More than 120 Maine physicians, nurses and other health professionals have joined the drug and mental health screening program by 2021, as part of a steady increase over the past three years, in follow the new government report.
Although they make up a small percentage of the workforce as a whole, the growing number of professionals in the program comes at a time when the worsening demands of health workers during the epidemic, also indicate an increase in misuse of labor. drugs to the general public.
Reports reviewed by The Maine Monitor show cases ranging from a doctor showing a hospital to a drunk nurse trying to obtain a doctor’s prescription under the name of a family member.
Guy Cousins, director of the Medical Professionals Health Program, says the growing number of professionals entering the intervention program indicates greater education and helps reduce stigma related to drug and alcohol abuse, and support required to treat conditions.
The Medical Professionals Health Program is part of the Maine Medical Association and conducts contracts with government licensing boards to provide mental health support and informal toxicology tests.
“Our mission is to protect the public and to help medical professionals learn to exercise at their highest levels,” Cousins said.
Last year, 123 Maine health professionals were transferred to MPHP for the first time – almost a 10% increase from 112 to 2019. And Cousin expects this year to continue. that method.
The new participants included 57 nurses, 39 veterinarians, 12 specialists, 10 dentists, four osteopathic physicians and one veterinarian.
Experts may be transferred to the program by another person, required to attend by a licensing board or to register voluntarily.
The number of self-employed participants has increased slightly over the past three years. Cousins say this represents a successful breakthrough in the program and a reduction in stigma as our understanding of the problems of drug use improves.
A lot of people can join the program, he said, if the epidemic starts to subside and health professionals have time to breathe and think about getting support.
Taking care of those who provide care
The health professionals in the program make up a very small percentage of all Maine health care workers. For example, 57 nurses under MPHP make up less than 0. This may interest you : Significant delays in food safety inspection do not pose a health risk, state officials say.2% of the 32,000 graduates and the Maine Board of Nursing.
However, it is important to provide support for professionals with behaviors that can compromise their ability to provide the highest level of care, Cousins said.
Last year, 21 nurses were authorized by the nursing board for activities related to drug or alcohol use, according to a review of The Maine Monitor’s disciplinary documents.
In one case, a nurse took oxycodone tablets while on duty. One was very drunk. And another nurse issued a prescription under the patient’s name.
In a similar review of disciplinary action taken by the Maine Board of Licensure in Medicine, seven doctors and paramedics were given a sentence related to drug or alcohol use last year. Another doctor arrived drunk when he was called to the hospital. One met the patient out of work and received the drug from him.
Experts estimate that 10-15% of the general population suffers from substance abuse. And this epidemic has increased those numbers.
The role could be higher for health care professionals, Cousins said. Doctors, nurses, and other health care workers deal with the physical, mental and emotional pain of their patients, sometimes with very little rest. During the COVID-19 epidemic, in particular, there was a high demand, a high level of care, limited resources and a declining workforce.
They also work in areas with drug access.
“Sometimes there is a planned expectation that someone on the other hand has no problems even if they have families, have relationships, have jobs, have job stress, I have work problems, ”said Cousins.
Participants can be monitored for many years, depending on individual circumstances. In 2021, there were 264 active participants in the MPHP program and 54 completed the program.
Last year, 127 participants underwent toxicology tests and seven were monitored for alcohol.
Medical professionals, appropriately, are held in high moral standards, Cousins said. But it is important to remember that they are human and have no faults. The expectation of perfection is unfulfilled and unjust, he said.
“Whether we’re going to put them on a shelf or put them in a good place, it’s an arrangement,” Cousins said. “This is a set of unrealistic expectations.”
Stigma also creates a barrier to people seeking help, he said. The science of drug abuse has been in place in recent years, but many are still afraid of enrollment and the negative consequences of their actions if they seek help.
Healthcare professionals may seek assistance with a confidential monitoring program.
The Nursing Board can also direct a person to complete a program. It is necessary to investigate any complaint it receives. If a violation of the Nursing Code of Conduct relating to drug or alcohol abuse is found, the board grants the licensee a license agreement which may include a review. The licensee can sign the agreement or request a case, after which the board issues a decision and order. The licensee may appeal the decision to the district court.
The nurse is allowed to continue training as long as she is monitored as long as the test rules are followed, said Kim Esquibel, chief executive officer of the National Nursing Board. Upon completion of the agreement, the nurse may request the board to terminate the test.
“The purpose of the board is to allow them to continue practicing safely in the monitoring program,” Esquibel said. “It gives them the opportunity to continue their livelihood and to continue to exercise, as long as they exercise safely and are monitored.”
The State Board of Licensure in Medicine follows a similar pattern for physicians. The Board investigates the complaint and may arrange the case, grant a leave of absence or refer the case to a district court.
The purpose of the board is to protect the community, said chief executive Dennis Smith. It does not provide specific health care services, but supports physicians and physician assistants “with education, awareness raising, annual financial support to the MPHP, free continuing medical education,” and in the case of formal and formal remedies required by the decision and order or agreement of consent. ”
The need for engaging in self-care
The epidemic has highlighted the need to highlight self-care among nursing students as a preventative measure, said Brenda Petersen, an assistant dean of the School of Nursing at the University of Southern Maine. See the article : East Baton Rouge Parish Receives $ 1 Million for New Mental Health Initiative.
Students learn about drug abuse and performance with the nursing board. But ethics need to be integrated into education so that nurses can learn to deal with difficult situations to avoid falling into self-medication practices, he said.
That is especially true during this epidemic, when health professionals were struggling with “moral injury,” more than fatigue, Petersen said.
“Moral hazard” is a term used to describe how a person deals with right and wrong.
“In order to be morally responsible, a person must feel that the offense has been committed and that he or she or anyone else has a moral compass. Guilt, shame, rejection, and anger are among the most common causes of moral damage, ”according to the U.S. Department of Veterans Affairs.
“This epidemic has shown us that we need to do a better job of preparing nurses for all the things we know they need as part of those skills, and that includes how they are willing to take care of themselves. , “Petersen. said.
Petersen said he is trying to build a culture of responsibility where colleagues ask each other directly what they did that day for self-care.
“We have a shortage of nurses who are able to cope with the environment, the pressures and all that comes with that. We have a responsibility, from the education side, to teach our nurses how to manage stress so that we can keep our caregivers strong. ”
