Coffee Before Clinicals

Nurses Confront Bias: Addiction, Recovery, And Respectful Care

• Jennifer Rossetti • Season 1 • Episode 4

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What if the fastest way to safer care is changing a single assumption? We sit down with educator and recovery advocate Shane Watson to examine how stigma around addiction silently shapes assessments, pain decisions, and patient trust—and how simple shifts in language and presence can prevent harm. Shane’s lived story spans early substance use, incarceration, and 14 years of long-term recovery. His candor opens a rare window into day-to-day recovery, the fear of being dismissed as “drug seeking,” and the relief of being treated like a whole person. Jennifer brings decades of ICU experience to translate those insights into bedside practice: treating pain as real, using person-first language, and gathering data before deciding. Together, we map out a balanced approach that meets needs while guarding against relapse—think smaller quantities, reassessment, lockouts, and family support for at-home dosing.

We also dig into the subtle power of therapeutic communication. Your tone, posture, and micro-expressions can either invite disclosure or shut it down. That matters when the difference between withdrawal and sepsis is a missed cue, or when a hidden med or illicit substance could trigger serotonin syndrome. Case-by-case care beats pattern-based shortcuts, especially with frequent flyers who might be presenting with something new. And because sustained compassion requires capacity, we talk openly about burnout, compassion fatigue, and how to cross the “line” into a room with presence while still protecting your own health with rest, nutrition, debriefing, and support.

Across stories and strategies, the theme is constant: addiction is a health issue, recovery is possible, and respect is a clinical skill. If you’re a nursing student, preceptor, or bedside nurse, you’ll leave with practical steps to reduce bias, improve assessment accuracy, and build trust that leads to safer outcomes. Subscribe, rate, and share with a classmate or colleague—then tell us one bias you’ll check on your next shift. Your small changes can have big consequences for patient safety and dignity.

Music by Smallrose Productions

SPEAKER_00:

Hi everyone, welcome back to Coffee Before Clinicals, where we're brewing up real talk for nursing students that are navigating clinicals, class, and life. I'm your host, Jennifer, an ICU veteran turned nursing professor, and I'm so glad you're here for this very special conversation. Today we're diving into a topic that touches so many corners of healthcare: addiction, recovery, and how we, as future nurses and care providers, can show up better without bias, without shame, with genuine human support. Joining me is Shane Watson, speaker, educator, consultant, and the heart behind Silver Ladder. Shane's journey isn't something out of a textbook. It's lived. From early substance use in middle school to heroin addiction to time served in Maricopa County jail. Shane's story is one of brutal honesty, hard-earned recovery, and real hope. Today he works with schools, healthcare organizations, and communities to educate on substance use, mental health, and stigma, using his story to create change from the inside out. We'll talk about what addiction really looks like, how recovery is lived day to day, and how healthcare teams, yes, especially nursing teams, can shift our culture, our language, and our care to truly meet people where they are. Whether you've cared for clients with addiction, are in clinicals and want deeper insight, or are simply human and hoping to understand this one is for you. Grab your coffee, tuck in your badge, and let's get into it.

SPEAKER_01:

My name is Shane Watson, and I am not my diagnosis. I am a mental health educator, I am a recovery peer support, I am a family support, I am a father, I am a husband, I am a small business owner, and I am an individual in long-term recovery. And I want to encourage people, whenever I have the opportunity to, that mental health and behavioral health are health. If someone is facing a challenge in one of those areas, it's not a failure of morality. It is a health issue. And the sooner that we can get people to fully agree on that, the sooner that people will speak up about what they actually are struggling with and get the health and the health care that they need. So today, Jennifer Rossetti and I are going to be talking about that. Now, Jennifer, obviously, your listeners know you and know your background. But in case this is the first time that somebody is tuning in to your show, you want to give the nutshell one paragraph background on who you are, and then we can talk about what we came to talk about today.

SPEAKER_00:

Sure. So I'm Jennifer Ozzetti. I am a registered nurse. I'm also a nurse educator for a university here in Arizona. And I've been a critical care nurse for 25 years, from anywhere from neonatal ICU, which is the tiny tiny babies, all the way up to open heart trauma adults. So I have a lot of background and a lot of experience. And I like to my purpose is that I'm able to share my knowledge for the next generation of nurses so that they will become better clinicians.

