But taking one of these, that was gone. And so I then did what anybody in the seat has done in the past, is take another one.
Melissa
And then for me, it was really sadly off to the races because the next day I woke up and I took two right away and went out and did yard work. And I didn’t have a headache, but I just knew that whatever feeling it was one that I wanted to have back. And when I was medicated, I wasn’t ruminating about maybe some sad patient that I’m wondering if they’re still there. It wasn’t always about nursing, but that consumed a lot of my life. I spent a majority of my time working, like most of us do, and so just that doubt and all that self criticism and stuff that just kind of vanished. And I was able to just live in some sort of false state of bliss, I guess, for a little bit. For me, it happened right away. I mean, I definitely was something that just was noticeable for me right away.
Melissa
But again, never ever would have thought and didn’t for the first couple of years that this would be something I couldn’t control. I looked at it very much like, I’m choosing to do this. How is this any different than somebody that comes home and has a glass of wine after work? And I could justify it all day long, and I did that for quite a while. Also at that time, I did have very frequent migraines as well, but I was definitely utilizing when I didn’t have migraines. But at that point, it was just kind of a recreation thing. So it was when I got home from work or when I had a day off. Never would have thought to wake up and medicate and get my scrubs on. Well, I shouldn’t say my pajamas in that job. I actually could wear the scrubs in the unit, so I would just wear my pajamas to work and I would put the scrubs on, but never would I have thought about doing that prior to work.
Melissa
That’s something that you do if you have a problem. And I didn’t. That’s what I told myself.
Terri
Right, and so how long did that last before you started diverting and it became more of problem?
Melissa
Yeah, so that lasted probably maybe a year. And that’s all. And then there was just a period of time where it wasn’t that I really wanted to wake up and do that, but unfortunately, this is something that I developed an everyday habit, too. And so waking up and then not having anything was very uncomfortable and it quickly became the story of I didn’t feel normal or right or alert or anything without being medicated. So I was having to do that before going to work, but again, would go to work and was like, least I’m not diverting, who would do that? And so I did that for years and I didn’t have to divert. And I think one of the problems was, and I know that something that I really took advantage of was the fact that I am a nurse. So any doctor that I had, primary doctor that I had, and I had switched primaries, I don’t want to say frequently, but several different times because I took several different jobs.
Melissa
And it had nothing to do with the well, I’m sure ultimately it had something to do with the disease, but it wasn’t to just change providers. I changed yeah, exactly. I changed hospital systems. And as you know, when you work for the hospital, that’s the insurance you have to go to their provider. So that kind of happened. But over all of those providers, they knew I was a nurse, they trusted me. I used that to my advantage. And I think in a lot of situations where I would, you know, towards the end and I’m talking, you know, six, seven, eight years into this prescriptions were dwindling down and a 30 day prescription was lasting a day, an hour. And that was a problem because obviously it’s kind of frowned upon if you call the next day and say, I’m out, nobody in the right mind is going to feel that.
Melissa
But honestly, the things that I was able to get away with and I know it was only because I was a nurse and I think I was more believed, but I would say you’ll never believe. I opened the car door at the gas station and the pill bottle fallout and all of them just fell into the one puddle that was on the ground. You wouldn’t believe it, would you? And boy, they believed it. And then they will come and pick up another prescription. And fortunately, that, for me, kept things out of the hospital, if you will, for a very long time, until it just didn’t, because there was no way around it. And that’s when I think I had the first thought that maybe there’s a way to do this. And I remember it specifically. One of the hospitals I was working at in ICU, so I only worked in ICU, but our open heart patients would come back, and this one surgeon would let us check off the boxes of what we wanted to or what we knew he wanted us to order set to fill out.
Melissa
Yes, exactly. And in that order, set was for the oral medication, pain medication, and then IV pain medication. Obviously, oral, to be administered after they have the breathing tube taken out. Sometimes that’s within an hour, sometimes that’s days. But either way, the IV medication and the oral medication were active from then on. And so it was easy to figure out how to figure that system out. And I did. And I remember the first time I did it, and I was so disgusted with the thought that even thought crossed my mind, and the fact that I had even gotten to the point where I was okay doing that. And I remember just saying, this is out of desperation. If I don’t do this, I can’t function. And I really couldn’t. But that wasn’t the hospital’s problem. But it was like, just this one time, and that’s it.
