The Symptom Media Podcast: Bridging the Divide in Mental Health

From Addiction to Advocacy: Nurses' Journey Part 1

• Lindi van Niekerk, Andrew Rubin • Season 1 • Episode 2

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In the first of a special two-part episode of The Symptom Media Podcast: Bridging the Divide in Mental Health, we confront the deeply personal and systemic issue of substance use among nurses. Our guests, Kristin Waite-Labott and Dr. April Lenzmeier, share their firsthand experiences with addiction, the consequences they faced, and the paths they took toward recovery. Kristin, a seasoned nurse and founder of WisPAN, opens up about her struggles with drug diversion, which led to incarceration, and how she has since dedicated her life to supporting other nurses in recovery. Dr. Lenzmeier, a nurse with nearly three decades of acute care experience, reflects on her battle with alcohol use disorder, its impact on her career, and how she now helps others through peer support and advocacy.

Through their candid stories and professional expertise, this episode sheds light on the hidden struggles of nurses with substance use disorders, the stigma that keeps many from seeking help, and the systemic changes needed to create a culture of recovery. Listeners will gain insight into the realities of addiction within the nursing profession, the challenges of seeking treatment, and the power of peer-driven support networks. Whether you are a healthcare professional, educator, student or advocate, this conversation provides a crucial perspective on protecting both nurses and the patients they serve.

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To learn more about Symptom Media and its mental health resource library visit: https://symptommedia.com/

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Hello everyone and welcome to another episode of the Symptom Media podcast, Bridging the Divide in Mental Health. I'm your host, Dr. Lindy Fannikark, and I'm grateful you're here. To learn more about Symptom Media's mental health resources, visit symptommedia.com. Our mission here is simple but vital, to bridge the divide between the clinical and the experiential. By fostering dialogue between research, practice, and lived experience, we hope to cultivate empathy and meaningful change in how we approach the challenges in our work, and our lives. In the first of this two-part episode, we're exploring a deeply personal and complex issue, substance use in nursing. Nurses dedicate their lives to caring for others, yet for those who struggle with addiction, they often do so in silence, isolated and afraid of the professional consequences. In today's conversation, we'll hear from two remarkable nurses who have journeyed through substance use, as advocates for change, and returned to the profession they love. Their experiences, one involving workplace diversion and the other alcohol use disorder, offer a powerful insight into addiction, recovery and the systemic challenges nurses face. Kristin Waite-Labbitt has been a nurse for over 30 years. She's the founder of WISPAN, the Wisconsin Peer Alliance for Nurses. She's also an author and an ambassador for the Lorne Breen Foundation. Dr. April Lenzmeier holds 28 years of acute care nursing experience. She's the founder of In the Rooms, a recovery peer support network. She also serves on the board of directors for the Minnesota Nursing Peer Support Network. Let's dive into the conversation. Kristin, April, thank you so much for joining the podcast today. It's great to have you here. I'd like to kick off our conversation and maybe ask you both if you remember the day, the moment, the memory of what made you realize that you really wanted to become a nurse. Kristin, do you want to go first? As long as I can remember, I've always wanted to be a nurse. It really is the only thing I ever wanted to do. My grandmother, who I adored, was a nurse. And one of my aunts, my aunt Amy, was a nurse, and I really looked up to her. So I just knew from my earliest memory that that's what I was going to do. April, how about you? wasn't a day that I realized I wanted to be a nurse. I was born a nurse. always say nursing found me and it was just what I wanted to do always. And so with that said, I saw the goals ahead of me like a roadmap to the future. I could see them like stars in the sky. I was a nursing assistant before I graduated high school and then I was an LPN and then an RN and so on and so on and have really dedicated my whole life to being a healer to myself and to others and Nothing fills me deeper than to be a nurse and to be able to provide for others around the world. All people, all walks of life. So April, I love what you said, it's being a healer. And I'm wondering if I can push both of you further. What about being a nurse, do you think echoed part of who you were? Kristen, what was it that was that attractive thing to you? I just know that I have always been like a helper. I've always, since I was small, like will jump in to help somebody who needs something, whether it's a small thing or a big thing. When I was a teenager, one of our friends was having trouble in the water and I dove in, even though I'm not a real strong swimmer, I just dove right in to help them, even though everyone else was still sitting in the boat. If there's an accident, I would pull the car over and help. Like, it just has always been a part of who I am. So