Lara didn’t need a therapist to explain to her why the drugs were so tempting. Her divorced parents had been physically and mentally abusive. She remembered vividly the days she arrived at school bruised from beatings, and the times her parents called her fat, ugly, and stupid or told her she would “never be smart enough to be a nurse.” Her mother was a mean drunk by night and a sweet woman by day, with no memory of her behavior the night before.
The program also taught Lara that she had been turning to narcotics to escape something else. Lara had believed she was strong enough to ably manage the horrors she saw in the ER—the dying babies, the grisly traumas. Her hospital allowed no time for debriefing; following a tragedy, nurses were expected to get right back to work. Lara had been repressing these images and experiences for years. She hadn’t realized they were eating away at her still.
Three months after Lara completed rehab, MDI placed her in a medical advice job. She had gone from working as a Level-1 trauma center nurse to answering an advice hotline. Mortified, she cried during her drive to work for the first two weeks. Every morning before 8 a.m., seven days a week, Lara had to call a 1-800 number to check whether she would be randomly tested. On testing days, within two hours of the call, she had to give a urine sample at a lab (and pay $55 for the test). If she missed the test, she would be kicked out of the program and lose her license permanently, no excuses.
Lara had slogged through the misery of withdrawal. She regularly called her case manager to complain. “I hate you guys!” she’d say. “I’m not doing this. You can take my license.” Ten minutes later, she would call back, contrite. “No, never mind! I didn’t mean it!”
The program was so strict that Lara met many fantastic nurses who gave up their licenses rather than stick with it. But she was determined to tough it out. “MDI will back you up when you reapply for your license. They want to know how serious you are,” she explained. “Now that I can look back, they did know what was best for me when I didn’t. I wanted to go back to the ER. But they had to approve the job.”
After two years, MDI allowed Lara to resume patient interaction by working at a doctor’s office for eighteen months. Finally, MDI let her interview for an ER job at a different hospital. Her résumé was still impressive. She breezed through the interview until the end, when she was required to mention the program. Every month, her employer would have to fill out forms asserting that Lara was not impaired at work.
Another nurse in the program had given Lara advice: “Just look them straight in the face and say, ‘I’m doing the right thing now, and have been for a long time.’ Don’t apologize. You made a mistake. You’re moving on.” So she did, unflinchingly looking the interviewer in the eye.
“I’m impressed that you’re so honest with me,” the interviewer said. She told Lara later that she gave her the job because she was so forthright.
Lara had done so well with her recovery that her mother asked her to take her to an AA meeting. Her mother never drank again. Soon, her brother made the same request. Before long, Lara’s family was sober. But Lara’s battle wasn’t over; it probably would never truly end.
After twelve months in the ER position, Lara was considered an official graduate of the program. She would not have to disclose her drug issue or treatment again.
Years later, when she applied for the job at South General Hospital, she didn’t mention the addiction. She considered herself fortunate for many reasons, one of them being that the coworkers and friends she did tell about her addiction didn’t judge her. She felt secure knowing that her friends, including Angie from one ER and Molly and Juliette from another, were supportive.
One of the great aspects of nursing was that it could forge lasting bonds. Working so closely with coworkers on matters intimate and important created the kinds of forever friendships that could buoy a nurse through long hospital days. Molly, a straight shooter, and Juliette, a loyal pal, fell into that category. “When nurses get to know each other, we have each other’s back. We really will do anything for each other,” said Lara, who worked every Christmas holiday shift for thirteen years straight before she had kids so that other nurses could celebrate with their children.
Despite the facts that nine years had passed since her first Percocet and Lara was married now with two beautiful children, at South General narcotics tempted her every day. There were even more drugs available here than at her first ER. Nurses constantly left half-full vials on the counters and the protocol for disposing of them was often ignored. Oh, look at that, there are some narcotics sitting right there, a little voice would nudge Lara.
She knew that the relapse rate for narcotics addiction was extremely high. To keep herself in check, she attended three Narcotics Anonymous meetings a week. She could count on dozens of friends she had made through NA who would help in an emergency. “In a way the addiction is a huge blessing because I have real strong people in my life now and they help me,” Lara explained. “I would have never thought that such a horrible situation would turn so positive.”
Lara had been doing pretty well resisting temptation, all things considered. Until six days ago, when her mom, long suffering from emphysema, died in her arms. She was 65. Lara was devastated. She didn’t know how to cope with the loss of a parent.
Now, on her first day back at work since the funeral, Lara stared at the vial in front of her. The narcotic promised her security, comfort, confidence, and a happy buzz that would dull the pain of her mother’s death. She wanted it so badly she could barely breathe. It will make you feel better. No one will know. You want it. You deserve it. Take it.
The Secret Club
Nursing is among the most important professions in the world.
In no other profession do people float ably among specialties, helping to ease babies into being, escorting men and women gently into death, and heroically resurrecting patients in between. There are few other careers in which people are so devoted to a noble purpose that they work twelve, fourteen, sixteen straight hours without eating, sleeping, or taking breaks and often without commensurate pay simply because they believe in the importance of their job. They are frequently the first responders on the front lines of malady and contagion, risking their own health to improve someone else’s. Nursing is more than a career; it is a calling. Nurses are remarkable. Yet contemporary literature largely neglects them.
At 3.5 million strong in the United States and more than 20 million worldwide, nurses are the largest group of healthcare providers. The women who comprise 90 percent of the workforce are a unique sisterhood whose bonds are forged through the most dramatic miracles and traumas as well as the tedious, routine tasks necessary to keep human bodies functioning. Nursing, for brave men and women, is “like a secret club that holds immense emotional joy and fulfillment in spite of shared tragedies,” a Michigan nurse practitioner told me. Nurses call the profession a secret club because their experiences are so novel, their jobs so intimate and occasionally horrifying, their combination of compassion and desensitization so peculiar, that they imagine nobody else could understand what it is like to work in their once-white shoes.
Pop culture would have us believe that nurses play a small, trivial role in healthcare; medical television programs tend to show doctors lingering at patients’ bedsides while nurses flit and intone “Yes, Doctor” in the background. But this is not the case. As a Minnesota agency nurse said, “We are not just bed-making, drink-serving, poop-wiping, medication-passing assistants. We are much more.”