How do I handle a coworker who came to work drunk?

[Nurse Beth, MSN]

I once had a prominent surgeon, who was also a recovering alcoholic, tell me that by the time a doctor shows up to work drunk, it's a sign that their drinking problem has progressed significantly. He explained that the progression usually starts with drinking only on days off, then eventually leads to drinking while on-call to finally showing up drunk for surgery.

You would think that someone would call out a doctor or nurse who is under the influence, but time and again, I've seen that's not always the case. I know of a doctor who routinely called the charge nurse every morning to ask what orders he gave during the night.

I myself once smelled alcohol on a co-worker when our three to eleven shift started. I was a new grad, and she was an older, seasoned nurse. I was naive and thought it must be mouthwash, but should have paid attention to how much it disturbed me.

Handling a nursing coworker who comes to work drunk is a serious matter due to the potential risks to patient safety, the coworker's well-being, and the overall work environment. Here are steps you can take to address the situation appropriately:

Ensure Immediate Patient Safety

If you suspect a coworker is under the influence, immediately ensure they are not assigned to patient care tasks. Patient safety is the top priority.

• Document observations. Note specific behaviors, smells (like alcohol), or other signs that suggest intoxication. These could include frequent and prolonged bathroom visits, an unsteady gait, or nodding off at the nurse's station. Accurate documentation can be crucial for any subsequent actions.
• Follow hospital protocol. Most healthcare facilities have clear protocols for dealing with impaired employees. Familiarize yourself with these policies and follow them closely.

• Notify a supervisor. Report your observations to a supervisor or manager immediately. They are trained to handle such situations and can take the appropriate steps, including assessing the coworker and arranging for their removal from the workplace if necessary. Employees who are under the influence will be drug-tested and given a ride home.

Offer Support

If you feel comfortable, express your concern to the coworker non-confrontationally. Sometimes, personal intervention can encourage them to seek help. However, this should be secondary to reporting the behavior to a supervisor.

Keep the matter confidential, sharing information only with those who need to know (e.g., supervisors, HR personnel). This helps protect the coworker's privacy and complies with professional standards.

If appropriate, encourage the coworker to seek help from employee assistance programs (EAP) or other support services offered by the hospital.

Reflect on the situation. Consider discussing the incident with a mentor or trusted colleague to process your own feelings and ensure you handled the situation correctly.

By taking these steps, you prioritize patient safety while addressing the issue professionally and compassionately.

Best wishes,

Nurse Beth