was really a natural thing for me to choose that as a career too, to be that helper. I think, again, similarly, my brother is a battalion chief for a fire department in our local community. My mother was a paraplegic. She did not need our help. But from the very beginning of my memories as a very small girl, I really wanted to help her. She was fiercely independent. But like Kristen was saying, there's people that walk into the fires when everyone else is running out. And I see that as a firefighter and my brother and me as a nurse, we were just born into a family where we wanted to run into the fire and be there for someone's most significant, impactful, hard, scary, vulnerable time in their lives. It's just something that's in us that we want to be there for that and hold their hand through that, whatever that may look like. I I like the analogy of the fire because it seems like it's very obvious, but I feel what I hear both of you saying is that you also notice where there is a need. And I think sometimes others are quite slow to notice the need, but you see it right up front and ready to jump in, which is very special. Today we're speaking about substance use and diversion among nurses. And Kristen, I'd like to give you the chance to read a little extract from the memoir that you wrote based on your own experience. in the book called An Unlikely Addict, One Nurse's Journey Through Addiction. This was where she crossed the line. If she had just stopped there, if she had just realized what taking that morphine would lead to, if she had realized that once she tried it, there would be no turning back, if she had realized the pain it would cause, but she didn't even consider any of that. She didn't consider the fact that she was stealing, cheating. If she had thought about it, she wouldn't have been able, she wouldn't have had the courage to do it. So she didn't think about it. She just put the morphine in her pocket, along with a syringe. smaller needle this time and excited when. Kristen, so this was kind of in the middle of your story. What led up to this point and what came after that point? If you could maybe give us a brief understanding of that. My substance use started really back in college. I went away to school. I had a ton of anxiety, although I didn't know that's what it was. And like many young college age kids, I went out one night with my friends and drank quite a bit and really had no experience with drinking or at least very little. What I found when I drank was that I felt wonderful. I felt like I fit in. All of the discomfort I had, all of that went away. And I thought I was funny and pretty and I just felt like a new person. And after that, I thought I need more of that. Like that is my answer to all of my issues in alcohol. So I found myself drinking quite a bit, more so than my peers, enough so that it took me six years to get my four year nursing degree. I had my first daughter while was in college. I did not make good choices when I was drinking and ended up pregnant, but really that was kind of the thing that saved me and got me through the rest of school. I was able to clean up my act, so to speak, for her and did that and graduated. Well, I went to work at a local pediatric unit, fell in love with pediatrics, and my daughter and I really had a nice little life. I drank sometimes, but I was a binge drinker, so maybe a handful of times a month I drank. Always at night after my daughter went to bed, I didn't go out very often with my friends. And so I had myself convinced that I was being a good mom. Like I did not see any issues with what I was doing, even though I drank like till I passed out. I was miserable for the next day or two. So things, you know, went along that way for a few years. And then later in the nineties, I started dating my first husband and he drank a lot. I didn't really date people who didn't drink like I did. and ended up marrying him even though he was not a very nice person when he drank. That same year that I started dating him, I had surgery, a minor surgical procedure, but I was prescribed Percocet. I loved that Percocet. From the first time I took that, I thought, this is great. The reason I liked it is because I got the same relief from it than I did from alcohol, like that same, that makes me feel better. but I didn't have all the side effects of alcohol. I didn't stumble around or act stupid or smell bad and I didn't have hangovers. So that was very appealing as you can imagine as I'm being an adult and trying to have a successful life. It was easier to maintain that with pills. So I found reasons to get more pills the next few years, maybe a handful of times, nothing outrageous, but still was deceitful getting them. would fake back pain from it. to go to my doctor's office and get some. My first husband was a carpenter and he'd hurt himself. He'd go to the ER and they'd always give him opioids, no matter what the issue was. He'd share them with me. I did that kind of thing. And then around the year 2000, I was working in a pediatric emergency room and we wasted a lot of controlled substances in that ER because our patients were little and the doses that our medications came in were large. So we were supposed to waste a lot of it. One day I had leftover that morphine in my hand and I didn't really think about it. just put it in my pocket and you know, with kind of the realization like, we throw away a lot of really good drugs