SPEAKER_01:

And I love what you wanted to talk about today. I think this is so important, especially for someone that's coming from my personal background and my professional background. You wanted us to have a conversation about how can we better help individuals who are struggling with substances or have had substance use issues in the past when they come to seek healthcare? How can healthcare professionals have a better understanding? Now, to give your listeners a little bit of background on me and why you want to talk to me about this, in addition to what I mentioned in the intro, my professional credentials, I am an individual in long-term recovery. I'm coming up soon on 14 years in personal recovery. And I went down a nearly 20-year path of substance use. Like most kids, I started with alcohol and marijuana in college, moved on to misusing prescription painkillers. And within a couple of few years of college graduation, I found myself struggling with cocaine, methamphetamine, heroin, you name it, substances that I never thought I was going to be messing around with. And those led me down a path where I ended up incarcerated multiple times, ended up a convicted felon as a result of the last night that I drank or used, and nearly lost my life. The good news is, where the story goes from there, is that I very quickly propelled myself 100% into recovery through the 12-step world, through counseling, through a variety of things. And right around my one-year sober date, I found the mental and behavioral health world specifically prevention for youth. A local nonprofit hired me to go out and to speak to kids at school, sharing my story of addiction and recovery to hopefully keep them from going down that same path. Fast forward through the next 14, 13 years there, I am now an independent LLC owner where I go out and I still speak in schools on substance use, addiction and recovery, suicide prevention and intervention. And I work as a support. I work as a recovery coach for individuals in recovery or wanting to be in recovery. And I work as a family support for families with addicted loved ones or loved ones in recovery. And so that is why you wanted to talk to me about this topic today.

SPEAKER_00:

Yes. So I I really, it's been something that's always on my mind because when I worked, when I had float down to the emergency room or even when I was in the ICO, we experienced this bias as healthcare professionals that when we hear somebody is a recovering addict or an addict, active addict, either way, we think they they're just drug seeking. And then that will affect our ability to effectively treat them and maybe misdiagnose, and then we're not treating them effectively. And also it will encourage our clients not to be forthcoming with us. And so we might not get the whole story. And so I wanted to talk with you and hear your perspective of what you've experienced as a recovering addict, and also to share as nurses what we can do to better support individuals such as yourself to make us just a better healthcare system.

SPEAKER_01:

I think what helps goes back to what I said, the very first line I said when we started recording. I am not my diagnosis. I think it's important to take a person-first approach. Am I an individual in long-term recovery? Yes. Am I a recovering addict? Yes. But I am me before those things. And I understand it's a very fragile balance, and I'm so empathetic for those of you who are in health care because it is important to not provide narcotics, addictive, or potentially fatal narcotics for someone who is truly drug seeking. But the flip side of that is there are people who in recovery, who are in recovery, who may need something that is a controlled substance. That's where I think it's so important to not assume, to not come in saying, oh, okay, I know what this is about. There are so many times in my life that I've walked into a situation and I've said, I know exactly what's going on here. And 30 seconds later, I realized I have no idea what's going on here. Don't assume. So approach as a person first. Think of that person as your sibling, your spouse, your child, your grandparent. And how would you want someone to treat them? Then after that, gather information.

SPEAKER_00:

Don't assume exactly what we teach our nursing students or our anyone in nursing. That's exactly what we treat, we tell them to treat the patient. Don't treat the monitor. So we don't look at the numbers, we have to treat the patient. So same thing when you have somebody who maybe has had been an addict current or recovering. We need to keep it in the back of our mind that they're that they do have this problem. We don't want to send them spiraling back down, but we need to treat them for what they're coming in for now. So if they're having pain, they're having pain. And pain is is subjective. It pain is what the client is telling you it is. And whether they're an addict or not, we need to treat them. We need to help relieve their pain. We're not there to to have them be recovered, not to be in recovery. We're not loss of words all of a sudden. We're we're not there for them to be help me out. Oh, where you go, the facility.

SPEAKER_01:

Oh, a a treatment facility, a rehab. You are not a rehab.

