I have an experience I want to share with you in hopes of getting some feedback. Firstly, this is not something that happened recently, it's something that happened last year.
During my first semester I became very good friends with a classmate. After the first semester I began to see a much darker side to her and it was obvious (even to her) that she was an alcoholic.
During our second semester at clinical one day, she staggered in while we were in pre-conference. Her eyes were bloodshot, uniform looked as though it had been slept in, hair a disaster, no make-up, pale as a ghost. I immediately knew she was hungover. Another classmate of ours knew it immediately too because he had seen her like that before in lecture (as had I).
Our instructor pulled her aside and this girl told the instructor that she had the flu (that's why she was late and looking so ragged). So the instructor took her into the back room and took her temp. Normal. During the clinical day, she was a MESS. Spent the bulk of her time at nurses station using foul language about other nurses from an area hospital, etc. When it came time for her to check off on her skill of giving eye/ear drops, the instructor asked me to come along so that I could learn by watching her do it. Let's just say it was a disaster and ended up with her snapping at our instructor in front of the patient.
After that incident, I pulled the instructor aside and said: Do we have a policy in place for drug testing students at clinical?
She replied: Why do you ask, who do you suspect of being on drugs?
I said: XX is drunker than a skunk right now.
She said: I'll take care of it.
Nothing happened though. I found out later in the week that another classmate had gone into the instructors office and reported that she was drunk that day as well. According to the instructor, if a student shows up to clinical and seems under the influence, it is the job of the NM at the facility to notice it and request a UA if they feel the need for it. Frankly, I was shocked because:
1. We all had to sign paperwork before the program even started that we could be randomly tested at any time.
2. I thought we were operating under the license of our nursing instructor and that if something happened to a patient while the student was drunk/negligent/etc, they could be held accountable. That is why I don't understand why the instructor couldn't/wouldn't do anything about it.
I will be in school with this person again in January. How should I handle the situation if faced with it again? Several instructors know about her alcoholism and her less than stellar performance. The program director also is aware. I've toyed with the idea of going to the NM at the facility next time (if it happens again) and telling her instead of the instructor. This seems like I'm jumping the chain of command, but how can I allow a drunken student to care for vulnerable patients?
If you have any ideas, fire away! This has been bugging me for quite some time now. I have even personally confronted this student and told her straight up that if I even so much as suspect she's been drinking, I will report her immediately. So she definitely knows she's on notice. But I feel like I"M the only one who considers this to be a valid concern.
Oct 16, '07
I wonder if the risk management or the NMs at the facility know of this "policy"?
I bet they don't, and would be really interested in hearing this theory.
Last edit by caroladybelle on Oct 16, '07
Oct 16, '07
Quote from traumaRUs
It is the instructor's problem and she needs to deal with it; swiftly and decisively! No iffs, ands, or buts. This is a pt safety issue not to mention this student needs help.
I absolutely agree, thus my amazement at the instructors lack of action.
As far as the student needing help, you are dead right. Everyone in her life knows about the problem, has encouraged her to enter rehab, has called child protective services, etc. This has been going on since she was 15. She refuses to deal with it, even though she acknowledges that she has a problem (to a minimal degree). I've done what I could, and have been slapped in the face for my concerns. I'm done now. I wish I could force her to get help, but I know I cannot. Plus I'm unwilling to put myself into a situation filled with constant drama (been there, done that with my parents). At some point she has to take the responsibility to deal with it. In fact, I was quite hopeful when she actually did enter rehab a few months ago. After being there for 30 days (under threat of disciplinary action thru the national guard, where she is a member and was missing work), two days post rehab she got a job as a bartender and got pregnant and of course, is still drinking. I cannot have that in my life. It sucks for her, but ultimately we are responsible for our own lives.
Sorry if I came across as a gossip in this post. It's been troubling me for a while now and I realize that I need to know what to do in the future if this should happen in school. I'm not so much concerned about what to do on the job--for me that's an easy decision...I report to my NM immediately and call security if things get out of control. In school though, it's a different thing. I don't have any power in school to make the right calls and have them be backed up by the program. This whole chain of command is holding progress back in this particular case. :trout:
After writing this (gosh, writing can be therapeutic!) I think I now know what to do. Whatever the consequences might be with my program, if I see her drunk at clinical again I will tell my instructor. If she's not off the floor in a reasonable amount of time (like ten minutes), I will go to the NM, consequences be damned because patient safety is more important than getting in dutch with instructors. Even if they resent it at first, I think they will later realize I did the right thing. And if they don't...who cares?
Thanks for letting me get this off my chest and for responding. I feel better. :spin:
P.S. Have any of you other students had this issue come up in your program? If so, how was it dealt with?
Last edit by DaFreak71 on Oct 16, '07
: Reason: Added a P.S.
Oct 16, '07
Something else you could do if the school continues to ignore this student and the way she shows up drunk at clinicals is to document what has happened and report it to your state board of nursing. Name the school and the clinical instructor. Ignorance of the nursing law is not an excuse for the clinical instructor ignoring this problem. If this lady were a licensed RN, she would be in danger of losing her nursing license or having her license suspended while she was put into a rehab or diversion program by your state board of nursing.
Last edit by Daytonite on Oct 16, '07