and I just slipped it into my pocket. I took it when I got home and I had that same kind of reaction like, my gosh, is that awesome? Like not only did it make me feel better, but it was immediate and that was really appealing. My life was really hard. My husband wasn't too nice. Work was stressful. So that made it better. Then fast forward a couple of years, I probably did that kind of behavior for three years or so, taking really every wasted medication I had instead of throwing it away, taking it. One day I had leftover fentanyl and I had the same kind of reaction the first time I took that fentanyl of like, holy cow, that makes me feel better. That fentanyl, if you aren't familiar with it, is a very strong opioid. The effect it had on me was immediate. I craved more instantly. Before, if I didn't get any wasted medication in my shift, I would go home. Kind of bummed out that I didn't have anything, but I would go home. Once I had that fentanyl, I had to have something every time I was on shift. There was no more, well, maybe I'll get some, maybe I won't. It was like, have to have it. If I didn't get anything left over from a procedure, I started stealing fentanyl from stocks. It doesn't take them long to figure out what's going on when you do that. So I was confronted when I came into work one night and my manager met me at the door, walked me into a conference room and sitting in the corner was a sheriff's deputy with a big gun on his belt. There was a detective that led this interrogation. The director of pharmacy, the director of security, the director of HR, the chief nursing officer, like all these people were in this room. And that detective confronted me with all the evidence they had that I had been diverting substances and I denied everything. As I look back on it now, I was just in a state of shock and panic. I had no idea how or what to say or what to do. I was just flabbergasted. My manager, who was there too, told me later that I looked very calm, like it was no big deal. But inside, like I was just in So I denied everything and they suspended me and security walked me out of the hospital. I ended up losing that job. I got fired. I lost my nursing license. I was charged with like 26 felonies. I ended up spending four months incarcerated. So it was that incarceration where I said, I did not like to. It was not fun. I don't recommend it, except for the fact that that was the thing I needed to wake me up and say to myself, I do not want this life anymore. I don't like it. I don't want it. And so once I got out of jail, I really threw myself into recovery. And, you know, I spent the last 20 years now kind of rebuilding my life into something I can be proud of and that I want it to be. Thank you very much for sharing that. It's very brave and special to hear you share your journey so openly. you. April, you've had your own experience with substance use as well. And are there any common threads with Kristin's story? My story starts as a very young girl, 12 years old, when I was introduced to alcohol from a neighbor. And from the second it touched my lips, I had an alcohol use disorder. I didn't even know it. I had to spend the next 30 years drinking to find out that I had a progressive alcohol use disorder, similarly to Kristen. Mine wasn't. pills or IV fentanyl and it was not licensure problems and it was not being arrested or having to spend any time in prison. Mine was just alcohol use and mine stayed with me like I said for that 30 years of problem drinking and it progressed over time until I hit a very spiritual, emotional, and physical rock bottom. And so backing up a little bit throughout that 30 years, I want to pinpoint the time where I was an ICU nurse. I was a critical care nurse and I was at the top of my game and I was in that ICU and it was my passion and my pride and really what I wanted to do and where I wanted to be and I cared for patients and families with my whole heart. And I didn't know how to cope with my deep emotions that I was swimming in since I was the age of 12 and I didn't know how to not carry other people's pain. So when I had hurting patients and families in that ICU, I shared that with them. And there is a culture, or there was for me in a critical care setting, where there is so much pressure, high burn, high intensity, high turnaround. I had to impress not only my patients and families, but my colleagues, my nurse managers, physicians, and other. and others that were around me. was a very intense environment and I would go home after my shifts and the only thing that I knew to do was to drink and to numb my pain, to try to figure out how to feel better. And similarly to Kristen, I didn't think about it. It really wasn't something I sat around going, I wonder if I should drink tonight. I wonder what the consequences of drinking tonight would do to me. It was so incorporated into who I was as a person and as a nurse that that's what I did to get through and that's what I did to be able to go back and face what I had to face in that ICU. And so what ended up happening is like Kristen, I was turning 40, I was about reaching 30 years of... problem drinking and that rock bottom that I talk about after a progression of intensifying alcohol use throughout those years really came to a halt. And I was fortunate enough to have my mother introduced to me that maybe, just maybe, my drinking was the cause of a lot of my problems. And just that small