Melissa
I just have to get through this 12 hours. I don’t have any other option. And for me, shopping around for this out in the public, on the streets, was just not an option. I didn’t have to do that. I wouldn’t know how to do that. So anyways, that’s the first time I did that. And I think from that point on is when it became very hard to look in the mirror and see just somebody whose moral compass is now just spinning out of control, because it just was a fine line in the sand, and I crossed it, and there’s no coming back from that. But I was very mindful that it wasn’t going to do it again until I did it again, because I was certain that there was going to be no way to find this out.
Terri
Right now, I know you attempted to get some help, and I want to hear about that. And I think I know. For me, one of my thoughts back in the day, before I’ve met more people and heard their story, has actually been okay. I can see how you succumb to it. But as a healthcare professional, especially, shouldn’t you recognize that there’s a problem? And maybe you’re scared and maybe you don’t know where to go, but recognize that I shouldn’t be doing this. This is dangerous for everybody involved, and I need to go get help. And maybe a lot of them do, but they just don’t know where to go. But you did recognize that and you did attempt that, so tell us about that.
Melissa
Yeah, yes, all good points. And I think much like others that I know who battle this disease, unfortunately, it just steals your mind, your soul, your worth, your everything. And so there’s no rational thought behind any of it. And I really, truly believe that even when I was realizing the depth of what I was doing and the risks I was taking and the lives I was putting at risk, it still was like, but I can stop if I want to. And I tried to millions of times and went through it all and could only make it a day maybe, but there was just still this just belief that it’s not as bad as It could be. And so anyways, I did though, multiple times realize that maybe I do need some extra help. Because like I said, I tried many times and was unsuccessful and I was so disappointed when I would go a day.
Melissa
And at that time a day was an eternity. Yeah. And just silently feeling so sick. I mean, the up and down off of Opioids is a very painful and just a very dark place. And so I did realize it and I was very passionate about my job. I loved my job, I loved being a nurse, I loved all that came along with it. I didn’t want to be feeling the way I felt and just this shame about myself and the nurse I was at the time. So I finally went to my primary care provider, actually, and said I don’t know how to say this. Well, I’ll just say, first of all, seeking help at my job at that time was just not an option. It was not an option. And I never held a job where I ever thought it would be an option because I knew what would happen.
Melissa
I worked in the ICU. Well, actually at that time I was working in the cath lab and my job was to do conscious sedation. And so I’m giving fentanyl and bursted all day long and if I can’t give fentanyl, I’m sure they can find somebody that can. So what good am I? Yeah, what else am I going to do there? So anyways, it just wasn’t an option. And so I went to my primary care doctor and said, look, I think I may be taking more than I should. And I just opened it up a little bit, enough to say that I was concerned that maybe I’m heading in the wrong direction. Can you help me? Can you just make a note in my chart that this isn’t an option anymore? Let’s try different medications. Let’s actually try something for migraines this time. Ten years later and can you help with that?
Melissa
And he said, sure. And he said, Actually, I’ll give you a referral to start, which is a rehab clinic in Madison, here in Wisconsin. So I went and actually did the intake assessment there, as know at that time, but before I left, only gave me a refill, obviously. So I was trying to spread it out. It was the last one, so I just had to spread it out and this was it. And I went to that intake assessment and I remember they were calling a name and it wasn’t my name, but they were calling a name and I was the only one in the waiting room and it was at night and I was really irritated because in the back of my mind I thought they’re calling for me. But they got my name wrong and how dare them? Do they not know my name?
Melissa
And just the fact that they didn’t know my name, it was like I’m done, this is not an option for me because in the back of my mind I didn’t take it personally.