SPEAKER_00:

We are not a rehab. You are not. We're there to treat them right then and for whatever it is they need. And then we can help them get the help they need after the fact. But we gotta look at our biases and make sure we're not we're not we're not neglecting what really is truly happening to those patients.

SPEAKER_01:

Absolutely. And I can use a personal anecdotal story here to illustrate that. Years ago, when I got into recovery, I told my primary care physician, which the practice that I go to, my primary care physician has come and left, and I'm now on a the fourth different one right now. But I was very transparent with them about that. And I had to be transparent with a new one. I want to say probably back in 2018, 2019, I was going through massive fatigue. And it wasn't a matter of like my sleep was off or my diet was off. I felt like something was really wrong. And I, you know, through asking me questions and whatever, and I kind of was thinking toward this way anyway, they were wondering if I had low dopamine, if my dopamine receptors were lacking sensitivity or whatever. And so the treatment professional said, you know, have you considered, you know, having us prescribe you Adderall? As someone who misused methamphetamines and cocaine and stuff in the past, that's the last thing I need to do. So I was transparent with him and I was like, no, that is absolutely not an option. So on the flip side of that, there was a time where I was really, really sick and I had a cough where something moved into my lungs and over-the-counter treatment, you know, dextromethorphan was not working. And like I genuinely needed something because I was up having this hacking cough all night, not productive. And in the past, when they've prescribed me, you know, promethazine with codeine, it has worked, it has helped. I was so nervous going to the doctor and saying that because I assumed, speaking of not assuming, I assumed it was gonna be, oh, you know, we have this here in your file and we can't do that, which I would have understood because you have to be really careful. But they actually asked a lot of questions. They listened to my lungs, they gathered data, they gathered information, and they saw, okay, we really do need to prescribe this to you. As someone in recovery, by the way, for those listening and are thinking, man, this guy had opioid addiction in his past and he's getting coding cough medicine. When I brought it home, I gave it to my wife to keep and to die to dose it out to me exactly as written on the bottle. When I got over the cough, I want to say half of the bottle was still left and she disposed of it safely.

SPEAKER_00:

So that would be one way that you could could treat the patient for what's going on and still be sensitive to the fact that they are a recovering addict or an addict, is maybe don't give them a whole bottle of codeine cough medicine, you know? Maybe give half dose and then have them have to come back to be reevaluated to see if they need more. And that's perfectly fine. You don't have to prescribe a whole bottle.

SPEAKER_01:

Exactly. That's one of the things that I think in recent years, healthcare is absolutely getting right. When I got addicted to opioid painkillers in college, it's because I got a bottle of Percocet, I believe it was, from an athlete who lived in my dorm. He had gotten a sports injury and he had had surgery and gotten prescribed it. He didn't like how he made it, made him feel. No, it makes you feel awful. That's what a lot of people say. And I was like, you know, I raised my hand like, oh, hey, I'll take care of that for you. And this was back in the 90s, where they would get a 30, a 60, a 90-day supply or like a 120-count bottle or something like that. Now, as you know, and your listeners probably know, it's what's kind of standard now or best practice is someone gets like a three to five day supply of that substance and then has to go back and get re-evaluated. That is that balance, and balance is one of my favorite words. That is that sweet spot, that happy medium where we can meet the needs while being cautious and intentional and wise about what we're providing and how much.

SPEAKER_00:

And I had a I've I've never been a an addict of any sort, not even a smoker. So, but I did have a a taste of what it's like to have that bias held against me because I have migraines and I went to the hospital. And being a nurse, I know exactly what I want. I know exactly what I need. So I went in and I've been a migraine sufferer since fourth grade, so 30-something years. My neurologist told me exactly what I needed to do. We've had a plan. I go in and I say, this is not a stroke. I have a migraine. I need two boluses of LR. Give me some Benadryl, and then give me dilatid, because back in the time, migraines were were treated with opiates and narcotics. And now we don't do that anymore. But back then, and immediately I got written up for they started treating me like an addict that I was drug seeking. And it and it felt terrible. It felt so bad to have that being thought that I was drug seeking when I just I knew what I needed for my treatment. And so I I can sympathize a little bit with what you might have gone through yourself.

