Our guest: Tracy Traut, MS, LCAC Program Director, Indiana Professionals Recovery Program
The tightrope walk of balancing patient well-being with healthcare worker recovery – we’ll explore it today! The Indiana Professional Recovery Program, also known as the IPRP, tackles this critical challenge head-on. They have a two-pronged mission: safeguarding patients from potential risks and offering support, resources, and accountability for healthcare workers struggling with substance use disorders. In this episode, we’ll delve into the IPRP’s inner workings. We’ll hear from Program Director Tracy Traut about their partnerships with treatment centers and employers, and most importantly, we’ll celebrate success stories. Join me as we explore the crucial work of the IPRP and how they’re fostering a path to recovery for healthcare professionals.
Terri
Welcome back everybody, to drug diversion insights. We have a sponsor for today’s episode, Midas Healthcare Solutions. They are introducing a new product to help deter and prevent medication diversion. Midas View provides a holistic approach to medication wasting and its documentation with the ability to integrate with your ADC’s, your emrs, and your diversion software. It allows for an easy to use system consistent with nursing workflow for the first time. Their 360 degree camera provides real time and on demand visual proof the medication was actually discarded anytime. Witness technology allows the convenience and flexibility when a witness is required in the disposal of unused controlled substances. Today, my guest is Tracy Trout, the program director for Indiana Professionals Recovery Program.
Terri
And for those of you that listen to the podcast regularly, you know that I am trying to work my way through all of the states, and I want to thank Tracy for being willing to take the time to talk with me today and tell us about Indiana. So, Tracy, welcome.
Tracy
Thank you for having me. I’m always excited to talk about monitoring because it’s an important alternative to discipline. Programs are important, and I really want to commend you for reaching out to all the states, because while we’re all similar, we also are very different. And I think getting the word out that this is something that is there and available is really important. So thank you for this opportunity.
Terri
Absolutely. Yeah, I agree there’s quite a few differences, but what I found myself is that being involved in the intervention or interview process and talking to others, many people don’t even know what the next step is in their state. So here they are talking to the person that they suspect has a substance use disorder, and they don’t know where to tell them or how to tell them. It’s like, well, go connect with HR. And then HR doesn’t even know all of the details of what it is. So it’s kind of a shame that we just, you know, kind of let it fall right there and then hope that eap or, you know, somebody can help them. So, yes, I think it’s important to know. Yeah. All right, well, let’s start with, why don’t you tell us a little bit about your background.
Terri
How did you get to where you are as an addiction counselor?
Tracy
So, this is a second career for me. I was, when I moved to Indiana, we left a lot of things behind in Chicago. I stayed home for a bit, did some volunteering, and then I was really fortunate to find a job as a director of a community mental health center that had a very interesting model where they used graduate level interns to provide the counseling, they were supervised. So master’s level, intern level, I really built that program up. It was a great job, and I stayed there for a long time, for seven years. And then somebody on the board was like, I think you need to take some steps outside, you know? And I was like, but I did that, and it was great advice, and it worked out really well.
Tracy
So then I went off to worked in community corrections for about a year, and. And then I went back to working for another organization that was doing a similar thing in community mental health, working with interns, have a private practice, and I also work at the Marine house, which is a 13 bed sober living facility for men here in Valparaiso. And that was really the turning point for me, was running some of the groups over there because I had a lot of certifications, but my college education was not to the point where I needed it to be. So those guys spurred me on to go back to school, which I did. And one day, one of my old professors called me up and said, hey, they’re starting this new company called IPRP. You should apply. I’m like, I don’t want to apply.
Tracy
He goes, no, you’re really good at this. You should apply. So I applied. Started out, I was a case manager for about eight months, and then I was promoted to director. And so this job uses all of my skills, but also gives me the opportunity to, again, working with young people, influencing their careers, helping them go forward, but also put my skills to test in a different way. I never worked with a lot of healthcare professionals prior to going into this job, and so it shed a new light on a new population. I would also argue a neglected population. We tend to take people in healthcare and do the same things that we do with firefighters and cops and people in the military, where they’re all, you know, skilled and ready to go, and so there’s never any problems. They can’t have problems.