Melissa
And also I didn’t belong there. This was a rehab clinic. If I was going to go through with this and I’m going to do this, shouldn’t I be somewhere where there’s like a beach or more clean facility to do this? I just was very arrogant about that. Professional. Exactly. This was beneath me and so I just went through the motions. They suggested an intensive outpatient program and well how is I going to do that? I work. That really was the truth. It was not going to be conducive to my work schedule and I would have had to have taken a leap of absence and how do I do that? How do I do that? Secretly, I guess was ultimately what it was. So I did that and then really never looked back and just didn’t call him back, anything like that.
Melissa
A couple of weeks went by, well actually I’m sorry, a couple of days went by, the prescription is gone. I called and asked to talk to the nurse working with my doctor, said I’m having really bad migraines now, I don’t have anything. And she said, well the doctor is out, but I’ll talk to the doctor that’s covering for him. And the next thing I know they left a message saying you could pick up a prescription. She wrote a prescription for Percocet for you. And nobody looked at my chart. There was probably note that even exists saying that maybe this shouldn’t be prescribed. So it was just off to the races again. And that’s when I started to really get into the diverting. And at that time I was in the cath lab and the only option I had was IV fentanyl. And the wasting process in a hospital is very loose.
Melissa
Even though it’s designed to not be. It is, it’s very much based upon a buddy system and a trusting system. And it was like, well I’ll waste that. And then I’ll just say, I’m just wasting whatever vial. Nobody needs to see the vial. They just sign their initials and it’s done. But meanwhile, the vials are in my pocket. And that’s how I did that for another month. And then at that point, I realized that once it had moved over into the Fentanyl, it just became a different, much different ballgame. It wasn’t a matter of, I need this. It was, I have to have this now. It was just a pull. That was no force that I know could have pulled me away from that. Certainly I couldn’t pull myself away from that. So knowing that, I began my search on the Internet, that what happens to a nurse when they reach this point.
Melissa
I was terrified. And I knew at that point that I was in way deeper than I could get myself out of. But I still didn’t know where to turn for help because my career was at stake. And I then just saw the articles that don’t do it. If you’re a nurse, don’t ask for help and all this stuff, and came across something through our Board of Nursing website offering confidential support to ask questions. If you’re battling some addiction problems and you need to talk to somebody and get some direction on how to handle this, we have a confidential line. Leave a message. We’ll call you right back within 24 hours, and we’ll help you. And I called that number. And I think back and I can’t exactly remember when or how or what, but I just keep thinking I had to have been so low and so desperate at that moment to call and leave my name and my phone number willingly and tell them what I was doing and ask for help.
Melissa
Because now I know. I mean, they’re mandated reporters, too. They could have just turned me in right then and there, but nobody called me back. Nobody ever called me back. Nobody ever called me back. And about a week or two later, I was caught finally.
Terri
Wow, it’s a shame. You tried. You really were begging for help, and it just wasn’t there for you. So you were caught, and now it’s up, and you’re now able to get the help that you were trying to get because you’re not hiring anymore from your employer. Right? It’s over. So now go get help.
Melissa
Yeah, it was over, that’s for sure. And as depleting and as soul crushing and just life changing as, that realization in that moment was that the jig is up, Melissa. Because it wasn’t just up at My. Everyone in my life didn’t know. They may have questioned, but anytime they had questioned before, it was like, Are you serious? You think I would do that? You think I would be that? I’m a nurse, I know what I’m doing. I just have migraines. So I fought off everyone and had it under control. Nobody would have saw that coming, apparently. So I was able to really just keep that quiet. But nothing like getting caught and facing possible felony charges that makes everybody have to know now what’s going on. So I had to alert everybody, really. And like I said, that was just such an awful moment in time.
Melissa
But it was also spring at the same time because I knew that now it’s out and now I can actually now I’m going to be getting what I need somehow. So that was a very good moment because to me it felt like the only way I could have had the freedom to get that help.
Terri
Right? Yeah. How did you get caught?
