A Tragedy Named Linton
On August 4, Nicole Linton blew past a red light at a speed of 130 mph and killed six people. Three of those people were a little family about 2 weeks out from adding a 4th member. They were on their way to the physician’s office for a check-up.
There has been so much information, often contradictory, about Ms. Linton. What I believe to be true (and relevant) is that she suffered from a psychiatric condition and elected not to take her medications. Her sister, Camille, has written a blog about her and if you read carefully, you’ll notice that she and Nicole hadn’t talked in a year.
Camille’s blog about her sister purportedly seeks to increase awareness of mental health issues and how our society treats the mentally ill. Surely this awareness was important before the deaths of five people. There were numerous accounts of her accolades and accomplishments. Nicole Linton was a hard working nurse and judging by her academic record, she was intelligent.
I can’t imagine the pain of knowing that someone I loved was responsible for six deaths and all the hope and love of their families that burned in the flames of that fiery crash. I probably would have written the same flowery blog about my family member.
Her sister postulates that she may have frontal lobe epilepsy. I understand that she is looking for answers but in her attempt to bring awareness to the toll of psychiatric illness, she diagnoses a physical illness. To the best of my limited knowledge, she does not work in the healthcare field.
What is known is that during the pandemic, Nicole chose to discontinue her medications. There is no explanation of why she did this. We don’t know if she consulted with her physician or was having intolerable side effects. Personally, I don’t know much about psychiatric illness. Is there a point in Bipolar Personality disorder where it is safe to discontinue medications? I have never heard of such a thing but there are lots of things I haven’t studied.
I’ve known nurses who took medications as ordered and had side effects impairing judgment. I’ve also met nurses who do not take their medication as prescribed for known conditions. There but for the grace of God, their day did not end with a fiery crash. It’s a little like drunk driving. Most people make it home but God help those that don’t.
I know a nurse who took her morning medications twice causing drowsiness that put her to sleep at the wheel with her final destination being a ditch. She was okay. Her director was not okay when it was learned that she took a patient’s vitals without a stethoscope or glucometer earlier on the same morning.
Patients will frequently report ‘stolen meds’ and most often, they are confused or misplaced the medications. But home health and hospice offer numerous opportunities to lift drugs from a patient. Is it likely that every single complaint of theft is the result of a confused patient misplacing their meds? If not, you may have an impaired nurse visiting patients.
There was the time I was a CIA agent working with ‘them’ when it was time to fire a nurse. Her version of my life was far more exciting than reality.
Can you see how any of these nurses could have caused great harm? A nurse who steals meds is most likely using them and how would you know if a nurse took an opioid therapeutically the night before for pain or is taking them indiscriminately? A drug screen only shows opioids but not the amount. A sleeping nurse can not drive. I will not be taking questions on that one. And if I was a CIA agent, what role did the patients play?
Even though you can never completely protect yourself from unpredictable behavior, you can take steps to lessen the chance of a catastrophic event.
Most state boards of nursing have standards that meet the same or similar criteria. Please check your state to ensure that you are not violating a nurse’s rights by asking about diagnoses or medications. If you are not violating any rights, your policy should be that any nurse who has a condition or is taking a medication that may impair their judgment or physical ability to perform the skills required must report the condition or medication to their supervisor. In Louisiana, the board further states that:
If a prescription medication states it Might or Could cause any form of impairment, a prescriber’s letter clarifying the impact of these possible side effects should be required. The prescriber’s note must state the medicine will not negatively impact the nurse’s ability to function in his/her job capacity.
If, upon hire, a nurse reports that he or she is taking a psych med, but later becomes symptomatic, their continued compliance should be investigated. A signed statement of understanding placed in their confidential health file would be a very good idea. These are not questions that should be asked prior to employment.
Your responsibility is to your patients first and then your nurses and other clinicians. No nurse should be fired because of a psychiatric condition except as a very last resort when continued employment is a danger to patients or to themselves. If you are unsure of a medication, ask the nurse to work in the office for a couple of days.
It is always expensive to have a psych condition or any chronic condition and I would hope you would not add to the nurse’s financial burden. Offer to get a rideshare service to and from work for a nurse with a new or changed med until the effects are known. Offer to have someone drive the nurse to appointments. I guarantee that the cost of a few Uber rides is cheaper than orienting a new nurse. Be the example. Eliminating the stigma in your agency will provide the staff with a safe place where they don’t feel like they have to hide their psych illness.
If you are a nurse who has a condition or takes medications that may impair your ability to perform your job, let your supervisor know. Although the focus of the week is psych meds and conditions, there are numerous medications that can impair your judgment. Antihistamines, new antihypertensives, etc. can make you drowsy and slow. If you believe that the information may not be well received, do it anyway. New onset diabetes can be associated with fluctuating blood sugars as a med regime and diet are established.
Be responsible. We are going into another critical nurse shortage and you will be able to work somewhere. Further consider contacting the labor board or a lawyer if you are fired as a result of being responsible. Failure to be responsible as a nurse or an organization can have disastrous consequences.
Just ask any remaining family members of Asherey Ryan, the pregnant woman on her way to a physician’s visit with her boyfriend and young son.