Terri
Yep. Yeah, no, that’s very true. And we’ve talked about that before on other podcasts, that whole de stressing the whole trauma that we go through, you know, every day with things that we see, and it’s just, well, that’s your job. I mean, that’s what you’re there for, so. And I think a lot of people don’t realize that when they go into the field, you know, they don’t. I mean, I guess it makes sense. Firefighters and. And police officers. I mean, you know. Right. But when you’re in healthcare, that’s certainly never anything that ever occurred to me that I would be at the bedside when somebody passed away after, you know, it’s like.
Tracy
Right. Or, or you’re a retail pharmacist. You know, I’m a consumer of those products. Right. I stand in line to pick up my scripts. You know, you stand in there long enough and you watch what pharmacists are undergoing. You know, John Q. Public should sort of wake up and how we’re speaking to these individuals. But, you know, day in and day out of people being upset about whatever it is going on with their insurance, etcetera, the high pays, the high volume of scripts in big pharmacies. I mean, it is stressful, and there are moments there when you are going to get faced with a lot and it starts to pile up like a trash compactor.
Terri
Yeah, yeah, that’s true. I didn’t think about that. I spent a little bit of time on the Upper east side of New York and their discharge pharmacy, and that was something else. So you’re right, it’s a different kind of trauma.
Tracy
Yes, yes. Right. You don’t conceptualize it that way right at the time because it’s like, okay, this is a little. But I’ll do my job because we sort of save all of that. It can’t be us that are having this. You know, we save it for what the other professions that really deserve it.
Terri
Yeah, yeah, no, that makes sense. Okay, so I want to learn about Indiana. First, let me ask you, did it recently undergo a name change? Because I was at a client’s facility indiana, and there were many conversations that said I span, or whatever the other name is, they would say so.
Tracy
So what happened was, so per legislation and per what the nursing, Indiana State Board of Nursing put together, it is still the Indiana State Nurses Assistance program. IPRP is just the sort of the acronym of our very long company name, which is Indiana Professionals recovery program. So we kind of shorten it. We spend a lot of time in our writings and things like that where it’s like ISNAP, IPRP, just so that I keep everybody on the same page. But we are still the Indiana state nurses assistance program. IPRP is the company that manages that. So we came up with, the company came up with a very generic name because we also have contracts with other people in other states. So we sort of did it that way. But we are still, I snap.
Tracy
And I know it is confusing, but that’s how the nursing board still refers to it.
Terri
They call it Isnap still?
Tracy
Yes. They call it I snap. Yes.
Terri
Okay. All right. So Isnap IPRP.
Tracy
Yeah, these are all kind of one in the same. We can run together.
Tracy
Yes. So Isnap is, was created by the Indiana State Board of Nursing and the legislature. They had to come together to put some policies, procedures, and some other things in actually build it into a law. So were able to do that. Our referrals from pharmacy and from nursing come in a couple ways. One, the professional can direct report to us and call us on the phone and just say, hey, I’ve got some issues. This is what’s going on. That is our kind of lowest way that people come in. Most of the time. They have had some kind of interaction with the IPLA, which is the Indiana professional licensing agency, and been in front of the board. And then they have also had maybe a board order, or they’ve been in front of the pharmacy board.
Tracy
They’ve had some kind of criminal altercation, maybe a DUI, some diversion, and then they’re instructed to call us. So we have a pool of nurses and pharmacists coming in that may or may not happen. This is their first choice. But what this does is sort of simply is allow them to continue their career while somebody is also helping them get stabilized. So it starts with a phone call. You call our office. Your first contact will be Kerry Graham. Carrie will assess over the phone using ASAM criteria as well as screening and brief intervention for referral to treatment. If that person needs treatment right away, boom, off they go to treatment. We have a lot of great treatment facilities that we have established relationships with, and we provide a list for them.