SPEAKER_01:

So and like I said, I can empathize with those of you in the healthcare profession because it is a very fragile balance. Because the flip side of that is if someone who is drug seeking convinces you that they need it, and that person gets something and they end up overdosing or something happens as a result, you're trying your best to not do that. So I get where the urge is to be overly cautious, and I think that that's smart. You can maybe start from that standpoint of being cautious, but don't assume ask pointed questions, observe, evaluate, and then make the decision at that point right there.

SPEAKER_00:

Well, the other thing so in that in the hospital in acute care settings, we are dispensing. So we don't have to worry so much about the overdose. But what also I want people to understand is that we need to not treat the individual differently either. We need to not talk down to them. We need to, you know, they are a human being. You know, if they're if they're an adult, treat them like an adult, you know. But we need to not belittle them, make them feel less than absolutely. They they are struggling. We are there to to help them. And if by doing that we talk down to them or we don't listen to them because they don't know what they want, they're just an addict. We might be missing crucial points, that little subtle cues, or they might not be forthcoming with us because they don't trust us.

SPEAKER_01:

They will withhold information at that point.

SPEAKER_00:

And nurses are one of the most trusted professions. We need to and should be right. We're with the patients more than anybody. So we need to make sure we are treating everyone with respect.

SPEAKER_01:

And again, that goes back to remembering that that's a person, you know. Even if this person is an addict, even if you have seen and heard enough to know that, okay, this person is in active addiction. This is a human being, you know, and great people can get caught up in unhealthy decision making. This is still a person that is worthy of living and worthy of health and joy and peace and freedom. Now, they need some guidance to make their way out of the woods at that point. But you're absolutely right. It not only harms them if there was assumption or condescension talking down, whatever, it harms you as the healthcare professional because that person's not going to be forthcoming with you. Oh, well, you already think I'm this. You already have assumed who I am. I'm not going to tell you what you need to know. And then you don't have the information you need to make those decisions. And the other thing that's worth remembering, let's say you've gotten 25 people in that day to your hospital who all have been drug seeking, and you get the 26th person that comes in, just because the prior 25 were, and you're you're tired and you're overworked, and you're like, man, I've been dealing with drug seeking all day, doesn't mean that number 26 is going to be. So take everyone on a case-by-case basis.

SPEAKER_00:

And that's like what my friend's story at some location in the United States. I don't remember where I was when she told me the story. She worked emergency room, she had a frequent flyer come in, he always comes in drug seeking, and they worked him up for drug seeking, they put him on precedex, put him off in the corner in the emergency room, watched him, but they missed that he was septic. And when you're septic, you present the same way as somebody who's maybe withdrawing, and that person did not have a positive outcome because they misdiagnosed. They just assumed they were drug seeking for the umpteenth time that they came in. So we need to treat each time. So maybe those 25 people did come in for drug seeking and they come in the next day, they're drug seeking, they come in the next day, they might not be drug seeking. And we need to remember that each occurrence needs to be treated differently, too.

SPEAKER_01:

That reminds me of body cam footage that I saw where there was a driver that was driving really erratically and got pulled over by police, and they're getting him out of the vehicle, and he seems very impaired, and they assumed that he was intoxicated, he wasn't following commands correctly, and they went hands-on with him pretty, pretty intensely, too. And it was discovered later he was having a diabetic episode. And it's like, you know, you we have to be so careful with that. I think it all goes back to if you were that person, how would you want to be treated? If that was, you know, your mom or your dad or your child, how would you want that person to be treated? So person first, don't assume, gather information, and then do it incrementally. Taper in slowly, like you said, you can give that person a small amount. Or as you clarified, I'm glad that you mentioned that in a hospital setting, you're you're not necessarily the one prescribing, you are treating the acute issue in that moment.

SPEAKER_00:

Right. We're dis we're dispensing, we're setting the IV rate. You know, there's ways that if somebody is, and and hopefully they're forthcoming enough with you to tell you that they're an addict or a recovering addict, but we when we're hanging a narcotic of some sort in an IV line, you know, we make it so that it's locked so that they can't pull off any, they can't self-dispense. Just make sure those extra steps are going. But do it with respect and dignity. Don't be like, I'm locking this down because I don't trust you. We're just, we don't want the temptation there. Like you said, with your your coating, you give it to your wife because you don't want the temptation. So we we but we do it with respect to the individual as well.

