nurse coming to work drunk

[nickola]

Recently one of the nurses on our unit came in drunk. She looked like she'd slept in her clothes, had foul breath, and was nauseous & pale. The nurse manager is her friend, and she put her in a room at the end of the hall, started fluids on her & gave her antiemetics- all on the clock. 3 hours later she felt better & was allowed to work the rest of the 12 hour shift, but was essentially useless. The rest of us felt very uncomfortable with this situation, and we wanted to report it, however, this nurse has been protected by the NM for a long time, and others have complained in the past- all the way to the top, to no avail. There is no one we can go to, & we all fear retaliation from the NM. Is this reportable to the BON? What is your take on this?

[kalevra, BSN, RN]

No, we have no proof, although she did say she'd been out drinking all night & just came to work. (not sure that's good enough since her BFF is the manager)

When you say started fluids and antiemetics, you are saying the NM used hospital resources to sober up the nurse?

I ask because if that is the case, then you might be able to use that as evidence.

Remember without evidence all you have are accusations. You don't want to be the one calling people out only to have no leg to stand on later.

[jadelpn, LPN, EMT-B]

When you say started fluids and antiemetics, you are saying the NM used hospital resources to sober up the nurse?

I ask because if that is the case, then you might be able to use that as evidence.

Remember without evidence all you have are accusations. You don't want to be the one calling people out only to have no leg to stand on later.

And I would think that would start with who got the antiemetics from where. Pharmacy usually keeps a good eye out for this stuff. Some places even count bags of fluid. Med rooms have cameras. So given a through investigation this stuff could be proved.

To the OP--I would also speak with the BON in your state regarding your reponsibility as a licensed RN in reporting unsafe practice. Cover your own butt. The LAST thing you want is for this to come back and bite you. Because I am quite confident if the NM is going down, she will NOT want to go down alone.

[psu_213, BSN, RN]

No orders for meds, the NM just gave them, as well as fluids, no orders. The nurse acted drunk, she said it had been 2 hours since she'd had her last drink, if so, she must've been plastered b/c she did indeed appear impaired!

I agree that it is a bad move by the NM to treat this other nurse. However, I'm still not willing to say that your co worker was drunk. In your first post she was "nauseous [sic] & pale." Next post she had been drinking all night and then came to work. Finally, a day later you said it had been 2 hours since she had her last drink. Now, I'm not saying you are making this up, but it seems strange that each time someone suggests that she was not drunk, you add evidence that she was indeed drunk.

[psu_213, BSN, RN]

However, to say that she IS drunk w/o having proof of her being drunk sets you up for a slander suit. She may look and smell like something the cat dragged in, but unless you had a BAC/UDS verifying it or had actually seen her pounding shots before she arrived at work, you can't say for certain if she was drunk.

I (and many people on this site) have gone to work not feeling well. Not hung over and definitely not drunk...just ill--i.e., pale, blood shot eyes, nauseated, not moving very fast, perhaps speaking slowly, etc., etc. Not being there, I cannot say that the nurse who was the subject of the OP was NOT drunk; however, I would sure be upset if someone reported me to the BON for being drunk just because I was not quite feeling myself. I think it would not be fair for you to make such a report without proof.

[tewdles, RN]

It seems that the facts are:

1. The nurse presented for work when unable to complete her duties secondary to illness (the cause of that illness or inability to work is not really relevant to you as you cannot determine the nature beyond reasonable doubt)

2. The NM identified that the nurse was not able to complete her duties.

3. The NM allowed the unfit nurse to remain "on the clock" even though she was not capable of working.

4. The NM practiced medicine by ordering IV fluids and prescription medications without consulting an appropriate provider.

5. The NM accessed and utilized patient chargeable items for a nonpatient activity without any agency notification or approval.

My recommendation would be to report your NM to the HR department and to Risk Management. Her behavior is indeed questionable and has placed her at tremendous risk. What happens relevant to the "ill" employee will likely flow from the investigation of the NM.

If you are working with a peer who appears or behaves as if they are under the influence of ETOH or other drugs, then you should report up the chain, beginning with the NM.

Your NM really used poor judgement when she did not send the employee home or to the ED for evaluation. She used worse judgement when she determined that she should treat the nurses symptoms without medical orders. She should not be allowed to continue in the capacity of manager and should be reported to the board for practicing outside of her scope...your employer should see to both of those things for you.

[jadelpn, LPN, EMT-B]

I (and many people on this site) have gone to work not feeling well. Not hung over and definitely not drunk...just ill--i.e., pale, blood shot eyes, nauseated, not moving very fast, perhaps speaking slowly, etc., etc. Not being there, I cannot say that the nurse who was the subject of the OP was NOT drunk; however, I would sure be upset if someone reported me to the BON for being drunk just because I was not quite feeling myself. I think it would not be fair for you to make such a report without proof.

That the nurse in question was drunk, not drunk, not feeling well, had the flu...no matter--the issue is that the NM practiced beyond her scope, against the policy of the hospital, and in doing so put all of the other nurses that were working and aware in a precarious position, as licenses in most states bind nurses to report certain activities, and unsafe practice is one of them.

I am not too sure that this NM would support if say the OP was BFF's with the x-ray tech who for whatever reason was not well and unable to function at work--so the OP decides to bring the tech to the floor, put them in a bed, and start fluids and meds. But because this was the NM, everyone was to turn the other way?

The OP states in a pp that she and group went to Risk Management. They are investigating the same. I would see what, if any, the responsibility is to report to the BON. Because risk managment nor the NM is going to pay someone's salary if a group of nurses get reprimanded or worse for not reporting what they are mandated to report. (IF this is a manadated reporting thing for the OP's state--and only the BON can decide that).

[psu_213, BSN, RN]

That the nurse in question was drunk, not drunk, not feeling well, had the flu...no matter--the issue is that the NM practiced beyond her scope, against the policy of the hospital, and in doing so put all of the other nurses that were working and aware in a precarious position, as licenses in most states bind nurses to report certain activities, and unsafe practice is one of them.

I think we are talking about 2 different things here. I was merely saying that you need solid proof before you make an accusation that someone was drunk at work. As for the NM practicing beyond her scope, that is a different matter and it should be taken to a higher level.

[tewdles, RN]

I think that it is true that one could not say for certain that the nurse was drunk...but it can be said with certainty that she was not able to carry out her professional duties and should not have been allowed to remain on the unit.

This was a failure of management to properly intervene...