Tracy
They can choose where they’d like to go, whether that’s outpatient, PHP or IOP. We do ask them to fill out paperwork. They complete all of that paperwork and take a drug test. And then we have three clinical case managers who are all licensed therapists in the state of Indiana. We’re one of the program few programs that does all of our evaluation in house. So we will do a complete biopsychosocial, give them five assessments. All of that gets wrapped up into what we call a biopsychosocial. And we staff that case. We come up with our recommendations, and then we provide the nurse or the pharmacist with those recommendations.
Tracy
Some of those recommendations are how many drug tests they’re going to get a year, how soon they can return to work, whether or not they need to see a therapist, helping them with self help meetings and really any kind of resources they need. That sort of all gets back built into our recovery monitoring agreement and then once they are active in that program, it becomes our job to anything they need assistance with. Are you making your meetings? Do you need to change a meeting? We ask them a lot of things, like when’s the last time you took care of yourself? When did you go to the dentist? You know, when’s the last time you got a haircut, got your eyes checked? You know, those kinds of things.
Tracy
And our main job in that is to keep them on the track so that they have support to return to that job. So there are some nuances in there that are different between pharmacy and nursing, but for the most part, they’re pretty.
Terri
Much the saying, okay, well, beautifully articulated. I think we’re done.
Tracy
That’s it.
Terri
So you mentioned nursing and pharmacy. Are those the only two licensed professionals that we handle?
Tracy
Yes. In the state of Indiana, there is another program for physicians, and there is also JLAP, which is for attorneys. So that’s about it.
Terri
Okay. Do you. So not unlicensed, I don’t know, radiology technicians or what have you. They wouldn’t come through.
Tracy
They could come through our program if they would like, but there was also be a fee associated with that. The pharmacy board, and typically boards pick up all of the fees for alternative to discipline programs. If you hold a valid license, it just can’t be expired. It can be on probation, it can be suspended. But if you come in, actually, the nursing board and the pharmacy board are taking care of our fees. We have had some people from other professions that have come in and, for example, they pay their $150 a month plus their drug test fees, and we can monitor them. So. But those are a very small percentage of the people that we monitor.
Terri
Okay. All right. So you answered. Yeah, another one of my questions. And the fees. So there are no fees for licensed nurses and physicians.
Tracy
Okay.
Terri
So part of your, probably your license fee to have your license goes toward this. And that’s what the correct license.
Tracy
That’s how the boards do it. I can’t remember what the percentage is, but it is a certain amount of renewal fees that these boards sort of take and then they put aside so that they can have these programs in their states.
Terri
Okay. All right. And you’re not a treatment program because you refer them out to treatment programs. Do you vet your treatment programs or is it just any program indiana?
Tracy
Yes. Okay. No, we do vet our treatment program. So there is a very long, I try to talk to everyone. I do get those calls occasionally. So I try to have a, a preliminary conversation with the treatment provider, you know, what do you guys have? How do you treat healthcare professionals? How many beds do you have? What interventions are you using? And we have a good chat, and then once that is complete, I send them what we call our treatment provider applications. So whether they’ve got all levels, you know, PHP, IOP, and aftercare, or they’re just one or the other, we do keep a list of that, especially detoxes. So sometimes people need to detox for a couple weeks before they slide into regular treatment.
Tracy
So they have provide us all that because we want to make sure they have the credentialing of their, you know, there’s a medical director, there’s things on in place that will provide really good treatment for our nurses and our pharmacists.
Terri
So is it safe to say then, no matter what treatment facility they select, if they’re on your list of approved treatment centers, then you all would be pretty comfortable with the process of, okay, it’s been successful, they can return to work. This is the arrangement, that type of thing?
