how comfortable would you be reporting staff (nurse/doctor) who seems intoxicated?

[I<3H2O]

If a colleague came in to work and smelled of ETOH or seemed impaired somehow, how comfortable would you be going up the chain of command regarding this? Would you fear retaliation? Would you report it anonymously? Do you have a good enough repoire with your coworkers that you could say something directly to them?

Lots of questions...wanted to get a conversation going.

[Boston-RN, RN]

I had to do it once, it was horrible. I was charge and she was going to be charge and I was giving her report and she smelled of ETOH. I finished giving report to her. I KNEW I could not leave I was fearful for my pts. I had worked with her for a year so it was very difficult for me. I found an educator on another floor I trusted and who knew the nurse better than me and asked her to come and see if it were just me or not. She agreed she also smelled the same thing so I had to call the clinical supervisor and also let my manager know at home (because of course this was the overnight shift on a weekend.) They pulled her aside and talked to her and she left and was put on LOA for a few months. She eventually came back and it was uncomfortable at first because I was sure she knew it was me but I didn't mention it I just asked how she was doing and we pretended nothing happened....one of the hardest things I have had to do.

[rn/writer, RN]

I had to do it once, it was horrible. I was charge and she was going to be charge and I was giving her report and she smelled of ETOH. I finished giving report to her. I KNEW I could not leave I was fearful for my pts. I had worked with her for a year so it was very difficult for me. I found an educator on another floor I trusted and who knew the nurse better than me and asked her to come and see if it were just me or not. She agreed she also smelled the same thing so I had to call the clinical supervisor and also let my manager know at home (because of course this was the overnight shift on a weekend.) They pulled her aside and talked to her and she left and was put on LOA for a few months. She eventually came back and it was uncomfortable at first because I was sure she knew it was me but I didn't mention it I just asked how she was doing and we pretended nothing happened....one of the hardest things I have had to do.

On behalf of all the people she could have affected and on her behalf as well, I say, thank you for having the courage to take action.

[diane227, LPN, RN]

You have a duty under the board of nursing rules to report any co-worker that you feel is impaired in any way. You should notify your charge nurse AND the nursing supervisor immediately. They should take the lead on taking action.

[barefootlady, ADN, RN]

Very comfortable with reporting anyone "under the influence" with working in the health care setting. These are lives we are talking about, and we need to take our duty to protecting those lives and giving the best care possible seriously.

[classicdame, MSN, EdD]

I believe it is mandated by law in our state that we report to chain of command. Remember, you are not doing that nurse/MD a favor by ignoring the situation. They are putting themself at risk also.

[jesswill]

I had to reply to this because it happened to me once! I was working as a traveller (so already not too popular with the staff nurses) and a regular employee came to work after lunch break and was obviously drunk. I figured this out when she came into a BR with me to help a patient transfer and nearly dropped him on the floor- she stunk of ETOH! I freaked out a little bit but knew I had to tell someone. I told the nurse manager and she was immediately pulled off the floor and didn't come back. Everybody knew it was me (or figured it out)- some thanked me and some really hated me for it. I don't regret it a bit, and it was absolutely necessary. It wasn't easy though.

[ANPFNPGNP]

I stumbled across this thread and I thought I should chime in about retaliation. I worked for a highly unethical doctor right out of NP school and I reported him to the Board of Medicine. I documented a lot of unethical stuff and sent it to them. I did it somewhat 'anonymously' with the people at the board knowing who I was, but my identity was shielded from the doctor at that time. Well, a couple of years went by and a few of the cases got dismissed (he's paying top dollar for a very good lawyer). About a year ago, I got a call out of the blue from one of the attorneys at the board and she told me they really needed me to testify against him in one of the cases, but I would have to sign a "Waiver of Confidentiality" in order to do it, since he would be present at the hearing.