suggestion made me realize, okay, she knows, I'm at bottom. I think I need some help and I opened my heart to a spiritual awakening and I found myself to the rooms of Alcoholics Anonymous but more importantly is in conjunction with that I found a nurse, a very strong nurse that was the founder of the Minnesota Nursing Peer Support Network that was standing up in front of other successful nurses and saying that she had a problem with alcohol and because she did that and she said that she also had a problem. with alcohol and she talked about the pathway to recovery, I was able to get on that path with her and here I am eight years later in recovery. April, thank you as well for sharing your story. You've mentioned there was another nurse that made it easier for you and I think neither you nor Kristen is alone in this. Kristen, can you give us a sense of like what is the scope of nurses being affected by substance use here in the US? So right, we're not alone in this, certainly. The American Nurses Association says that about 10 to 15 % of nurses struggle with some form of substance use, and 6 to 8 % of them are working impaired, which is the really concerning statistic. So in the United States, we have about 5 million nurses. And if we use the lower of the two statistics, so 10 %... of nurses struggling with some form of substance use issue. That means there are 500,000 nurses in this country that are struggling. If we look at the second statistic, that's six to eight percent, six percent of nurses are working impaired. That means there are 300,000 nurses in the United States working under the influence of drugs or alcohol enough to impair their practice. That was certainly me at the end. You know, I was taking that fentanyl at work probably for the last couple of months that I was there and diverting. Those are the nurses that we need to reach. Those are the nurses that need help urgently, emergently, before they end up in a tragic situation, either hurting themselves or hurting a patient. That isn't why we went into nursing. We go into nursing because we want to care for people and make things better for people. And we need to make things better for ourselves first, so that we can then be a little bit better caretakers at work. I'd like for us to talk a little bit about some of the factors. I feel both of your stories really reveal some of the contributing factors to substance use. April, you've done a lot of work, especially around workplace factors, and you've got a research paper where you wrote, even under normal or non-COVID circumstances, nurses are exposed to a multiple risk factor for addictions, including highly stressful work environments, easy access to drugs, negative attitudes towards patients struggling with addiction. and the strong conspiracy of silence that covers up the reality of substance use disorders. These factors come together in a perfect storm, endangering patient safety and sometimes ending the careers of some of our most engaged nurses. Can you maybe expand a little bit on what are all those workplace factors that really come together as the perfect storm? First I want to say I love how Marie Manthe explains the perfect storm in her article, Substance Use Disorders, and the American Nurses Association, A Call to Action. That's the article that you're referencing. She highlights how all these different things or all these different factors really line up in like this perfect way that not only endangers the nurse, it endangers the public. And for me, first and foremost, it was the shame and stigma that was related to substance use disorder and my problem drinking. This had to be my secret. When I would come to work extremely hungover or ill from my drinking, or if I was going to need to drink after my shift, I didn't talk about that with anybody. Nobody knew that that was what I was dealing with inside because if they did, I felt as if, and I had seen and experienced other nurses around me, their licensure would be destroyed, they would lose their job, I would not have money, I wouldn't be able to feed my children or have a roof over my head, a home to live in. And that's a big secret to have to hold and to try to figure out how to navigate your way through something like that when you're afraid that if anyone knew that you were drinking the way that you were. that your life would be over and you wouldn't be able to survive. The next thing I want to point out as a perfect storm for me was similar to the mommy wine culture. It's this phenomenon where there was not only normalizing of drinking in the culture where I was working as a nurse when I was having a lot of my problems with drinking, there was normalizing, there was glamorizing it, and there was even an encouraging. encouragement to go out after work or to go out on the weekends together and really drink a lot because it was helping all of us cope with a lot of our related stress. And so when other nurses saw that I was sick the next day or when other nurses were sick themselves and it was, we're hung over again today, not only was it accepted, it was funny and we would talk about how we were going to nip it the next time we went out and get on top of it with more alcohol. And so as a bedside nurse, I did transition into a leadership role. And when I was a nurse manager, after all of that experience in the, the acute care setting, I was introduced to a whole new level of burnout, isolation, fear, judgment, targeting