NURSE'S CONFESSION OPENS DOOR TO HEALING FROM DRUG ADDICTION

One Sunday evening last April while at work in the intensive care unit
at the Veterans Affairs Medical Center, 35-year-old registered nurse
Kevin Gilbert withdrew 14 milligrams of morphine and 60 milligrams of
the central nervous system depressant midazolam from the hospital's
electronic dispensing system and injected himself with the drugs in an
employee bathroom. Twenty-four hours later, found out by his
co-workers and confronted by a representative of his nurses' union,
Gilbert admitted his addiction for the first time, opening a floodgate
on the secrets of his illness and, at the same time, a door to recovery.

Now on federal probation, in recovery and under contract with the
Tennessee Professional Assistance Program - the first step in a
three-year process to maintain his license and salvage his career -
Gilbert said he's feeling better than he has in months.

"There's a certain freedom in saying 'it doesn't matter' and going
on," he said in a recent interview. "Even with all the restrictions
I'm under and all the other things going on, it's still a lot better
life than it was seven or eight months ago."

Gilbert said his downward spiral began some 18 months before the
incident at VAMC with a combination of work-related stress and
personal problems.

"It was the stress of nursing. Being understaffed adds a lot to it. I
had been working two jobs. My wife has lupus and wasn't working at the
time. And I began having neck and shoulder problems.

"I had had percocet before for my neck and shoulder, so I began taking
it from the VA. And within about a year and a half, it escalated to
intravenous use. It happened rather quick."

Suspecting something was wrong, Gilbert's wife took him to a doctor.
He was prescribed antidepressants but continued to hide his addiction.

"I still didn't disclose to my wife or my doctor, and I guess this is
kind of where it led me to," he said. "It came to a point toward the
end, that I couldn't tell anybody. I was too embarrassed. I couldn't
stop on my own. It was really a pretty horrible situation to be in -
to be that controlled by something."

As for Sunday, April 27, Gilbert said, "I'm not sure what was going on
with me that day. It was an isolated incident. I wasn't doing that
much every day. I don't know why I did that much. Maybe I was trying
to quench a pain, or maybe I was crying out for help.

"Sometimes with an addiction, we blind ourselves to everything else
until we are ready to stop it and find a cure for it. It's kind of
like the old saying, 'The only time you can really change something is
when the pain of staying the same is greater than the pain of
changing.' "

With his first admission, Gilbert said, "a flood gate opened and I
told my supervisors everything." And although he was suspended from
work, he said he was supported by both his co-workers and by the
hospital, which helped him get into treatment and worked out a
last-chance work agreement that it later rescinded due to the federal
charges brought against him.

"My case came to a head in a federal facility. If it had been at . . .
any other hospital, they probably would have let me go and turned me
in to the nursing board because they don't want the publicity. A lot
of people have done that.

"I could have lied and denied everything, and they probably couldn't
have proved anything. But I chose to tell them everything and to be as
forthcoming as a I could."

On the evening he first disclosed his drug use, Gilbert was sent to
the hospital's emergency room for lab work. The next day he began work
with the VAMC's employee assistance program. From there he went on to
Indian Path Pavilion for substance abuse treatment, and it was there,
he said, he found his most valuable ally, the Tennessee Professional
Assistance Program.

One of numerous professional associations across the state under
contract with the Tennessee Department of Health, TPAP randomly
screens Gilbert for drug use, monitors his compliance with his
recovery plan and, when the times comes, will advocate on his behalf
before the state Board of Nursing.

But it is his TPAP support group of about 15 other nurses also
recovering from addictions - all either working in nursing or working
to restore their license so they can return to nursing, that Gilbert
said has proved most beneficial.

The benefit, he said, is the group member's personal insight into the
problems they all face daily and the sharing of the coping skills that
serve them best.

While Gilbert's contract with TPAP will keep him in the program for at
least three years, Jason, a pharmacist, recovering addict and a former
counselor for the Tennessee Pharmacists Recovery Network, said
recovery is a lifelong commitment.

"Recovery is a lifelong change if you want it to work," he said. "You
can't think of it as a temporary thing. If you do, you will relapse."

"Addiction is a disease just like diabetes, heart disease or anything
else," he said. "Unfortunately, most people don't see it that way.
They see it as a moral problem.

"TennPharm sees it as a disease. They see the need for treatment and
they advocate for chemically dependent practitioners.

"There are issues that the non-medical community doesn't see. It's the
ease of access that puts us at risk. And there is a need to maintain
contact with other recovering people who are doing the same things
that we are doing."

For pharmacists who daily count out the same pills that may have put
their careers or even their lives at risk, the TennPharm recovery
contract typically extends five to seven years. But after eight years
in recovery, Jason said, he still attends the program's group meetings
weekly because the members help him realize he is not alone and
because he fears, without their support, he may "lose focus and to do
something detrimental."

"(Addiction) is a deadly disease," he said. "In my eight years, I've
seen probably 20 deaths as a result of it. It affects whole families,
wives, husbands, kids, parents.

"(Recovery) is a day to day process. Doctors, physicians and
pharmacists are no different than anyone else. It's one day at time
with reliance on God."

For others at work in health care fields quietly struggling with
chemical dependencies, Jason said his best advice is, "You are not
alone. Get help somewhere."