how to handle a coworker under the influence of an unknown substance

begalli · Jan 22, 2005

When working with the HHA, are they working under your direction and license? What I guess what I mean, is it considered that you delegate work to him?

From what you say, I think you did the right thing by reporting your suspicions.

Blackbird · Jan 23, 2005

Or damned if you don't conduct your investigation properly.

Ouch.

It would appear you have been stung.

A similar incident happened to me a few years back when I was working on the ambulances. A colleague of mine demonstrated similar traits to yours: he was aggressive, walked in a zigzag, had difficulty reading the charts and privately I wonder if he'd started DIY testing the S8 cabinet but, as a junior, I refrained from taking direct action and instead relayed my concerns to the officer in charge. I did not suggest drug use but instead merely reported my observations.

Turns out that he was hypoglycaemic and was later diagnosed as a diabetic and it was only picked up after the officer had a friendly chat to the person concerned and subsequently my colleague had a blood test done after swearing blind he wasn't on drugs. When the tests came back with the evidence, my colleague then successfully sued another colleague for defamation after "word got out" that he was using drugs. Personally, I think a number of things here: that the litigious action, while unfortunate, was a fair call as people need to be reigned in when speaking out of turn as gossip can have a devastating impact on a person's career; that my colleague had a duty of care to ensure he was in the best of health and that you're damn lucky you weren't sued by reporting a person being under the influence of an illicit substance with nothing to back it up.

When in doubt, before reporting an incident (and thereby making it formal which severely limits the way the complaint is manoeuvred), after you make a personal diary note of the incident and your observations as a protective measure, find someone who you can approach informally first. If someone feels you should report an incident, get them to suss it out at their level - ie. a senior staff member with 'more rank' can have a casual chat with the person concerned and not cause offence. Then THEY make the call.

stbernardclub · Jan 23, 2005

First off I was just surprised that your pt takes food by mouth on a vent? Usually they are on tube feed. But as for how you could have handled things different, I just feel that too many people were made aware of your feeling. Thats really a slander suit you could have set yourself up for. You cannot acuse anyone of being on drugs or alcohol. Just as in charting, you can only state what you see. Now that he has a negative report, I just hope he drops it, cause I know you meant well.

How do you deal with a person who is under the influence of something and you are not sure what? situation: i am a private duty nurse-- caring for a quadraplegic on a vent-- he's fully aware of his surroundings-- HHA came in and i could not understand a word he was saying--eyes red--unsteady gait--aggressive attitude with me and pt-- tried to feed the pt and could not make it to his mouth--i was so upset--the pt knew he was on something-pt said marijuana i thought it was alcohol--so i had to stay calm- my biggest concern was that we had to put the pt in bed with a hoyer lift and i was afraid he wouldn't make it- i called one of the nurses on the case and she advised me to observe him-- i didn't call the agency--i tried to talk to the HHA-- I said to him are u on any medication that i should know about? he got upset with me-- so i said to myself that is it--next morning -- i spoke to the incoming nurse and she agreed that i should report it- so, i did --wow --- what a mistake-- everyone was on my case-- saying why did i do it -- he's a nice guy-- he got problems at home-- i was like what! u go to be kidding me-- this guy put my pt at risk-- even more hilarious was that even the pt wanted him back and so did his girlfriend-- i spoke with both of them -- and they want to give him a second chance-- am i crazy --but my thinking is why take the chance- but also a big part of this situation is the fact that the turnover rate of HHA's coming thru this place is high bc the pt is not easy to deal with -- he is very anxious and he'll curse u out in a minute--honestly i am so fed up that i am ready to hit the road? i found out friday that the results to his drug test was negative --so, he'll be back on the case to fill in-- so now im paranoid-- so im looking for a new job-- anyway if anyone has any input on how i should have handled the situation-- i feel as if i should not have said anything--my concern was if he came in the next day the same way and something happened i would have felt responsible--
u know the old saying "damned if u do and damned if u don't"

teemarie · Jan 23, 2005

Or damned if you don't conduct your investigation properly.
Ouch.
It would appear you have been stung.
A similar incident happened to me a few years back when I was working on the ambulances. A colleague of mine demonstrated similar traits to yours: he was aggressive, walked in a zigzag, had difficulty reading the charts and privately I wonder if he'd started DIY testing the S8 cabinet but, as a junior, I refrained from taking direct action and instead relayed my concerns to the officer in charge. I did not suggest drug use but instead merely reported my observations.

Turns out that he was hypoglycaemic and was later diagnosed as a diabetic and it was only picked up after the officer had a friendly chat to the person concerned and subsequently my colleague had a blood test done after swearing blind he wasn't on drugs. When the tests came back with the evidence, my colleague then successfully sued another colleague for defamation after "word got out" that he was using drugs. Personally, I think a number of things here: that the litigious action, while unfortunate, was a fair call as people need to be reigned in when speaking out of turn as gossip can have a devastating impact on a person's career; that my colleague had a duty of care to ensure he was in the best of health and that you're damn lucky you weren't sued by reporting a person being under the influence of an illicit substance with nothing to back it up.

When in doubt, before reporting an incident (and thereby making it formal which severely limits the way the complaint is manoeuvred), after you make a personal diary note of the incident and your observations as a protective measure, find someone who you can approach informally first. If someone feels you should report an incident, get them to suss it out at their level - ie. a senior staff member with 'more rank' can have a casual chat with the person concerned and not cause offence. Then THEY make the call.

