Polices for impaired professionals

  1. Our hospital is attempting to establish some polices for dealing with impaired professionals and other employees. Does anyone have any information on what other hospitals do? Thanks
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  2. 9 Comments

  3. by   sparrow
    Define impaired, please. Are you talking of physical, mental or chemical impairment? This last topic is a real problem for us and I'm interested in hearing what other places are doing. Do they routinely test, or test only for cause? If a drug problem is revealed, should the hospital arrange to enter the employee in treatment and pay for same? If you test for cause, what criteria do you follow? Who determines what that cause is? Etc.
  4. by   CardiacRN
    Just as a point of interest(I know I am going a little of subject), is your employer giving you routine/random urine tests? If so, where are you located(i.e. state--metro-suburubs--rural). I ask because I have NEVER been asked, despite hospitals having drug screening policies.........
  5. by   ckipp
    I presume you are referencing substance abuse as impaired. Check with your State Board of Nursing. Some states have very active Peer Assistance programs that can guide you in policy development. Ohio is one of those states.
    Hospitals have drug testing policies, so they can legally test for "due cause". I once worked at a hospital that had no policy in place. I was the weekend supervisor. I was called by her peers as she "reaked of alcohol". This was detected by a peer assisting her in bedside care. I had to send her home for the day, but she never had further disciplinary action. To my understanding, this was not her first time. Per the CEO, I could not test her as they had no policy for dealing with suspected substance abuse. Most other hospitals I have worked in, have clear, detailed policies with mandatory testing at any time for "due cause". If you refuse testing, you are terminated. This is legal as in most states, nurses are at will employees. The reality is you can be terminated for just about any reason. Due cause does not have to be noticable impairment. It can be altered documentation, or narcotic dispensing discrepancies.
  6. by   sandygator
    Regarding the "impaired nurse", referring to
    substance abuse:
    Having 'been there, done that' is, unfortunately my only point of reference for this reply. For 12 years I "partied" with my
    PICU co-workers, always indulging in my drug of choice, alcohol. As stress took it's toll
    my abuse of this substance increased....and everyone I worked with KNEW it. Yet they waited until I showed up at work one night reeking of alcohol and in charge of our 18 bed unit to call our supervisor at home to
    confront me, test my blood alcohol, and send me home to wait for the results. The results
    were below a level that would be cause for
    any disciplinary or corrective action, and I went back to work.....with no one talking about the incident. My supervisor asked me the night I was sent home if I had a problem with alcohol abuse...I said "no" (as anyone with an abuse problem would say) and that was the end of it.
    I subsequently went into a deeper depression
    became suicidal and finally entered a treatment center by my own choice. I was appalled at the number of nurses who were in-patients at this facility....both for substance abuse and depression. I will never cease to be amazed that my co-workers, with whom I had worked and been friends for 12 years could not bring themselves to come to me personally and state their concerns that I might have a problem with alcohol abuse....and that my Supervisor was totally shocked....after 12 years!
    I have been searching for articles related to this problem among nurses, in order to present it as an inservice to my co-workers, to no avail. This is a serious and rampant problem in our profession and it is being "swept under the rug".
    One cannot apply to be a clerk in a convience store without submitting to a drug screen, yet NO hospital I have worked in for 23 years has ever demanded this of their nurses. Why? I personally believe it's because there would not be enough nurses drug-free to satisfy their staffing needs.
    I would really be interested in hearing from those of you who know or suspect that your co-workers (or even yourself) may use addictive substances. Ever hear..."I need a drink" after a particularly gruelling or harrowing shift?
    And by the way...This month I am celebrating 2 years of sobriety.
  7. by   judith
    Good for you, Sandygator!
    You are absolutely right: the proportion of substance abusing healthcare workers is appallingly high...and still largely unconfronted. I've never been asked to do any drug testing in 17 years, which i find very curious, given that i'm responsible on a daily basis for the very lives of my patients .
    I was fortunate to have sobered up in nursing school, so much of my practice has been imbued with an awareness of the issue of alcohol and drug abuse that many nurses are not privy to. Believe me, you will have far more to offer your patients (and colleagues) in terms of understanding, compassion and assisstance than those who haven't confronted their own habits.
    As mentioned earlier, some state boards of nursing (Maine for instance) have fairly clear standards and programs for dealing with impaired nurses. The board will help in dealing with individuals, in creating policies and re-entry programs. it's worth checking into.
    Not confronting an impaired colleague or reporting to a superior puts any one of us on very shakey legal and ethical footing.
  8. by   mirn
    I am a fairly new hire at my hospital. When I hired in 8 months ago, I was required to take a urine drug screen. This has been the practice at our hospital for some time.

    As for substance abuse programs in the workplace, our hospital has a service that will remain CONFIDENTIAL, provide free counseling and refer you to a substance abuse program. This is a voluntary option. I have never heard of anyone being sent to this program by the employer.

    By the way Sandygator, YAY! Keep it up!!! If you are ever in Michigan, I would love to work with ya. We could all learn something from your experience (...like about communication with our peers!) I wish you luck.
  9. by   ckipp
    Congratulations to Sandygator on 2 years of sobriety! I have dealt with about 10 nurses with substance issues during my management career. I agree there are many more out there. The hospital I currently work at does mandatory drug testing for all employees prior to employment. We can also request an unannounced mandatory test with any abnormal behavior patterns. It amazes me that nurses think it okay to come to work under the influence of narcotics as long as they are "prescribed" for some problem. We need to remember we are responsible for patient's lives.
  10. by   CHUBBY
    Years ago, I took care of a nurse who respiratory arrested at the nurses station after shooting up 300mg Demerol. She refused rehab (because she had already been through it), so I took it to the state. 2 years ago, she was brought in by co-workers (from another facility) to have a drug screen run cause she had been seen taking pts. meds...so,even with going to the board of nursing, nothing is guaranteed. Nothing gets done...'til someone dies.
  11. by   LAS
    I am currently dealing with a situation involving a staff member that is highly suspected as being a substance abuser and has a documented history of functioning impaired. Her history is almost three years long. She has been caught falsifing medical records and stealing narcotics. What is infuriating is that she is now trying to have her latest reprimand (that she signed) removed from her file. Talk about denial. Yet she is still giving patient care.

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