people hating me just because of my title as a nurse manager. And that really was where it ended up being the all-time low for me where I needed to surrender and get that help. But hopefully you heard that we call it that Swiss cheese phenomenon where all the stars were aligned, all the holes were there for this alcohol use disorder to really make its way through to my deepest despair. Kristen, is there anything you want to contribute around the workplace factors that you think really adds to this within nursing? Yeah, well, I realized that I came to nursing with the predisposition to using substances for coping. Like I came to nursing with that. I think it's important to know that. And I think it's important for new nurses to recognize that about themselves. I also worked in pediatrics, as I mentioned, and we dealt with a lot of very tragic cases, but we did not very often talk about or deal with. how difficult that really was. We just kind of went on to the next tragic case. I should say we did have some debriefing that we did sometimes, but it was very high level and not very deep. Really just, I think, for them to check off a box saying we did it. Or maybe we just didn't take it seriously. There's always that too. I never took breaks. There was a general understanding that we didn't take breaks. I mean we would like high five each other at the end of the shift if we hadn't gone to the bathroom or if we hadn't had something to eat or drink like we woohoo I made it the whole shift. That is not something to be proud of. The only breaks I really took were to smoke. I smoked cigarettes at the time. Another great coping skill I had. I rarely took vacations. When I did take vacations they were all around drinking or drugs if I had them. I didn't deal with any of those things. I didn't Think about the fact that I didn't have breaks. Like none of that really occurred to me. I buried all of that under the alcohol and drug use. I certainly wasn't the only one, as we've heard in the numbers and April and I can attest to, not the only one who does that. Like healthcare is riddled with that drinking culture. I have the same stories about back then going out drinking after work or going to parties and drinking until I was... blacked out and talking about how funny that was the next day like my peers and I would say, ha ha, that's hilarious. And it isn't funny. It isn't funny. And we need to change that. We need to start dealing better with our feelings in a more, in healthier way. Yeah, I mean, I remember as same as a young physician, there's just no space to say how you're feeling. And so you try and it. That is the strategy. You go through a 36 hour shift and like you, think, well, I had a 36 hour shift once where I had 30 minutes somewhere in the middle of the day and 30 minutes somewhere in the middle of the early morning hours that I ate some food and that was it. And the rest of the time you were just on. And my coping strategy was to go home, cry my eyes out, eat a bunch of chocolate and watch a really sad movie. But somehow you wear it as a badge of honor. So tomorrow morning you're back there and you're doing it again and everyone's like, right, you can do this. So let's just keep going. So I think no matter what it is we turn to, if we can't verbalize how we're feeling about these things and have space to actually process, like you say, once emotions, it becomes risky for us. April, you spoke about how it started for you where you feel it's almost from the age of 12. And as health workers, we are more than just our jobs and our workplaces. What other factors do you think in your life contributed to this becoming the strategy look, turning to substances as a way to finding relief? how we're incorporating this because I had to learn at one of my recovery sites that I was at that I'm actually not a nurse first. I'm April 1st and I'm a nurse next. And I had a huge life outside of what I was doing at work that was contributing to my problems and my problem drinking. I was a young mom and I... I mean, I wasn't necessarily young. I had young children, I should say, but I was a mom and I had two babies in one year because I had a diagnosis of cervical cancer and I needed to have an emergent hysterectomy after my babies were born in one year. They're Irish twins. And I had a struggling marriage and we had a struggling business that we were getting up and running. I was going back to school after having these babies and having this hysterectomy and a cancer diagnosis. to try to complete my four-year degree, my BSN in nursing. And I was trying to balance work and life and friends and partying and trying to learn how to be a critical care nurse and then going back to get my parts of my MSN. And so I'm a high achiever, even though I had an alcohol use disorder and I had this blooming family and all these personal issues and I had all this growth at work and it was all happening to me at the same time. And so it wasn't just the nursing aspect of things, it was just a part of my whole pie of problems that were contributing to the way that I was not coping in a healthy way. Kristin, how about for you? What of that resonates with you? What was your experience like? I think my issue started when I was young. We were taught very early on that it was not okay to show your feelings or to say something was bothering you. That whole, you know, stop crying or I'll give you something to