Tracy
Yes. And so exactly because we know what’s going on and we’re also getting updates. So we also ask our treatment providers every couple weeks to send an update in a form because we want to know that the person is there, they’re being compliant. We also encourage the treatment centers, if they’re discovering, you know, resource issues or the participant is having some other kind of difficulty, to reach out to the case managers, because we’re only going to be able to help somebody if we’re having conversations, if we’re all in our own silos, we can’t effectively work that way. So we are in touch with a treatment provider pretty frequently or as much as they need. Oftentimes our treatment providers will also let us do an intake of someone.
Tracy
They’ll put them in a private room, give them a laptop so we can do the intake with them. So once they’re discharged from inpatient, let’s say, and going to IOP, we don’t have a gap there where they’re like, I’m feeling better. I don’t need to call eye snap, right? So we try to keep everything as close together, working seamlessly as we can, so we don’t drop any balls.
Terri
Okay. And when the time comes, if the healthcare professional decides they want to return to work and they’re deemed ready to go back to work in some capacity, I know sometimes it’s without access to meds and it’s in a different, you know, but sometimes I think they do go back to access with meds who is the person, which group is it that really works with the facility? Is it IPRP or is it the treatment center?
Tracy
So most times when people are exiting treatment, so let’s say, so PHP is partial hospitalization program. So if they’re going from PHP, which they may be in a place facility, you know, eating their meals, they’re staying there when they’re transitioning into IOP. Oftentimes, we do not let people go back to work until they’ve completed PHP and IOP because that gives us a longer window of time. At that point, their treatment provider or their therapist, or if they’re being prescribed meds like their psychiatrist or whatever, will fill out a return to work assessment, which is another assessment that we provide. They fill that assessment out. It’s their patient. They’ve been working with them, and they can kind of give us a clue as to what’s happening. The biggest thing that we restrict are two things.
Tracy
One, we don’t want anybody going back and working, you know, 80 hours a week. And whether that’s in pharmacy or whether that’s in nursing, people work a lot of hours, so we want to sort of pull back those hours. And also, in the case of nurses, some do go back without a narc restriction, but it’s rare that happens, and that is really based on diagnosis and sort of what the substance use issue was. But it’s pretty rare that people don’t have a narc restriction going back at least for six months. And this makes it a little more complicated in pharmacy. Unfortunately, a lot of our pharmacists can’t go back to work while they’re on probation. And a lot of our pharmacists, until they complete monitoring and complete those probationary requirements, it’s rare that they can be a practicing pharmacist.
Tracy
A lot of them will maybe sometimes take jobs in other areas. So that is one of those differences I was talking about. You can get nurses back to work. It’s a little more difficult for people in pharmacy, but they have to do the same thing, get a return to work assessment. But what we’re looking at is when you go back into that environment, you really need to be aware of the fact that your job is stressful, that your body and your mind are healing because you’ve just taken something out and you didn’t replace it with anything. So we are very careful to check on them a lot. Lots of times when our nurses go back to work, and some of our pharmacists, they’re checking in once a week with their case manager. And they’re talking to their clinical case manager.
Tracy
It’s not an hour long phone call. You know, sometimes it’s just 20 minutes. Just checking in. How are you doing? How are you handling this? And making sure they’ve got a good support system before they actually walk back in that door. So.
Terri
Yeah. And kind of giving them somebody to be honest with. Like, were talking before we started recording, you know. How’s your day going?
Tracy
Great.
Terri
It’s like, it’s really not. But, you know, we don’t burden people with our.
Tracy
No, we don’t.
Tracy
That’s really hard. And it’s also a little stigmatizing to be the person coming back to work because lots of time words gets out.
Terri
Right.
Tracy
So and so is coming back, and they’re in a monitoring agreement, and then they become the other. And it can be professionally isolating.
Terri
Yeah. I was just thinking in terms of the pharmacists. I mean, I guess in a hospital setting, you could just remove their access to any automated dispensing machine, and then they’re clinically, you know, doing their thing and they don’t have touch meds. But then if you’ve got a tech that’s like, hey, can you check this for me real quick? And it’s controlled substances. That’s where that person is kind of like, oh, I can’t do that. Well, why can’t you do that? So that. Yeah, that’s, I guess where the rub would be. Right there is. You could keep them away from it, but they. People would probably know.