SPEAKER_01:

And that's one thing for me, it's just an extra layer. Like, so after, you know, I had been, I think it was several years in recovery at that point. And so I wasn't even necessarily tempted to use more than I should. But it's just avoiding even the appearance of going back to old habits. As you know, I'm very transparent about my story. And one of the reasons I'm as transparent as I am is if I were to start heading back to old habits, people would pick up on that as as well. So I have a question for you, actually. So, you know, you asked me how can healthcare professionals better, you know, treat those who have had substance use histories in a, you know, in a way that's fair and it's caring and it's non-judgmental. From a healthcare professional's perspective, is there anything that you would suggest to people who are coming in who maybe do have that history in order to communicate more clearly, you know, to get a a positive result from you?

SPEAKER_00:

Well, I think we've talked on it that they need to be forthcoming, but you have in order to be forthcoming, you you have to trust that individual. There has to be a set of trusts. So I think then it falls back on us as healthcare workers that we have to allow you to feel comfortable and trusting with us. So if you come to the hospital and you you get that judgmental medical pro doctor or or or somebody, then maybe you feel more trusting with the nurse. So make sure you tell the nurse, hey, look, I don't, I didn't feel comfortable telling the doctor this, but this is something that's going on with me. I think it's important that you know that this is my history. And then the nurse can have that conversation with the doctor, or vice versa. If it's not comfortable with the nurse, then tell the doctor or tell the next nurse, because usually you have it one every 12 hours. But I think it gets back to I wouldn't know it from an from a recovering, an addict's recovery stance in that what would make you feel trusting and comfortable, except only we've talked a little bit about it. But we need to present that that personality of comfort of it's that first impression.

SPEAKER_01:

It is. What it would be is that initial contact. How are those initial moments?

SPEAKER_00:

Right.

SPEAKER_01:

What is the tone like? What is the body language like, the facial expressions, the nonverbals, as well as the words that are being said? I think that sets the tone for all else that follows. It's it's even less of a clinical thing and it's more of a basic human interaction that often sets the tone to can I trust this person?

SPEAKER_00:

Right.

SPEAKER_01:

Can I be transparent with this person? Are they gonna judge me? Have they already judged me? And sometimes, by the way, speaking of nonverbals, a lot of people think they poker face things a lot better than they do. And if we have pre-existing biases about, you know, people in recovery or whoever, we may think we're doing a great job, you know, poker facing it. And they're reading on us that like disgust or whatever it is. And maybe we've not even spoken a single word, but that person's thinking in their mind, oh, here's another drug seeker, and it's showing on their face. Be conscious of those nonverbals. I read research, you know, and there's research that conflicts with this, so this may not be 100% correct. There's some research I read that said 93% of the message that is conveyed is not in our words, it's true, it's in our nonverbals. And when people hear that, I've I've, you know, when I've gone out and I've spoken to parent groups at schools about that, and I've shared about, you know, talking to their kids in a particular way. I've seen people kind of like, you know, wrinkle their brow and kind of squint, like, really 93%. And a great example I use is this. You know, imagine I'm a dad, I have a 16-year-old son, I love him very much, but I found out he's doing some things that I'm kind of concerned about, you know, and I'm sitting down to talk to him. And the first words out of my mouth are, you know what, I love you. Do you understand that? Now the words are I love you. That's what the words are. Is that what the message was just conveyed? No, dad's clenching his jaw, he's clenching his fist, you know. So be conscious of those nonverbals.

SPEAKER_00:

So in the nursing world, we teach our students that, but we call it therapeutic communication. Nice. Okay. So that's that is a true statement. And we do teach it. And we have to remember that using our therapeutic communication instincts, which is body language. Are you standing there cross-armed? Maybe you're tired. You've worked three 12s in a row. True. And you're you just you don't have a smile in you because you're just exhausted.

SPEAKER_01:

And you're human too.

SPEAKER_00:

And we're human too. And usually, you know, you don't get a lunch break, you don't get a bathroom break, and you're exhausted. And you just want this patient to let you give the medicine so you can get going. But you got to remember each and uh each inter interaction, absolutely gotta keep our therapeutic. It was it's so funny. I know this is kind of off topic, but when I worked at Disney, we had a line that when you cross that line, you have to be in character.

