Impaired Nurses...what should you do...

Trauma Columnist · Dec 27, 2005

I would ask if this impacts the care of his patients? And...how do I know this information? I don't see this as being impaired. Granted, he's noncompliant but many patients, both nurses and non-nurses are noncompliant. What are your concerns?

Editorial Team / Admin · Dec 28, 2005

I totally agree with traumaRUs. Nurses are human just like everyone else. We make mistakes, do not use common sense, abuse our bodies, do not listen to our health care providers, and, on.....

I, too, wonder what your role in this is??

Marie_LPN, RN, LPN, RN · Dec 28, 2005

What should i do? Not a thing, until pt. care is compromised, because it's not my business.

And i'd also wonder how i had acquired that much information about someone's health that's not mine, my pts.', my husband's, or my children's.

jeepgirl, LPN, NP · Dec 28, 2005

it's not your problem. mind your own business!

Keysnurse2008 · Dec 28, 2005

what should i do? not a thing, until pt. care is compromised, because it's not my business.
and i'd also wonder how i had acquired that much information about someone's health that's not mine, my pts.', my husband's, or my children's.

the information was not "asked" for.it was given. he tells everyone....and yeah...id call it impaired bc it has compromised patient care,has impaired his judgement and performance. when your blood glucose is over 500...i feel "you" are not medically stable enough to be caring for patients.i mean the safest thing is for "you " to be hospitalized yourself at that point.is it the same as if they are consuming a narc? no...it is a horrible health problem that i wish no one had. but is he "ok" enough to be working in a high acquity icu?i am asking out of concern.....bc....it has not only affected his health......it has affected patient care. so ...what do you do with a coworker......that you care about...in this type situation.how can you handle this?dont read something "malicious" into this...bc....it just isnt there.i am asking.....what do you do when one of your coworkers health problems impair their ability to safely provide care to patients?this could be.....from mental disease, poor cardiac function- leading to be unable to tolerate activity, constant hyperglycemic states( severly unstable ones)[/b])...you could apply it to any diease process. when the coworker that you care about....is functioning like that....it breaks your heart.but...what do you do? do you sit back....and watch day after day as they come in pale , diaphoretic, weak, exhibit strange behavoir...and you watch them test their bg and it reads "too high to read"....day after day...what do you do? they are caring for sick sick cardiac patients often times on numerous numerous cardiac drips.its kinda like you are torn..so...looking for advice.....how would you handle it?some have said youd do nothing......thats kinda easy to say...but when you are bagging up a 30 year old acute mi patient that had events overlooked by that person.....can you live with the decision you made to remain quiet? not an easy question ...is it?but thats the reality a friend of mine is working in.so...i am looking for advice for her.how would "you" handle this?

llg, PhD, RN · Dec 28, 2005

You report and document the compromises in care, focusing on the compromises in care, NOT on your speculation as to why they occurred and/or your co-worker's personal health practices. WHY they occurred is up to the official investigation to determine.

As a friend, you talk to him about it, tell him you are going to report any poor practice you have personally witnessed, and encourage him to seek whatever help he needs (medical and/or legal.)

llg

Trauma Columnist · Dec 28, 2005

I still stand behind the idea that you need to document care issues, not the possible why's of the problem. Personally, a blood sugar of 500 doesn't mentally impair everyone, especially someone that is consistently noncompliant. Now, if his legs start to fall off, then there is a problem. I would not want to be too personal here. Pretty soon, we'll get to the point where we say obese nurses compromsie care, people that need eyeglasses to see compromise care because they have to have their glasses to read, etc.. I agree with llg - document behavior and patient compromises only.

Keysnurse2008 · Dec 28, 2005

Actually..it isnt "my coworker".I just happen to be the one she(the concerned coworker) called tonight for advice. I honestly didnt know what to tell her.This is a coworker she really cares alot about....and she doesnt want to do anything that will hurt him. If it were a Diabetic that was fairly controlled ....id tell her to stay out of it and just "watch".But...its a very very brittle diabetic that is routinely running above 500.So...what do you do when your loyalties are torn?

* And for whoever wrote- stay out of it..its none of your bussiness.....sorry to tell ya....it is your bussiness if you knowingly are aware a practitioner is working in an impaired state.....and you say nothing.....make no intervention...is that correct? You may think so now....but what about when its your mom lying there after a bad cabg? If she died bc he wasnt up to par enough to notice the subtle changes...is it ok then?Will you still behappy someone "minded their own bussiness?". I can understand her loyalties....but I really dont know what advice to give her. She tried talking to him 2 nights ago when he tested 485....and got "cut off cold" as she called it.So where does she go from there?This nurse is only 24 years old...and doesnt have a mean bone in her body...and is distraught over this.So..what would you tell her to do......This is the Nursing issues Concerns and how they affect patient care forum.....so when it affects patient care whats your advice?

Marie_LPN, RN, LPN, RN · Dec 28, 2005

People have given advice. Document. But make sure you have enough evidence of compromised pt. care., otherwise, that'll be a question they'll ask.

jsixxerrn · Dec 28, 2005

I am a type I diabetic and I know personally how he feels. Bad glucose control can effect your ability to provide proper patient care. The only problem with diabetics is we do not like to be labeled as freaks. If you are really a true friend talk to him away from work. Do not make it seem you are trying to correct a wrong.Talk too him like you are concerned about hishealth away from work. Maybe catch him on a off day and treat him too lunch and express it as a concern to his health not like a punishment. DO NOT AND I REPEAT DO NOT talk to him about his diabetes control at the nurses station around other people even though he brings it up. It makes him feel like he is neglecting himself and this makes his control even worse. I have been in his situation and nothing makes me madder than a non-diabetic talking to me about glucose control even if they are right. Try to express concern for his health and see if this will help. Hopefully this may help you. Please do not tell him that his glucose control is impairing his patient care he will feel handicapped and not able to do his job and this hurts. Beleive me I know. Just try it from a concerned friend perspective and tell him you would like to be able too work with him for many more years and help him through this. He may have personal problems that may be causing his glucose control neglect. This is a very hard thing to talk too a diabetic about it is much like walking on thin ice there is a thin line between helping and hurting in this case. Best of luck

Trauma Columnist · Dec 28, 2005

Okay, TNN nurse - I think you have several opinions to choose from with most advocating documentation of specific actions involving a care deficit. Good luck.