help

If it is not effecting their performance at work than it is really not your business. If it is effecting their job performance than you take it to a supervisor.

it most definately affects performance and I am the supervisor. No one will do anything about it and I am afraid she is going to hurt someone. Is there anything I can do?

If you are the supervisor than shouldn't YOU be the person doing something about it? What is you policy on random drug testing or the policy on handling an employee you feel is impaired? Are you part of a corporation? If you can't find a policy at the facility then you need to get them involved to get you a policy. Once you have the policy, you need to follow it to the letter.

I dont want to put too many details on here but I guess to be more clear administration wont give permission for anything to be done, even though everyone knows something should be and needs to be. Was wondering if anyone else had ever run into this situation before.... And have been unable to find a policy and dont want to lose my job...

Sadly, she probably will hurt someone. I have an administrator who refuses to deal with employee situations as well. It's hard. To protect yourself, I would document everything - all your observations of the employee, your conversations with the administrator. Observe her work carefully. You could start writing her up for other things and get rid of her that way. I would continue to try to talk to the administrator about the safety issues involved with this employee. If your facililty is big enough, perhaps consulting HR would help.

Depending on what type of prescription drugs, check you facility policies. At my facility, any employee who is taking narcotic pain medications can not work while taking them, a dentist appointment can actually put a person off the schedule for a couple of days should a codeine script be written, same with muscle relaxers, anything that may inhibit safe care of the resident, via ability to think and process or lift and aid, can prevent the employee from working their shift....per policy... safety first.

If she is doign anything wrong, then you need to document it so you have a paper trail. Once you have the papertrail, it can be passed on to the BON to investigate.

I dont want to put too many details on here but I guess to be more clear administration wont give permission for anything to be done, even though everyone knows something should be and needs to be. Was wondering if anyone else had ever run into this situation before.... And have been unable to find a policy and dont want to lose my job...

Depends on the state regs. In FL a licensed nurse must report nurse that 'may' be under the influence of drugs or alcohol- failure to report to the BON is a risk for you losing your license. But even so in your case- it can be determined that you knew she was impaired, and your 'I don't want to lose my job' won't hold water. Not to mention, your ethical responsibility, job or no job.

Observe her work carefully. You could start writing her up for other things and get rid of her that way. .

WRONG. She needs to be direct, and accept whatever happens. Follow procedure all the way, even if it hurts. Lies never prevail. No way. Drug test her based on the explicit policy, document her behavior (which a policy would not allow, prescription or not), and report the mess to the BON. You are obligated to do just that.

The fact that the impaired nurse has a prescription isn't the determining factor. Perhaps she is doubling her dose, or mixing the Rx drug with another drug(s) or alcohol. She needs to be tested before she hurts someone. Heads will roll if she hurts or kills someone and "everyone" knew it was going to happen.

This sounds like an urgent situation to me.

My suggestion for writing her up for all performance issues is "by the book". I'm saying this assuming there is no policy and procedure for handling an employee like this. I've been blown away by how many places don't have a P&P in place until they're in the middle of situation. Document like crazy!!

Testing won't prove anything except that she takes a prescription. It won't show she is impaired and unsafe to practice. On performance reviews you can address behaviors, and suggest a medical leave may be warranted. You must be specific as to behaviors - exactly as you would be with a patient - no subjective ideas - you only have suspicions, not proof after all. Be kind, objective and in no way say anything slanderous. Explain what you have observed as to her care, and state you are concerned. As far as protecting the patients, all you can do is document errors and create a paper trail that will eventually lead to termination.