SPEAKER_01:

Okay.

SPEAKER_00:

So you have to think that line. And I, and when I worked Disney in the high sch in high school, and then I became a nurse, I always thought, okay, the line, the patient's door is my line. That's really and I'm on character, even though, and I know in my heart I love all my patients, but I'm exhausted. So I cross that line and it's like, okay, I have to be on. I have to be smiley, I have to be happy, I have to, I have to be compassionate, you know, even though my body is worn out. And I think of that line, and that's just reminding me something I like to do.

SPEAKER_01:

That's a great way to put that. That reminds me of there were schools I would go speak to students and they would have me speak the entire day. I would be doing one-hour sessions, six of them back to back to back. I gotta give group number six everything that I gave to group number one. Now it is exhausting. I would bring a bag with me with like bananas and protein bars and electrolyte drinks. Like I treated it like an athletic performance. But I think that your example of the Disney line, I need to be in character right here, is so important. And I think that that's where with healthcare, like pretty much everything else in life, mental preparation is a big part of that. You know, setting your mind toward what am I going to be like today, or when you're about to walk in a room, what am I going to be like right now? Intent, being intentional, being present, being mindful, and knowing how you're coming across.

SPEAKER_00:

For my students that are listening, it's like when you come to class, you have to be on. Don't come in like spaghetti strap bathing suit and relaxed and in flip-flops and sitting in the back with headphones on, but you know, like really be in, show your professor how you're going to treat your patient. Absolutely. Be present, be in the moment. And so I think by remembering that when somebody who's in recovery or something like that comes to you as in the emergency room or on the floor, you know, be present, listen. It's active listening. We need to have active listening with our patients.

SPEAKER_01:

Absolutely. And it reminds me of this this little things are big things. Little things add up to big things. One of the topics that I teach on is uh suicide prevention and intervention. As a matter of fact, I teach a two-day, 14-hour suicide intervention workshop called Assist. It's applied suicide intervention skills training. There's a story I read once about someone who was contemplating suicide and they wrote a note. They left a note, as some people do, and it said, I am going to walk the length of the Golden Gate Bridge. If one person smiles at me or says hello or good morning, I will not end my life. And it sounds, there's, you know, when we're thinking through rational minds, when we're in those who are listening to this, who are in a healthy place mentally and emotionally, they may hear that and think that sounds irrational, and it may be irrational. But sometimes for someone who is exhausted, they're hurting, they're fatigued, they're in pain, maybe they're terminally ill or they're going through some major thing, the tiniest little thing can completely change things. And just by you coming in and the way you treat someone and the tone in which you talk to them, as much as the medical assistance that you're giving them, that can be a game changer. You have a tremendous amount of power beyond the fact that you're treating someone physically as well.

SPEAKER_00:

Yeah, that and and that's I mean, even uh not just our patients, our clients, whoever we're with, but anyone, you know, you might be at the grocery store and you just have a friendly face and you smile, you might make that person stay. And it's that butterfly effect, you know, that's gonna help. It's gonna help them. Maybe they were in a bad place, and by that smile, it's like I can do this. Yep. So, and we have to remember that when we see our patients when they come into the emergency room or the or on the floor, that you know you might be the only happy thing that they experience.

SPEAKER_01:

It's entirely possible. So and that's then we move a step back from that. That's where taking care of your needs and your self care in order for you to be the best version of yourself at work that you can be, because you might not get that lunch, you might not get that break. Well, when you do have control over your time, what is your sleep like at home? What is your eating like at home? Are you doing self care things to fill your vessel back up? Because you are poor. Pouring out of your vessel into other people all day. So that's where we take a step back, even from getting to work that day, the day prior, the days prior plural, taking care of yourself and doing that preparation.

SPEAKER_00:

Yeah. So that, you know, keep going on with that line of thinking is we do teach our students, you know, nursing, we give, give, give, give, give. And we have one of the highest suicide rates. We have burnout. Our nurses since COVID are fatigued because we're understaffed all the time. And, you know, we got to make sure we're taking care of ourselves. That compassion, we get compassion fatigue because we're giving, giving, giving, giving, giving. And we need to make sure you get back. It's like the oxygen in the airplane. That's the example that I use. I love that. I love that example. You got to put the oxygen on yourself. Or when I was an EMT, you know, that you have to make sure the scene's safe. You have to take care of yourself. Because if you have you become impaired or not able to help, you can't help everyone else.