Terri
There’s something. There’s something going on there. Yeah.
Tracy
And the pharmacy board also says, no, pick while you’re. Sorry. I should stop talking. No pharmacists in charge while you’re in monitoring and those kinds of things. So.
Terri
Yeah, yeah, that’s a pretty. Yeah, it’s a pretty good stressful job.
Tracy
That’s a whole lot of.
Terri
Depending on what state you’re into, it can be even more. All right, so your website does a really nice job of laying out all of the steps of this, which is great. I. You know, some websites, you just. If it’s completely new to you and you just don’t understand what’s going to happen, it’s very beneficial to be able to get onto your website. So everybody go look at Indiana’s site if you want to know how a lot of them work.
Tracy
Right.
Terri
Yeah. And step five, is the recovery monitoring agreement. So what does that look like for someone?
Tracy
So that is our recovery monitoring agreement is basically a contract. So what we’re saying in that is we’re laying out what all the stipulations are. So, for example, working nurses and pharmacists, drug tests 20 to 26 times a year, if they come in and they have just started, they’ll be at 16 drug screens. So the recovery monitoring agreement tells you things kind of step by step of what we’re expecting of you. We list people’s medications if they’re going back to work, if they require a return to work assessment, and how many meetings we’re going to ask them to go to. We have some wonderful people in the state of Indiana, one man in particular who’s a retired therapist who runs an amazing support group for healthcare providers.
Tracy
And out of that group, in the last six years, I have just seen amazing recovery coming out of that. So that’s something we’ve listed there. We want you to go to one nurse support group a week or, you know, do some kind of other self help meetings. We don’t relegate them to just twelve steps. They can do twelve step programs celebrate recovery, smart recovery. There’s also refuge recovery, which has more of a buddhist philosophy. So we give them information on all of that. So that’s all listed in their RMA and the other things are entered in there. Excuse me, I’m not speaking. Well, is that you’re going to start your RMA on this date and you’re going to end it. So most of our nurses and pharmacists are in an RMA for either three years to five years.
Tracy
We do have shorter rmas, and those are diagnostically based and situation based. So let’s say somebody comes in and they’ve had a DUI. It’s a first DUI. There was no impairment at work. Those kinds of things. We might, in that case, offer a twelve to 18 month RMA. But if there are larger problems, co occurring disorders, meaning there’s substance use disorder there, but also a mental health issue, those tend to go hand in hand, then that RMA is probably closer to five years, because really what we’re looking for is getting you stable while someone’s kind of got their little bit of their thumb on you. We’re drug testing you, making sure you’re getting therapy. And healthcare providers are tough to treat. They’re a really tough breed.
Tracy
So getting them to, like, go to therapy is, you know, it’s like making the first grader go in the door that doesn’t want to go in. Right. We just keep shoving them in. So we’ll list those requirements in there. They sign it, we sign it. When they go back to work, we ask them to take it to their employer and have their employer sign it, because that way then we’re all on the same page. We’re not asking the employer to manage the monitoring. We’re asking you by your signature, you are letting us know. You know, they have a narc restriction, that they’re being drug tested a minimum of one to two times a month that we are checking on them. We ask for a worksite monitor report so everything goes into the recovery monitoring agreement. So it’s kind of one stop shopping.
Tracy
You know exactly what your requirements are.
Terri
Yeah, well, and that’s good for the healthcare system that takes them back. So, you know, as the person who’s monitoring and in charge of making sure where all those controlled substances are, I want to know that you guys are taking it seriously and that, you know, they’re being checked up on and monitored. And so that puts, so I think it is important. So that monitoring agreement, does that come later in the process? It’s not like they walk in the door and then you sign these things.
