When the Tables Turn
I’ve worked in a variety of settings in healthcare during my twenty-two years as an RN: Outpatient surgery, home health, ICU stepdown, skilled nursing, clinical education, family medicine, pharmaceutical sales, and so on. One thing I never thought I would do was be the director of nursing for an inpatient psychiatric unit. Until the tables turned, and I was patient in one.
Flashback to 2016, I struggled with alcohol, pot, bulimia, anorexia, and severe anxiety. My life had fallen into the proverbial gutter. I was unemployed and unemployable. I had just received a letter from the state board of nursing that my license was suspended due to tampering with a drug screen. (Which I had admitted to in order to avoid getting caught ingesting marijuana.) I avoided the letter from the nursing commission for months, which only worsened the situation. I hid in plain sight by trying to self-medicate until it was over.
My provider had me on Prozac for depression and anxiety, but I wasn’t sleeping and often forgot to take it. Looking back, I realize that I took double doses some days, skipped doses other days, and occasionally washed it down with wine. A recipe for disaster. During that time, I went weeks without sleep. My days consisted of pacing around the house, ruminating on my situation. I was also struggling with bulimia and anorexia, essentially in the form of drunkorexia, getting most of my calories through alcohol and not keeping much food down. The absorption of Prozac was inconsistent at best and toxic at worst. In hindsight, I was a ticking time bomb.
I knew little about mental illness, and my justification was based on my mantra that “I could save your damn life in a code blue situation.” Therefore, you should stop whining to me about your feelings. I was a no-nonsense nurse. Mental health- yawn, who has time for that? Certainly not me. However, you know that saying, “If you don’t make time for your wellness, you will be forced to make time for your illness.” I was soon forced into treatment for ten of the longest days of my life.
Danger to Self
After a suicide attempt, my family had me involuntarily committed to a facility near Seattle for safety. When I was admitted, I remember yelling at the nurse, “You locked me up with all these crazy people!” I was disheveled and tremulous. She looked and me and smiled knowingly. “We don’t talk about our peers that way.” Peers? No, these people were not the same as me. I was just going through a rough patch! Yet I honestly had no insight into how my behavior appeared to others. I couldn’t possibly. My brain was scrambled.
My mood was labile, as in it vacillated from crying & praying one moment to screaming with pressured speech the next. I told long, tangential stories and was incredibly fidgety. My presentation was manic, and I paced the halls until my feet blistered and bled. I wanted to die. In my mind, I had no life to go back to. My husband and I were estranged because of my drinking, my career was falling apart, and my friends and family were at their wits’ end.
The old term was 5150… you might have heard it in a rap song. You can be detained civilly for being a danger to yourself, a danger to others, or gravely disabled. Being gravely disabled is a bit more nuanced. Suppose you have fallen from your baseline significantly. In that case, it counts as a grave disability even though you carry out basic daily living functions. For example: if you are a mathematician who suddenly cannot add two plus two (and maybe starts putting ketchup on your Cheerios), that might qualify. Sometimes the higher the baseline, the lower the threshold. Regardless, my attempts at self-injury and disorganized state of mind were enough to have my family concerned. It was too much for them to handle without professional intervention.
Witness Authority
After I left the hospital, I stumbled for a while, trying to find my footing. I tried various medications, and they kicked around a few diagnoses. Was she bipolar? Was she borderline? Turns out; I was severely struggling with alcohol use, malnourished, and having adverse reactions to Prozac. To the outside eye, it was as though I just had a nervous breakdown, but there was a lot more going on. Abstinence from alcohol and pot seemed to be the tip of the iceberg. I also had to work through an intense recovery program and seek counseling. It was a hellish existence I wasn’t sure I could come back from. Yet somehow, I did. Literally, one day at a time.
After six months sober, I found a psychiatric unit in my hometown and applied. The manager looked at my resume and appeared skeptical. “You have no psych experience. Why do you want to work here?” I explained my struggle with SUD and that I had been detained in a similar setting about a year ago. “It’s called witness authority,” I said, half joking. Unfortunately, I also had to disclose that my actions landed me in a monitoring program for nurses. But I did not back down from my story or rationalize my behaviors. I just owned it all. It was one of the bravest moments of my nursing career. She took a chance and offered me an on-call position.
Today, nearly six years later, I am a hiring manager at that same company. I’m very transparent about the job, but I am equally passionate about the work we do. The first thing I teach new psych nurses is to look the client in the eyes when they are wheeled in on the gurney. This is a human being, and you are caring for them on one of the worst days of their life. If you do nothing else right, treat them as kindly as possible.
Being Human
My mom, a retired nurse of several decades, had used the phrase for a while. “There is no us and them.” I guess it just never really made sense until I came face to face with my own humanity. We are all just human beings navigating pain, suffering, and crises that can become intolerable to endure. As nurses, we get caught up in mundane tasks, and it all becomes so routine. It’s easy to lose sight of the importance of connecting or empathizing with others.
I personally was the worst offender. My perspective as a nurse was cynical and jaded. As for mental health or addiction issues, forget it. I disregarded my patients as weak and ill-willed. In the initial months when my life and career turned into a dumpster fire, I was certain the Karma Gods had come for me. Maybe I deserved this after the jerk of a nurse I had become.
Through recovery, I realized that what was destined for me was to understand the human condition truly. This humbling process not only made me a better nurse but also it made me a better human. And for that, I have the capacity to see people truly. I am above no one. Not the person locked in a psych ward or unhoused on the street. They are just trying to survive like I was. We are all just human beings being human. I can completely understand that now. Turns out, I am human too.
Peace Within. Bullsh*t Out,
Kate
YOU’VE BEEN SELECTED: Kate Vitela has been an RN in Pacific Northwest for over two decades. She has been sober since 2018. You’ve Been Selected is a column that describes her journey through addiction, eating disorders, and what is now known as Drunkorexia. The title comes from years of mandatory drug testing Kate endured after nearly ruining her nursing career due to alcohol. Kate recalls seeing these words appear on her phone each day she was chosen to randomly drug test to prove her sobriety to the nursing board.
Kate chronicles her struggle with body image, perfectionism, stigma, shame, and burnout throughout her career. She also turns this twisted narrative into triumph as she internalizes it as a sign from the universe to speak up and tell her story. Kate continues to work as a leader in the mental health nursing field and is studying to become a board-certified nurse coach.
In her free time, Kate is actively involved in the fashion industry in the PNW. She also serves on the board of the Break Free Foundation, which produces twice-annual shows for NYFW. She has been modeling for two years since starting the blog Walk Your Talk.
Follow along with Kate on IG @katevitela or email her directly at vitela.kate@gmail.com
A Disco Ball is Hundreds of Pieces of Broken Glass, Put Together to Make a Magical Ball of Light. You are NOT Broken, Friend. You are a DISCO BALL!
Resources Are Available
If you or someone you know is experiencing difficulties surrounding alcoholism, addiction, or mental illness, please reach out and ask for help. People everywhere can and want to help; you just have to know where to look. And continue to look until you find what works for you. Click here for a list of regional and national resources.
Resources Are Available
If you or someone you know is experiencing difficulties surrounding alcoholism, addiction, or mental illness, please reach out and ask for help. People everywhere can and want to help; you just have to know where to look. And continue to look until you find what works for you. Click here for a list of regional and national resources.