SPEAKER_01:

You're you're another casualty at that point. Right. Yes. And yeah, that's I remember those examples where you're, you know, if there's an auto accident, you're looking for low-hanging power lines, you're looking for, are you in a lane of traffic and those things? And it's in the the airplane example is fantastic too. I love that with the people that go into healthcare, you're often the kind of people who instinctually your first thought is to take care of someone else. But if you have completely emptied your vessel, you can't pour into that other person.

SPEAKER_00:

Yeah, there's and and I did, I had to take a step back after COVID, being in New York, helping with those, all that situation there and seeing what I saw. I did get burned out. And I took a six-month sabbatical from nursing and was like, I don't know if I still can do this. And I had to refill my cup. So it's it's it is real. It's it's after 20-something years, I was like, okay, I'm done. I can't do this anymore. So, but you got to surround yourself with support.

SPEAKER_01:

Yes, that's the other thing. As as part of your self-care plan, surrounding you with people who they fill you back up.

SPEAKER_00:

So to get that back on topic, I think if we can refill ourselves and make ourselves where we can cross that line and and be in character to to be therapeutic communication to help those with substance abuse or or addiction or whatnot, when they come to us, then they can feel comfort comfortable to talk to us. We need to present in a a way that we are open. And and I find it funny because most people I can sit and they'll start talking to me.

SPEAKER_01:

And I you're that kind of person.

SPEAKER_00:

I think it's that I think a lot of nurses are that type of person. I think if you can present like that if you're going into this field, then addicts will and recovery will be forthcoming with you. But when they do, you cannot you cannot show expression. You know what I'm trying to say? You have to be like, okay, well, we can We're back to the poker face.

SPEAKER_01:

Yes. Be conscious of how you're coming. And I don't have a poker face at all. But I think that you pretty much don't need to because I think you genuinely are compassionate. I think you genuinely are non-judgmental. You're the person that initiated this topic today. So I think you're someone that it's safe to show on your face what you're thinking because your mind is not in that place of, ooh, okay, yeah, this is what we're dealing with. Now you're like, how can I help you?

SPEAKER_00:

Yeah. So, and that's I think a lot of nurses when we go into the field, we just can't lose that when you're brand new nurse scratch. You're gonna change the world. We're gonna change the world, we're gonna make a difference. And you will, and you do that one person, if you save one life, you You've done it.

SPEAKER_01:

Right. That's it. But then after 20, 25 years, it's like, yeah, you need a you need that you need that, you know, refresh and restart, which the sabbatical was a perfect idea.

SPEAKER_00:

Yeah. So and that's healthy to say, even if it's not 20, 25 years, maybe it's five years, and you're like, okay, I need, I need a I need to reflect, I need to take a break.

SPEAKER_01:

Given the nature of the field, five years is not surprising either. It's you are, you know, they call it vicarious trauma. You know, you are absorbing secondhand things from people and being a compassionate person and seeing someone in pain or injured. If you have a conscience, it will affect you. Now, obviously, there's a way that you learn to, I don't want to say compartmentalize that, to stay on task during your day. Yes. But it does add up over time, and that's where the sabbatical or some other way of allowing you to, you know, renew yourself is crucial.

SPEAKER_00:

For the most part, I can dissociate when I'm at work. I'm at work. When I come home, I have the support where I, you know, I'll never always mindful of HIPAA. You never can say anything. But I have that ability to share and decompress what's happened. But there would have been a few times, especially when I was pregnant or when I had my my kids, I'd have a patient come in that was I remember one time I had this one patient come in. He was five years old, and his life was changed forever because he was allowed to sit in the car front seat for the first time and the air black deployed and poor outcomes came out from that. And I had a five-year-old at home and I cried and I'd go home and I just I woke him up and I just hugged him. Kids are a whole other deal.

SPEAKER_01:

Yeah. You know, seeing kids going through that. It's it's it's hard to see anyone, but children is a whole other deal, especially if you're a parent yourself.