Melissa
When? How? What had happened was it was a Friday and actually that Friday at work, it was the week before Nurses Week, I’m sorry, Health Professionals Week. And the employees there had decided to start this new monthly award that they would give out. And it was going to be based upon the person who’s the biggest helper and most willing to jump in and just help. And so I was given the inaugural award for that. And it was like this plaque that they were going to have my name engraved on and they were going to keep adding to it. And they’re like and I have a picture that I have in my favorites on my phone because I look at it all the time and remind myself that is never the person I want to go back to. But here I am, smiling, eyes droopy, tired.
Melissa
Nobody recognized that. But holding a plaque with people around me that were just so gracious and really honoring that I was willing to jump in and help, and I was. And that is still a part of me, and I know that I can’t erase that. There still was a large part of that was really my intentions were really true with that. I mean, I always do want to help out my coworkers and I wanted to do as much as I could, but I also would be lying if I said a lot of that wasn’t being offered so that I could have the opportunity to take the waste.
Terri
Exactly.
Melissa
So it was lined with good intentions, but it really wasn’t full of them. So I got the award and I went home that night thinking I had collected enough to get me through the weekend and see what’s important to remember is it’s not about any sort of it’s not like going out and getting drunk and it’s not like having a great time. This is just about daily maintenance. So it was like, do I have enough to just keep me baseline for the weekend so that I can function? I have a small child at home and so I had to function. So anyways, for what I thought I had collected and enough to get me through two days got me through Friday night. And so Saturday morning woke up and started doing some yard work and then quickly realized that I can’t do that because I’m really ready to come out of my skin.
Melissa
And my dad happened to come over, and I said, oh, hey, dad, why don’t you want to ride to the hospital with me? Because I need to change something on my schedule. But I was fully intending on getting I had to get something I had to do that packed up my dad and my daughter, who at that time was two. And we drove to the hospital, and I said, just wait here, I’ll be right back. And I walked went up there, badged myself all the way up to the top floor. And when the elevator opened, one of my coworkers was there dressed in scrubs and a hat, and they had been called in, and I wasn’t on call, so when the doors open, we both looked at each other like, oh. And I said, what are you doing here? And she looked at me and she said, well, obviously we got called in, and she said, what are you doing here?
Melissa
You’re not on call. And I was like, oh, no, you’re right. I mean, I just came to I have to change something on my schedule, and just very casually, or so I thought, just blew it off. Like, don’t you come here on a Saturday when you’re not working and when the clinic is not even open, that type of thing. So the whole emergency team is in the first suite, catholic suite. And I walked to the catholic suite directly across the hallway and then didn’t have the lights on, but I just wanted to quickly access the system. And by that point, I wasn’t even covering my tracks well enough to pull up somebody who has even been in the cath lab. It was just anybody in the hospital that I could find that had a PRN for the same medications that I would have available. I pulled them up, and in doing so and trying to get in and out of there, I miscounted.
Melissa
And the minute I closed the lid and shut the door, it went discrepancy. And right away I had a little bit of a turn in my stomach, and I thought, oh, that’s not good. And this right here demonstrates the power of addiction that I immediately thought I’ll be able to talk my way out of it on monday. I’ll handle it. It’s not a big deal. I can talk my way out of it. Grabbed a stuff and left. And then I went home and thought I’d had enough to get through the next couple of days and got enough to get through Saturday afternoon. So went back and did it again the next day, not knowing. Now that really what happened. Well, I’ll tell you that in a second. So did it Sunday, came home Sunday night. I was sitting in the basement with my daughter, was two. And I have a video right before I got this call of her kind of bouncing and then falling out of this little tiny chair, and were laughing, and I was like, basically as on top of the world as I thought I was at that time, just happy and content and not sick.
Melissa
And I got a phone call, and it was from an unknown number, so I let it go to the voicemail, and then I listened to the voicemail and it basically said, this is hospital administration and don’t come in. You are under investigation for diversion. We’ll be in touch. At that moment, I immediately got off the couch and I walked upstairs and I started looking out the window because I thought, that’s it. I thought for sure the police are coming. What’s going to happen to my daughter? I was just pretty inconsolable. Come to find out, though, after reading the police report many months later, that it was that Saturday that I was there the first time and caused a discrepancy that alerted one of my coworkers that they were a little suspicious of why I was there and where I went. And so they went somehow in the room, then found the discrepancy, called security, who then called the police department, and essentially the jig was up on Saturday, but Melissa didn’t find that out until Sunday.
