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Trust Your Gut, Follow Your Intuition & Speak Up
Q&A with Tonia Bales, CRNA, who has seen firsthand the dangers of drug diversion.
Publish Date: August 26, 2021   |  Tags:   Anesthesia Opinion Supply Management
Tonia Bales, CRNA

You were a successful nurse anesthetist when you gained national attention from Dirty John, a podcast about your former husband John Meehan, disgraced CRNA, con man and infamous drug diverter. How did that affect you? 
One of the most important things was validation of what I had gone through. Professionally, I started speaking at anesthesia conferences to bring awareness and education to substance use disorder (SUD). Personally, I relived and processed everything again, but there was so much healing in that for myself and my two daughters, who were hearing the whole story as adult women from a source other than their mother. 

What lessons can anesthesia professionals take from the story? 
The medical profession isn’t immune to a psychopath like John. That said, most providers who divert aren’t criminals like Dirty John. They are often respected friends and colleagues who need help. Around 5% of providers will self-report; the remainder require intervention. A staggering 10% to 15% of all clinicians will misuse alcohol or drugs during their careers. Anesthesia providers have daily access to anesthetic drugs, placing them in a unique, potentially deadly environment. As experts, they have the misconception they know how to use the drugs safely — an internal dialogue that can get them into trouble. SUD is a progressive disease and often lethal if not addressed in time. Fortunately, it’s treatable, and providers are often given the chance to return to work in institutions with re-entry to practice protocols. 

Multiple professional boards and several facilities were fooled by John Meehan. What does this say about the healthcare system? 
John doesn’t get as far as he did without the cumulative effects of multiple small errors in various parts of the system. Healthcare professionals often err on the side of trust and compassion, which puts them at risk of being conned. They often ignore their intuition and gut feelings, but these attributes can help them identify and manage people who are not trustworthy. 

What can facility leaders do to reduce the risk of drug diversion? 
Open the discussion about diversion signs, behaviors and protocols to all workers. Having a diversion response program will give confidence to staff about how a diverting provider will be handled and the process that will be followed. Diversion is an uncomfortable topic, but having a plan in place will ease the uncertainty. The American Association of Nurse Anesthetists’ website (AANA.com) has a wealth of information on wellness and peer assistance. Their helpline (800-654-5167) is manned 24/7. Anyone can call the number anonymously to report a diverter or ask for help. OSM