SPEAKER_00:

But you know, it's the same with um with any patient that I have, you know, I try not to associate them with someone personal because then it I can't do my job. So, but when I have someone who comes in who's, you know struggling, I know they have substance abuse or not like that, I try to treat them right then. And I want my nursing students to understand that there will be times that it's you struggle to not judge. We're human. We but if you see, if you feel like yourself is starting to maybe judge somebody because you find out they're an addict or or something that makes it more personal, step out of the room, take a moment, you know, have somebody cover your patient. If you absolutely have to, maybe switch a shift to switch a patient assignment, but try to step out of the room, re recompose yourself, and then go back in. Remember that Disney line, cross that line.

SPEAKER_01:

So I think that that's important. A pause, pauses are underrated, even for a couple minutes, you know. And and I'm sure that you're in your field you've you've learned about box breathing and things like that to re, you know, kind of recompose yourself. Yeah. I appreciate so much you thinking of this topic. And so my answer would be, you know, basically that preparation in advance, taking care of yourself, being conscious of how you're coming across. Don't assume, take people on a case-by-case basis. Remember that someone is not their diagnosis, gather information and then move forward on that.

SPEAKER_00:

And then my advice to you or to your pop population such as yourself is don't be scared to share because there are so many incompatibilities between medications. So if you're on something, we need to know it. Don't be scared to share. If you are not comfortable with your assignment, you have the autonomy to say, I want a new nurse, I want a new doctor, I'm not comfortable. This is not a safe space. And feel empowered to speak up so that because if you're not forthcoming with us, we can't help help you.

SPEAKER_01:

Absolutely true. Because that you where you're talking about the medication interaction, if someone is not forthcoming, instantly makes me think of if someone is, you know, about to be prescribed an SSRI and they're using like an illicit substance like MDMA, which acts on serotonin, you have the risk of serotonin syndrome. I mean, and it's one of those things where just a yes answer, some clarity, some transparency right there can be life-saving. Right. And so that goes back to people in my shoes, where if you do have a history or if someone who is actively using, let them know. Because just like I encouraged healthcare professionals to remember that mental and behavioral health challenges are health challenges. I want to emphasize to those who may be in active recovery or active addiction, active use, that it is a health issue. And I encourage you to be transparent. I will say that I have had a really positive experience since getting in recovery, since getting sober. I don't feel particularly judged for from the interactions that I've I've had for the most part.

SPEAKER_00:

And you're in the minority in that. Because the majority, I think I read a study, it was 75, 88%. I mean, it was high. Okay. That most addicts, recovering addicts, feel judged.

SPEAKER_01:

Okay.

SPEAKER_00:

Feel like they cannot be forthcoming. They, in fact, they don't seek treatment because they're fearful of that is scary.

SPEAKER_01:

Where somebody won't even go seek help as a result of that. Uh that actually shouldn't surprise me because I know how many people who are in active addiction don't speak up to get help for their addiction specifically. Not some, you know, not another physical issue, but specifically that, the percentage who won't tell another person. And the more that we can humanize this whole dialogue and remind everyone, whether it's a healthcare professional, it's a family member with an addicted loved one, or it's that person themselves. You are a human being. That person is a human being worthy of love and respect and care. And that's why I think it's so important that we had this conversation today.

SPEAKER_00:

Yeah. So especially this month, this is Mental Health Awareness Month.

SPEAKER_01:

Love it. Yeah. Thank you so much.

SPEAKER_00:

Thank you. Thank you, Shane, for coming on and sharing so much honesty, insight, and hope. You really helped us see addiction and recovery not as a separate from health care, but as deeply woven into our work as nurses. To you listening, if you walked away with one thing today, let it be that recovery is possible, healthcare bias can be changed, and every moment you show up with curiosity and care matters. If you like this episode, please subscribe and rate us on Apple Podcasts or Spotify. It really helps others in the nursing community find us. And share it with your classmate, your study group, or a colleague. The more we talk openly about this stuff, the better. One more sip. Take a breath, let yourself be as human as your patients are. You're building the muscles of compassion, and that's just as important as vitals and meds. Stay curious, stay kind, stay caffeinated, and I'll meet you in the next one. Thanks for being here.

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Jennifer Rossetti

Host
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Shane Watson

Guest