Tracy
Yeah. No, once when they initially contact us, they’re going to fill out some releases of information. We have a whole form that we’ve developed over the years for the participant. We call them participants for the participant to fill out. So it’s an easy way to tell us what’s going on without, before you have to meet us face to tell us what’s going on. So they can list what happened, if they’ve been in trouble before, any medications they’re on, if they’re already going to therapy, if they’ve been to treatment. That whole thing up front answers a lot of those questions and then we schedule them for intake. We do not put you in a recovery monitoring agreement until your intake is complete. We’ve staffed a diagnosis and staffed the recommendations. So we spend it in.
Tracy
We’re small staff, but we spend a lot of time carefully talking about our cases and we try really hard to do it case by case. You know, not looking at what we’ve done with the last twelve people, but what is specific to this healthcare provider and what do they really need? And I know some of our participants feel like we’re very unfair and there’s a lot of rules and it’s like, you know, being on probation or parole, we’ve heard it described, but we do try really hard when we hit that RMA to give it everything we’ve got that’s individualized to that person. Okay.
Terri
Do you have a. Yeah, that makes sense. I mean, they’re not. They’re probably not agreeing to a whole lot at the beginning, and so they have to get through a certain portion of it to then say, okay, this makes sense. Do you have a feel for how many people? So you mentioned that not a lot of people come in just on their own saying, I need help, which is a shame. It would be nice if we could get to more of that. So when they do come to you because they’re in some sort of trouble, what percentage of them still continue to deny that they have a problem that they shouldn’t be there?
Tracy
Very good question. Most. I would tell you that if we just did it on 100, like, 100 is the total.
Terri
Right.
Tracy
I would say, coming in the door, 95% of our people are like, it wasn’t that bad. It didn’t really happen. They’re lying. It’s very rare that someone, you know, it’s about 5% of the people coming in the door that are like, my life’s a wreck. I’m totally at rock bottom. Please, you know, help me.
Terri
Right.
Tracy
It’s always like, the board is making me. The board is making me. The board is making me.
Terri
Right, okay, all right. So you’re seeing. I mean, we see it at that point, at the facility level, and they’re like, no, I’m not. It’s like, well, okay, we think you are. So, you know, we’re reporting. And so they’re still denying, even then, when they get to you. Yes.
Tracy
Okay. Yeah, yeah. And sometimes when you watch as things go by, if something happens, you know, so there are consequences in our program to not following the rules. You know, you can sometimes lead yourself to getting kicked out and having to go back in front of the board. Terminate. It’s more appropriate word. But even in that, when you’re having those discussions, it’s sort of like I’m. You put me in here, and I didn’t really deserve it. Even though things have been going really well for me and I’m clean and sober, they don’t quite grasp the gravity of what happened to begin with. So insight takes a long time. It’s a painful process for all of us.
Terri
Yeah, no, I’m sure it is. Okay. So, yeah, a lot going on with that, I think.
Tracy
Yep.
Terri
Do you have a feel? I mean, obviously, if they graduate from the program and you never see them again, you assume, you know, everything went well, but do you get people coming back after they.
Tracy
Occasionally, yes, occasionally. So we have been at this now it’ll be six years in June. And I would say that. So we took over the contract in 2018. So we are just now at the tail end of, in 2023 and 2024 of people that were really started with us and then are now finishing. But I would say that it’s about one and a half to 2%, as it can be. Sometimes that will cycle back through or have multiple times. Now, here’s where I say that, because they will have one encounter with us and then another encounter, because in those early stages, they are still fighting any kind of, you know, consequence for their behavior that they can’t maintain. You know, one of the things we have now is alcohol. Can’t drink alcohol.