cry about was common. literally my parents said that. So I learned to shut my feelings off very early on. And I mean, that resulted in anxiety and depression in my teens and, you know, young adult life. But I learned when I went to college and I had that first experience with alcohol, that made all that better. Like the alcohol made all of that go away, at least for a little while. So once I realized that, I sought that out until I felt better. That culminated, of course, in my diverting and getting fired and all of that. Also in that was my marriage. I told you that was not great. I ended up with a divorce right around the time I first tried fentanyl. So I imagine that that made it more appealing. It made the feeling. More appealing because I felt like such a failure not being married, like not being successful, having a successful marriage. I was really afraid and anxious because I had a second daughter in my marriage. So I was going to be a single mother with two daughters. I had no idea how I was going to cope with that. I didn't know what that was going to be like. I was severely depressed after the divorce. So all of that laid into it in addition to having a difficult job. dealing with all of that trauma at work. Substances made all of that tolerable until they turned on me and became my, you know, nemesis. I'm just curious, like, what do you think would have helped you either in childhood or throughout your life, or even as a nurse, that would have given you the space to share some of those feelings? What could really have aided you in these journeys? Because I think dealing with cancer or dealing with relationships, those are hard things on top of a very stressful job. And it strikes me like neither of you and I know myself wouldn't have lifted my hand and said, listen, this is a little bit too much. I'm struggling. Is there anything that would have helped before it got to substances maybe? I know for me, had I been taught that it was okay to have feelings and to talk about those feelings, I think that would have helped. I did seek out therapy off and on and tried to get help, but I was so uncomfortable with sharing my feelings that I didn't. I just continued to pretend like everything was okay and things are going really well. Yeah, I'm doing great. So the therapy was not very effective. But I think starting young, teaching our our children that it's okay to have feelings. It's okay to show this is how you show that you have feelings and to do that appropriately would be really helpful. would add the same, but I didn't know until I had a doctorate in nursing practice and dedicated my project to outreach to nurses that are suffering from a substance use disorder that it is one in 10 of us. And actually after COVID for nursing and critical care nurses, I think it's even more. I think that if I would have been introduced to my risks early on, I could have maybe potentially made better decisions or had the courage to reach out. I think what Kristen said though was really significant. I came into nursing with a predisposition to addiction. I was born an addict. I was an addict since I touched alcohol at age 12. However, I think that the journey through my alcohol use disorder could have been a different one that could have put less people, less patients, and less families in the way of danger and dysfunction had I just known what my risks were, what the consequences to my use was. not only to myself, but to others. And if I could have just learned that in school, and then if I was introduced to that in the workplace as being more of something that was normal, or not normal, but more objective and factual, like, hey, welcome to the intensive care unit. We're so glad to have you working here. Here's a couple of things we would like you to be aware of and consider. You're at a greater risk of a lack of coping and or coping in ways that could potentially be unhealthy. And here's what your resources are. I really had absolutely nothing to guide me in this drinking. It just remained a secret. And if anyone knew my secret again, I thought my world would end and it's just not the reality. Yes, I mean, I'm reflecting about my own experiences. I'm listening to you and you're both having the education or the knowledge, the awareness of something and then the support around that would make a big difference to all our journeys. Christine, in your book, you wrote that addiction as well as you've explained it as a progressive series of crossing one's own personal and professional lines or values. Before you were charged with the 26 felonies, you said earlier that even when you were confronted with that everyone sitting in that room, you still denied it all. You remember what, yeah, what were some of the messages and the things you were telling yourself throughout? Denial is very powerful. I am a reasonably intelligent person and I could tell myself things that were absolutely not true and believe the lies I was telling myself. I should also say I am a very moral person. I tell the truth. I don't have any outside of these issues. I didn't have any legal issues. I don't even have a speeding ticket. I obey the rules. I obey the laws. But there was something about this drug use that even though I knew it was illegal, I rationalized it and denied it was a big deal. Once I started stealing the fentanyl from stock, I would convince myself every day driving to work that I would never do that again, that