Terri
Yeah. As long as you’re not creating discrepancies, if people aren’t intentionally looking at the automated dispensing machine activity, sometimes you can get away with coming in on your day off, but as soon as your name, why was she here? And then questions start.
Melissa
Yeah, and that was.
Terri
Well, I mean, there’s a lot of takeaways in here, right? Yeah, a lot of takeaways. Not only for those that have a substance use disorder and can see themselves heading in that direction and not getting the help that they tried to get because other people, quite frankly, kind of let you down. And then for those who are monitoring for drug diversion.
Melissa
Exactly. And I think it’s important, too. I do want to add this because in the talks that I do now, we talk about how to recognize this in a coworker and so forth. When I read the police report and it gave the names of the nurses who essentially called security and alerted everybody to this. When I first read that, it hurt. My heart was instantly heavy because my initial reaction and granted this was only six months or so into my new reality, I was upset because I was like, why would you do that to me? Why didn’t you come to me? Why didn’t you try to get me help or whatever? Those were my friends. And it didn’t take me long after that and maybe less than a year, so maybe a month or two later that I was able to say, thank God that they did do that and they really saved my life.
Melissa
So I say in the talks that it’s so important to not because had they done it the reverse way and just said, hey, Melissa, we could cover for you, whatever, I probably would have been dead by now or by then. So the fact is I really encourage it couldn’t have been easy for them to do that. And I realize that and I acknowledge that and I think the fact that they did that anyways, it’s just important to remember that you could be saving somebody’s life. And that’s exactly what they did to me. They literally saved my life. And so I’m very grateful for that.
Terri
Yeah, well, on that note, I think it’s been about eight years that you’ve been in recovery.
Melissa
Yeah. So I celebrated eight years of sobriety on May 4 of this year. So yeah.
Terri
Congratulations.
Melissa
Thank you. And it’s incredible. I mean, I couldn’t even go a day before. I couldn’t go 8 hours. And somehow, not somehow, I know exactly how it’s happened, but eight years, that’s a long time. And it’s just sometimes when I have to relive this and tell the story over, I even catch myself drifting off in the middle of the story thinking, is that really my story? Because that just is so far from the person I am and the person I even was at that time. I was quickly doling away from drugs, like so many people are and wasn’t able to grasp onto anything. It just happened too quickly. But it is my story. It is the reason I’m here now. But sometimes hard to actually hear those things because it is just very different than the person I am today. Thank God.
Terri
No, I’m sure. And I thank you for reliving that for us and telling it. And I hope that it helps somebody out there in whatever space that they’re in a peer that is watching it happen with somebody or somebody that’s going through it themselves or absolutely somebody that’s thinking about whether they should say something or not because they have suspicions.
Melissa
Right. And I’m hoping yes, that there’s a lot of takeaways and if it just only reaches one person, that is enough because this is something that is unfortunately a reality more than we like to acknowledge or admit to.
Terri
I think that’s part of the problem. Right. Because we don’t acknowledge that it’s the reality. It’s very quick to pass it off as something else. That’s not what people first think of when they’re thinking, oh, that was kind of weird what they did.
Melissa
Right. And there’s so much that goes into that. There’s so many layers to that. I mean, nursing is voted what, the most trusting profession for 20 years in a row? And then you hear this story. But ultimately, yeah, we’re all human and to meet somebody who’s not touched by some sort of connection to substance use these days is very hard to find because we’ve all either seen it, we know somebody with it or we’ve dealt with it in our immediate family and it’s much like a cancer or something. It doesn’t discriminate. I never thought I would end up here, actually, after all this happened. And I had to meet with the board of nursing face to kind of allow my license to be suspended, and I had to explain to them what happened, and I had to sit at the end of a big long board table with all the board members sitting around it.