Tracy
While you’re monitoring whether alcohol was your problem or not, you can’t drink alcohol. So somebody just said to me the other day, I’m a responsible adult. I went and celebrated my birthday, and I drank alcohol, and I didn’t over consume. Well, Terri, the issue isn’t the overconsumption. The issue is that you’re supposed to be clean and sober, and we don’t do that. Right. So that’s a consequence. And so it’s trying to really, between the treatment center and the responsor and a therapist and all these other things we put in place in us is trying to get them to change the thoughts up here. Right. But so much of that substance use is a maladaptive coping mechanism. I can’t tell you how many nurses say to me, oh, oops, you know, I accidentally took a tramadol and I thought it was Excedrin.
Terri
Yeah.
Tracy
Now, our pharmacists don’t ever say that.
Terri
Because you’re not a very good pharmacist.
Tracy
Like, a huge problem. Right. But, you know, I had one guy that thought about it one time, and I’m like, don’t even, don’t. He just started laughing. He’s like, you’re right, Tracy. I really shouldn’t do that. But even as a nurse. Right.
Terri
Yeah.
Tracy
There’s a difference there. So. But it’s really hard because I have to accept all of these things about myself, and it’s difficult. So if I keep pushing back at you, then maybe that’s not who I am.
Terri
Right, right. Yeah. No, I. The first step is admitting it.
Tracy
Right.
Terri
So. And then that’s where everything changes.
Tracy
No, I get that.
Terri
Do you? Obviously, there’s more nurses out there than pharmacists. Do you, what percentage of pharma do.
Tracy
You see a lot of pharmacists right now? Our numbers are low. We have 24 people in our pharmacy program. And I want to say, I just looked at this the other day, 1516 of them are pharmacists and the rest are pharm techs. So. And my nurse numbers are. We are topping out at 362, last I looked. So big difference. Yeah.
Terri
Interesting that your pharmacist number is higher than your pharmacy tax.
Tracy
And that was the first time in the first, as we round out the, rounded out the first quarter, 2024, that was the first time that we have had more pharmacists. And then pharm tax, first time referrals are way down in the pharm tax, so they don’t get their, the board does not pay their fees, so they all have to pay to be in monitoring. And so I think that is pushing down the numbers.
Terri
Sure. Now, indiana, are the pharm techs are licensed and paying. Okay.
Tracy
So it’s underscored. Yeah. They do have to have a license.
Terri
They don’t pay their fees.
Tracy
Yes. I wonder.
Terri
Yeah, I wonder what the reason for that is.
Tracy
Yeah, it’s a good question. You know, I tend to push it, and then I also sometimes have to back up.
Terri
Yeah, yeah. I found myself in those positions as well. Yeah.
Tracy
Yeah.
Terri
So do you have any particular people and cases that come to mind for you that when they came in, they just were kicking and screaming, but at the end of it, they were just so thankful with how it changed their life?
Tracy
Oh, I have a million of those stories, and I can share two quick ones with you. So we had a nurse come in and did the intake. The next thing I know, one of my clinical case managers in my office, sliding down the wall, sobbing. She’s really upset. I’m calming her down. I’m like, okay, what’s going to happen? She’s like, she’s just waving paper, right. And so I’m trying to figure out what’s going on, and she’s like, she’s going to die. I know it, I know it. She’s going to die. I don’t want her to die. I said, okay. Very resistant. Took us, it took Carrie Graham, who is our first person you talk to? Myself and our compliance director. But we finally got her into treatment. It was a rough, probably first six, eight months, and were not sure.
Tracy
And I can tell you she is almost ready to complete her RMA. She has, she and her husband did a lot of work in their marriage. They have reconciled. They have a baby, and she got her prescriptive authority back also for her aprn and amazing transformation. And I will never forget at one of the board meetings, and they said, what have you learned? And she said, I have learned that I can do hard things and I can handle hard things. And so that it was amazing. That is an amazing transformation. And we had another crna did not particularly get. He didn’t get in any trouble. His hospital didn’t even know what was going on. He had this brilliant idea that he was going to just kind of rehab it home, and his wife informed him that wasn’t really her role.
