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Blacked Out on Fentanyl for a Day

— A nurse in recovery shares one of her loneliest moments

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This story is from the Anamnesis episode called A Nurse. A Pandemic. An Addiction and starts at 2:40 in the podcast. It's from Tiffany Swedeen, RN, BSN.

Swedeen: Hi, my name is Tiffany Swedeen. I'm a nurse in Washington state. I have worked in acute care for the last 16 years, and since 2012 I have been an ICU nurse. I also work as a clinical nurse instructor at a local community college. And I am a nurse in recovery from substance use disorder.

So, I was working in a medical ICU at a hospital that was caring for the first COVID patients, actually, in our nation. It was a shocking situation, because we went from being a normal medical ICU, which is a really challenging situation. It's high-acuity patient care. But some of your shifts aren't always that bad. I mean, we have patients who are all different levels of acuity. And sometimes patients are walking and talking, and they get better. And there's still a sense of hope, when we're caring for patients. And the pandemic, really, took that away.

I didn't know if the medicine we were giving or the treatments we were doing were helping, or were they making things worse. There was not enough staff to support each other. And so it felt like I was in over my head.

And it was when we lost a 20-year-old. That just felt so random. It just felt so ridiculous. And then five people died in 24 hours. And a colleague of mine walked by me and casually said, "Well I don't take care of patients anymore. I just take care of bodies."

My manager did rounds, checking in, walking door to door, asking nurses how they're doing. And I looked her in the eyes. And I said, "We are not okay." I said, "The staff talks to me, but are they talking to you? How are we going to help ourselves and each other?" And she said, "I don't have any idea." And that's the captain of the ship.

In the fall of 2020, Tiffany started looking for a new job outside the ICU, but her manager asked her to stay through the holidays. Tiffany agreed, mostly because she felt guilty about leaving her colleagues. But things weren't getting any better. Suddenly it was December and more patients were dying. Tiffany, who is a certified recovery coach, was continuing to lead support groups online, while feeling more isolated and vulnerable than ever.

After seeing so many families lose loved ones to coronavirus, Tiffany attempted to reconnect with her own. She phoned her mother on New Year's Day. The conversation didn't go well. She had also emailed her brother, whom she'd been estranged from for a few years. He responded on Saturday, January 2, but continued to keep her at arm's length -- she believes because of her substance use.

Swedeen: So, it just was a weekend of rejection, is what it felt like. So that was Saturday night. I didn't sleep. I was really just feeling unworthy. And, you know, hindsight, I have thought so much about this. Could I have just called in sick? Could I have called in and said, you know, "I didn't sleep and I can't make it to work." But I had recently had to call in sick, and that's a whole other conversation about nurses needing to take days off for being ill, or needing a mental health day.

And so I didn't. I just went to work on Sunday, January 3. And, I actually don't like to share too many details about how diversion works, because we shouldn't teach people how to do it. So, but I will say that there was an opportunity to take a large amount of fentanyl, of IV fentanyl. So, I took home the fentanyl, and used it at home, and pretty much blacked out for a day.

I Wanted to Disappear

And I think what I was feeling at the time was not, not that I wanted to commit suicide in any active sense. But I just wanted to escape the feelings. I just really wanted to escape. I felt like I had asked for help at work enough times and nothing had changed. And I wasn't thinking about the future. I wasn't thinking about everything that I had, to everything that was good, and the people that I wanted to keep my integrity for. I wasn't thinking about the program that I'm in, or the UAs [urine analyses] that might be done. I just think I felt impulsive and reckless and wanted to escape my feelings.

And then I just went back to work like normal on the 6th. So, I went to work Wednesday morning, and within an hour of my shift, my manager came to talk to me. She asked if she could talk to me in her office, and a part of me knew, you know, I just, I just sank. I mean there could be so many things to talk about, but I looked in her eyes and she said she was sorry. So, I knew for sure. And I wanted to disappear. That's, that's how I felt. I just wanted to disappear.

And, gosh, I thought I felt lonely before. I've never felt so extremely lonely, because I couldn't think of one person that I could call to help me. And that's not because I don't have people in recovery. I have many, I have hundreds of connections in recovery. It's because I had spent the last 4+ years building this platform of recovery advocacy. And I could not imagine for a second, telling anybody that, that I had failed.

Check out other stories from the Nurses in Recovery episode, including "Job, License, and Livelihood on the Line" and "Nurses Are Not Unbreakable."

Want to share your story? Read the Anamnesis Storyteller Tip Sheet and when you're ready, apply here!