Melissa
And I remember before I started, my attorney whispered to me and just said, just take a couple of deep breaths and don’t say too much, but just say what you have to say. And I had a moment where I just thought I rewinded my life ten years prior to that in nursing school and thinking of the Board of Nursing and how did I wind up here? And would I have ever thought that I would have been here? Nobody could have ever convinced me that would have been possible. And so I just was quickly not even in control.
Terri
Right. And I remember you shared with me we didn’t talk about it here, but I remember you shared with me that somebody came when you were in nursing school, I believe, or new employee orientation or something. And he told you his story and how he had ended up with a substance use disorder and had diverted and that you were actually, like most of us that haven’t been through it. You were actually quite judgmental. Like, how in the world did you do that? Or could you do that? That would never happen to me. So it wasn’t just that you were lying to yourself and had always had issues. I mean, literally, that was the furthest thing from your mind that you could ever succumb to that.
Melissa
Yeah, well, and it’s exactly like what you had said touched on earlier, that you’re a nurse. Don’t you know better? Don’t you recognize the signs leading up to this? And it kind of reminds me of back at my first job that I had the cardiac or the cardiothoracic surgeon that would perform all the operations for the open heart patients that we would recover. He would disappear after he brought the patient back, and then he’d come back like 15 minutes later and he just stunk like cigarette smoke. And I never forget my brand new nurse there thinking kind of along the same lines that he smokes. Does he not know better?
Terri
Surgeon?
Melissa
Yeah, he literally cares for I mean, he does surgery on people all day long and he’s out there smoking. So it’s along the same lines. Right.
Terri
An addiction is an addiction, right?
Melissa
Yeah, exactly. It’s almost like you become outside of yourself and you don’t see that you’re going to end up in the same percentage of population. But yes, that did happen in school and throughout that guy’s talk there was a lot of things. I was shocked. I was disgusted. I was curious. This was also way before I even had any experience with the medication, but very much judgmental, because how do you not control that? How does somebody ever get to that point? And that was my belief about alcoholics, addicts, anyone, is that you’ve kind of chosen this path, so I don’t really feel bad for you that you’ve got your license taken away from you. And then, unfortunately, that perception and that judgment followed me for a very long time. And working in the medical system, I’ve seen it. I’ve seen it firsthand that people are turned away at emergency rooms because we just label them as they’re drug seeking.
Melissa
So, yes, that was very much my mentality. But I can tell you one thing, though. As much as I thought that maybe that was more of his character defects instead of actually a disease, his story was one of the very first things that came back into my mind when I couldn’t look at myself in the mirror and any longer be proud of who I was, who was looking back. When I first started my career, I was very proud. Look who’s looking back. Like, this is somebody who made it through nursing. Mean, whoever who would have ever thought Melissa was going to get that far? I mean, I pulled off know, my mom was so happy about that. But just the work that I was doing and the lives I was touching and changing and helping and saving, I quickly became that person. I just couldn’t look at myself because I didn’t see that anymore.
Melissa
I saw just this disappointment and this just how did you get here? Yeah.
Terri
And was his story kind of a beacon of hope for you when you thought about him? It’s like he came out of this, I can do it.
Melissa
It was but what more overshadowed that for me was more of the fact of I’m still not like him. I mean, I haven’t gotten caught. I’m not going to get caught. Is that interesting? Yeah, it was. Well, he was doing something different. He was using IV drugs, and he was falling asleep, and I’m not doing that. I have energy, and I’m caring for everybody. You’re still in control. Totally. Yeah. Even though I was 100% not. Yeah. My inspiration didn’t come until much later on, until after, unfortunately, I was.
Terri
Okay. All right, well, thank you very much, Melissa, for your sharing. Congratulations on your eight years and keep up that hard work, and I really appreciate you spending your time with me. Thank you.
Melissa
Yeah, thank you. And thanks for doing this. I just think it’s so valuable and so important, and I just appreciate the space and the non judgmental space to be able to share this with the hopes that we can start to look at this for what it is and try to help. So. Thank you.