Tracy
But when he came in with a plan, and it was like, I’m not going to go back to being Crna, and I’m going to work one year, and he worked one year doing dialysis, and then on year two of monitoring, he went into and just did, like, a GI lab. And year three of his contract, he’s on a five year contract. On year three, he progressed back into CRNA. And what was amazing, though, is how he handled his own recovery. He and his wife together worked on their marriage, and he has been really out there. And so is the other nurse that I just mentioned really out there availing themselves to nurses, pharmacists, you know, like, I will talk to you. Let’s maybe go to a meeting. Let’s look at this. And they are, they’re doing incredibly beautifully.
Tracy
And we do have so many people who come in and say, get the help, and they, you know, go back out the door again, and occasionally we’ll see him, or occasionally we’ll hear from them. And those are really good stories to have.
Terri
So definitely. So that Crna gentleman, he came in voluntarily, then? He was one of those?
Tracy
He did, yes.
Terri
And if they come in voluntarily, you have no obligation to report them to. So he’s done all of this without the licensing board even realizing that there was a problem, correct?
Tracy
Yep. And that is possible. I do want to put one caveat on that. If you don’t follow the rules and you relapse, you divert, you do things. It is my duty as a licensed professional in the state of Indiana, also as a program director, that I will have to file a consumer complaint. I will say this on our very slim margin of people who self report. Those people have been, they have sailed right through, done everything they’ve needed to do, taking care of themselves. So I wish more people would self report. I really do. Yeah.
Terri
Well, and I think. Well, I don’t know. I was going to say, I think part of it might be that they don’t know what is waiting for them out there and what is the resource. But then again, you get 95% of your people that do come in that are not self reported, that are still denying it. So clearly they’re not ready yet. Yeah, you gotta get ready. Yeah, you do. You would hope that. I don’t know, it’s just one of those things. You would hope that a healthcare professional would recognize it. Like, okay, you didn’t plan to be there in the first place, but now you are. You need to recognize that there is an issue there.
Tracy
Mm.
Terri
So.
Tracy
Right. Because I think sometimes they are focused on, I am the person that is supposed to do the caretaking. I’m the person that’s supposed to do the healing. Right. You know, and they don’t ever back up and say, you know, possibly there could be something here that I’m not dealing with, that I’m using alternative maladaptive coping mechanism. So I’m not necessarily the girl in addiction treatment who believe. Who’s a disease model. I’ll probably take a lot of hits for that. I’m used to it. But I think that there is a piece of this that becomes so much about the way people cope because there’s nothing else to cope. And they do similar things with eating too much sugar and shopping and, you know, taking melatonin and whatever.
Terri
Right.
Tracy
But there are pieces of that blow your life up in a really big way. And I also think the way we conceptualize addiction and mental health, people who are college educated, have big jobs, and are professionals are deemed as those people that are not going to have those issues.
Terri
Right, right.
Tracy
So.
Terri
Yeah, yeah. Very complicated piece.
Tracy
And a wide range of personalities. So.
Terri
Yes, yes, absolutely. All right, well, this is great.
Tracy
So you’re.
Terri
Your program sounds great. Thank you for all that you do. I’m sure you have good days and bad days, and, you know, even the one example you gave, you said six to eight months that she.
Tracy
It was rough, so.
Terri
But, you know, the team stuck with it. Stuck with her. And then the result on the backside is fantastic. So not easy what you guys do. But thank you very much for. For what you do.
Tracy
Thank you.
Terri
Makes a difference. All right, a reminder for those of you out there attending Nadi this year, coming up here real soon this month, visit the Midas Healthcare solutions exhibit to learn about their unique approach when it comes to controlled substance wasting. The current process detracts from patient care and can result in lengthy investigations and is proofless. Midas View is an intelligent technology rich wasting system that can help deter and prevent drug diversion. Thank you again, Tracy, and I’m hoping I’ll see you again soon. Tracy is involved with West Virginia’s program, so we’re going to try to get something set up with the team there for West Virginia.
Tracy
Thank you.
Terri
All right. Have a great day.
Tracy
You, too.