Another 10 months went by and they finally had a hearing on the case. I got off work at 3am, drove almost 4 hours, then testified against him at 8:30 am...that was in January. On the way home I got a call from my boss who informed me that an official from the hospital just called him and told him I wasn't allowed back in the hospital effective immediately. It appears the doctor contacted them and said I had "lied" and I was "harassing" him...I don't know all the specifics at this time, but I basically lost my job.

Approximately 3 weeks ago, I got a call from the attorney at the Board of Medicine and she informed me they were opening fourteen new investigations based on my testimony and they were reopening all of the cases that had been dismissed. He was probably made aware of that information at about the same time, because he filed several civil lawsuits against me (harassment, defamation and Breach of Contract) AND he has also filed a restraining order, which is basically a "gag" order, since I haven't seen or talked to that man in over 2 years (although I did see his sorry face at the hearing).

I'm meeting with an excellent civil attorney next week and we're going to file several counter lawsuits. Yes, I may come out ahead, but there certainly isn't any guarantee of that. I've got some good evidence against him, but I would have a lot more if I could get people to talk and tell the truth! Now, do you know how many people will be afraid to testify against him...fearing he'll sue them? All I want is for justice to be served. I did what I did because I wanted to protect the people of this state, plain and simple. The fact that all of this has happened to me is surreal to say the least.

I confronted the doctor about his unethical ways a few days before I quit. He was obviously afraid I was going to report him (I already had), because his wife e-mailed me a couple of excerpts from my contract (pasted below with names and dates deleted). I didn't find the e-mail until a few weeks ago, which is really weird, because it came at a time when I really need it! It's amazing that these people really think they can threaten someone with legal action for reporting them for illegal and unethical behavior! That's like Hitler getting the Nazi's to sign a contract and then suing them because they reported him for killing Jews...AMAZING!

Dear Ms. ----:

This letter is in regard to your relationship with ------- (the “Practice”) pursuant to that Nurse Practitioner Employment Agreement between you and --- effective ----- (“Agreement”). A copy of the Agreement is enclosed for your reference.

Although your status as an employee of --- is no longer valid as of -----, we would like to remind you of certain obligations that you agreed would remain binding upon you by signing the Agreement. These obligations include, but are not necessarily limited to, the following:

I. Confidentiality. Pursuant to Section 7 of the Agreement, you must not disclose any confidential information of ---. Furthermore, you must not have retained any of ---’s papers, marketing materials, records or other information of any kind from your time as an employee of ---. Section 7 of the Agreement specifically read as follows:

7. No Disclosure or Reproduction. Nurse expressly agrees that during the term of this Agreement and thereafter for the longest time permitted by applicable law not to disclose, use, make use of, furnish or cause to be disclosed or furnished any Confidential Information, except as required in the course of Nurse’s employment by --- or as provided by the laws of the State of -----. Nurse further agrees not to remove from the premises of ---, directly or indirectly, except as directed by ---, any document or object containing or reflecting any Confidential Information at any time during or after the term of this Agreement. Except as Nurse’s duties require, Nurse agrees not to produce or permit, directly or indirectly, the production or reproduction of any document or other form of communication containing or constituting Confidential Information. Upon termination of this Agreement, Nurse shall immediately return to --- all Confidential Information (and all reproductions thereof) and all other property of --- in Nurse’s possession or control.

II. Other Covenants. Pursuant to Section 8© of the Agreement, you may not disparage or criticize ---. Sections 8(a) of the Agreement read as follows:

(a) Other Covenants. She shall not take any action or make any statement, written or oral to any person which disparages or criticizes --- or its officers, directors, employees or practices, or which could disrupt or impair its normal operations.

--- is prepared to enforce its rights under the Agreement should you be found in breach of any of your obligations under the Agreement.

If you have any questions or comments, please do not hesitate to contact me.

[Straydandelion]

A lot depends on how well I know this co-worker. If well enough to know this is an unusual situation.. I would attempt to talk them into going home if that didn't work report it. Retaliation or not, I feel that honesty would be the best policy. If I didn't know this co-worker well at all, I would report it to the appropriate chain of command. The issue is patient safely first.