I didn't need it. I just kind of gave myself a pep talk like you're not going to go to the, you're not going to take it. It's going to be fine. You'll get through the shift. Everything is fine. You don't need that anymore. And I really believed that I would be, I'd be good. And then the minute I walked through the hospital doors, especially towards the end, it was almost as if I was pulled into our little office where we kept our transport packs, where the drugs were stored. I was almost pulled there. And as I was walking towards that door, I would be saying to myself, I just need it one more time, just one more time because of XYZ. Like I always had a reason. that it was really important just for this one more time and then I will never do it again. And I absolutely believe myself that I would never do it again, that I was just gonna do it one more time. I also convinced myself that nobody would notice. Like nobody will notice that I've changed the drug log entries. We used paper back then. They wouldn't notice that. They wouldn't notice that the fentanyl was missing from the pack because I had broken the ampule and put it back. with some saline squirted in there so they would just think it got broken. Like nobody's going to notice that. They won't look into it. I convinced myself it was just garbage so it wasn't a big deal. Nobody cares that I'm taking the garbage. Nobody would care. Nobody will notice. Which nobody did notice but obviously it's a big deal. Anybody knows that. Like I had myself convinced that all of these things were true even though also I knew that none of them were true. That's just a really weird, that denial is really weird. April, you said the light went on for you when your mom made a comment to that. Can you tell us a little bit more about what was that turning point like for you? I mean, I'm sure you can reflect on what Tristan is saying around how you were rationalizing, justifying it. What made it switch for you in your mind? What ended up happening for me is I was physically at my worst and unhealthiest. Like I said, I was turning 40 years old and I could not even get up the stairs without stopping to take a break to get my breath. I was full of fluid. I had pitting edema in my ankles. My blood pressure and my pre-diabetes checks at the doctor were out of control. They were getting me recommending medications. I was spiritually broken. My children did not like me and were very hurt and angry with me. Unfortunately, my children saw me drink. My marriage was failing. I had quit my job as a nurse manager, not because, again, not because I was in trouble. On paper, I made it through. I had no licensure problems. I had no corrective action problems. I had no challenges when it came to that part of it. But I was dying. Honestly, my spirit was dying and my body was dying and I was 40 years old. I was supposed to be to work one Monday morning. I took a different position after I had stopped the nurse manager role willingly and voluntarily. And I couldn't go to work because I was so sick. And I sat on my mother's bed. and I was in between two places, going to a hospital and getting the help that I had provided for so many patients in my 20-something year of nursing and critical care. I knew that I needed some Ativan or I needed another drink just to get through that Monday, and I couldn't do either. I couldn't go to the hospital and ask for help and get on an Ativan drip, and I could not drink more that day. So I went to my mother's bed and I just sat there. I didn't even have to talk about what was happening with me very much because she knew. And we sat there together for a while and I was the sickest I had ever been. And she just looked at me and said, may I make a suggestion? If she would have said, I think you need to do A, B, and C. If she would have said, you are a failure, you are horrible, you are shameful, you are disgusting, you know, get a life. She didn't do any of those things that Many people will default to saying to someone who is in such a horrible position. Instead, she said gently, I'd like to make a suggestion that maybe just maybe your alcohol use is a contributing factor to all these problems that are in your life. And that's when the heavens opened and I could see the light. And I knew I was in an AA meeting that night. And like I said, it's been eight years since it hasn't been an easy eight years. There was a relapse in there. And it wasn't smooth and it wasn't easy. And with the combination between the AA Alcoholics Anonymous and the Marie Manthe from the Minnesota Nursing Peer Support Network, and that nurse standing up and saying she had the same issue that happened to her, I hung on to that and I made it so far for today. I and I think even just today is an amazing achievement. I so appreciate both of you being willing to share as honestly and as vulnerable as you do. Thank you. Thank you for joining us for this conversation on substance use in nursing. Kristin and April's experiences offer a powerful testimony of how substance use affects the personal and professional lives of nurses. But the conversation doesn't end here. In part two of this episode, we'll explore what can be done, how nurses, colleagues, and institutions can take action to support the recovery and create a culture of understanding. To learn more about today's guests and access the resources listed, visit the Symptom Media podcast page at symptommedia.com.