I think i have been misunderstood... I never said he was on drugs .. i just reported what i observed.. also . this was not the only time he came in acting strange..the agency made their own conclusion... also, i know if i would have waited u know what the nurse i spoke to would have said if something would have happened to the pt the next day.. well the nurse knew about it and she didnt report ...there u go... hang me out to dry

I agree with u that i should have spoken to someone else.. i should have said it to the director of nursing at the agency.. also i am in a difficult place bc i am contracted thru another agency.. so this makes things more complicated,,thanks for the tips

Blackbird · Jan 23, 2005

Whoah there Nellie. I'm not judging you, Tee. I wouldn't do that. You said that you discussed your scenario with the patient and this led me to believe that your conclusion was passed onto staff. But all situations are great to assess in hindsight which is why I gave you an experience of mine and I also mentioned that I misjudged the guy at the time. (I did think he was on drugs! How ill informed of me was that? :)) Then I wrote how grateful I felt that you weren't sued.

If you have a dismally poor management stream and you have no way of lodging an informal incident report, this is where diary notes come in handy. Then, if someone comes back and says, "Well, I didn't hear anything from Tee..." then you can produce your log book and go to town.

But please don't think I'm hanging you out to dry. Believe you me, I'll be the first one to rush in here and spill my guts to you all about my fears - and my mistakes when I make them (my placement is this November) as I'm sure I will!

teemarie · Jan 23, 2005

First off I was just surprised that your pt takes food by mouth on a vent? Usually they are on tube feed. But as for how you could have handled things different, I just feel that too many people were made aware of your feeling. Thats really a slander suit you could have set yourself up for. You cannot acuse anyone of being on drugs or alcohol. Just as in charting, you can only state what you see. Now that he has a negative report, I just hope he drops it, cause I know you meant well.

I never told the agency he was on drugs ... i only reported what i observed..and ur right too many people did know how i felt i was very upset bc the agency did call the pt , pull the HHA off the case, and was testing him for drugs..-- which they took upon themselves to do... they could have handled it differently...also, i gave the HHA the benefit of the doubt i tried to talk to him .. i asked him was he on medication or was something wrong , but he became very angry .. this was not the only time he replied angrily to me when i asked him something... even when i advised him to do things differently when he made a mistake he became very angry...

teemarie · Jan 23, 2005

Whoah there Nellie. I'm not judging you, Tee. I wouldn't do that. You said that you discussed your scenario with the patient and this led me to believe that your conclusion was passed onto staff. But all situations are great to assess in hindsight which is why I gave you an experience of mine and I also mentioned that I misjudged the guy at the time. (I did think he was on drugs! How ill informed of me was that? :)) Then I wrote how grateful I felt that you weren't sued.

If you have a dismally poor management stream and you have no way of lodging an informal incident report, this is where diary notes come in handy. Then, if someone comes back and says, "Well, I didn't hear anything from Tee..." then you can produce your log book and go to town.

But please don't think I'm hanging you out to dry. Believe you me, I'll be the first one to rush in here and spill my guts to you all about my fears - and my mistakes when I make them (my placement is this November) as I'm sure I will!

I thank u for ur input i appreciate it ... thanks for taking the time to reply.. touchy subject for me.. i know i didn't handle things right... i guess n i am searching for answers

Blackbird · Jan 23, 2005

She'll be right, mate. All you can do is learn and not take things personally. Even if you take away just one tip from here, you're doing great.

I think you have amazing restraint. Five years ago, I flattened my supervisor with a left jab when he tried to implicate me in his failure to carry out a procedure. I was fuming at such an injustice and I lost it. Not cool. Thankfully, we had a beer afterwards and all was forgotten but it could just as easily have gone the other way. Rather than crucify myself over my appalling behaviour, I learned my lesson. When all is said and done, it's all you can do.

CRNA Someday · Jan 23, 2005

I think you did the right thing. Perhaps not talking to the other nurses, (although I would have done the same, to be honest, to make sure I was not seeing something that wasn't there). If you didn't report it, and this HHA WAS under the influence of some kind of drug (or hypoglycemic, or even just way too tired from lack of sleep) he would be putting your patient(s) at risk and you could have been held liable if anything happened. IMHO you were obligated to report such behavior in as objective a manner as possible and let his employer deal with him in their own way (as you did).

As nurses, we are our patient's advocates, especially in a home care setting, with no other supervision. It's a shame the blame has been placed on you in this situation.

Alison, RN

renerian, BSN, RN · Jan 23, 2005

You did the right thing. Been there done that. If he keeps it up file a hostile work enviornment situation at work.

renerian

teemarie · Jan 23, 2005

I think you did the right thing. Perhaps not talking to the other nurses, (although I would have done the same, to be honest, to make sure I was not seeing something that wasn't there). If you didn't report it, and this HHA WAS under the influence of some kind of drug (or hypoglycemic, or even just way too tired from lack of sleep) he would be putting your patient(s) at risk and you could have been held liable if anything happened. IMHO you were obligated to report such behavior in as objective a manner as possible and let his employer deal with him in their own way (as you did).
As nurses, we are our patient's advocates, especially in a home care setting, with no other supervision. It's a shame the blame has been placed on you in this situation.
Alison, RN

wow, thank you for the words of encouragement. .. this situation has got me so bent out of shape--- i am trying to get over it ... but it seems im not there yet--- in time .....