Showing up at work smelling of alcohol

Nurses Safety

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I work in a LTC facility where there is this one CNA that occasionally shows up to work smelling of alcohol. I haven't worked there long but I've been told that this happens with him frequently. Yesterday I had to take a few steps back from him because the smell was so strong. His eyes were so red and glassy. He claims that he was drinking the night before and is fine to be at work. The DON and the Administrator are aware of this problem but apparently choose to do nothing about it. To my knowledge he has not harmed any residents YET. Is there something that can be done about this or do we just sit back and hope that he doesn't end up hurting anyone?

Originally posted by fab4fan

Be very careful...a wrongful allegation could put you in a precarious position legally, esp. since admin. is not backing you up.

You have to be an advocate for your pts., too, but make sure you have your "ducks in a row," so to speak.

There would be no wrongful allegations in this situation because he admits to having been drinking the night before each time someone approaches him about it. But I'm sure his "night before" ended only shortly before coming to work.

Yep,

If I closed up the bar at 2am and went to work at 7am I would have considered that "the night before".

Duckie,

He had two warnings. The car wreck,were I'm assuming that he lost his transportation and the warning from you.

Then he lost his job, so make that three. I suppose there have been more "signs" that he might be going down the crapper before and after these incidents.

Remorse comes long before you hit the bottom and it is felt by everyone around you before you can feel it.

Doesn't sound like he feels it yet, so maybe you helped push him towards it.

A drunk driver caused me to break 3 vertebrae two years ago and I still have back pain every minute of every day!

My patients mean too much to me to risk their safety to some drunk!

If it was that noticeable that you had to back up then you need to go find someone in administration and tell them to do something about it. If they let the person stay then I would write a complaint to them and I'd keep a copy for myself and I'd be looking for a new job ASAP... Let a few family members get wind of the drunk and complain to admin, then I bet they do something. You know if that aid hurts someone, administration will say they knew nothing and that you should've reported it to them... They will try to hang you just to save themselves.

Specializes in Trauma acute surgery, surgical ICU, PACU.

I agree with all the comments about helping this person get help and support that he needs.... but this is work, and patient safety comes first. This person needs to leave the workplace ASAP... his illness and getting treatment is a secondary concern.

Making this person leave the workplace is the start of getting them the help they need!

No bleeding heart here.

Peeps has the good stuff here.

The CNA needs caring confrontation with mandatory referral to the facilities EAP (Employee Assistance Program) or, if applicable, state nursing assistance program. The CNA is subject to firing if he doesn't do the follow through OR follow their recommendations.

Nurses are very enabling and that is why we find it so hard to do this confrontation. We're not "sure". It could be something else. Much like child abuse reporting, you don't have to investigate your concerns, you just have to have a reasonable concern in order to report. The person who investigates it DOES need to be able to think broadly about possible other causes but if it looks like a zebra and smells like a zebra, it's probably a zebra.

Effective confrontation starts to break through the denial of addiction. As long as an addict is effectively enabled (ignored, excused, covered for), he or she can believe that what they are doing isn't impacting anyone. Confrontation starts to break through this respectfully but firmly.

Tough when admin isn't on board for any of this.

In my state CNA's are certifiied by the Department of Health and Environment. I would go to my employer and tell them they have 7 (you pick the number) days to refer this CNA appropriately or I'm going to the agency that licenses them. I WOULD definitely check with my state nursing association about whistle blower protection. The Employer is accountable for turning a blind eye to this CNA's problem.

Just a note why the employer should stay a little invested in this guy or gal. When an impaired employee is coming to work, he endangers patients, the agency for which he works and, of course, him or herself. It's a crisis for everyone. However, research has shown that adult addicts can be powerfully influenced in their recovery process if they have a reason to get straight: a job, a marriage, a relationship. Especially if this person is a long term employee, the facility needs to stand by him or her. It's the right thing to do. But his job must genuinely be "in jeopardy" and there needs to be a mechanism for reporting compliance with the treatment program. That's what makes professional assistance programs so nice. But I'm not sure professional assistance programs extend to CNA's, for better or worse.

Great comments Molly,,, I was going to state most of those but u beat me to the punch!.. I did an intervetion on a contract CNA in our hocpital, we smelled alchol on this breath... called the supervising agency, and he left to straight to provide a sample, as we say

I had a similar, but worse situation when a doc came in on a weekend "plastered." He started rambling orders that made no sense, and were potentially harmful. I had the Unit Service Coordinator call the nursing supervisor in our hospital to come check it out. (I used to work at TGIFridays, so I can ID a drunk fairly well......)

The supervisor requested the doc go to ER. He refused. She requested he go to the lounge and sleep it off while she called a cab for him. Again, he refused. We called security and had him escorted off the unit. The police were called, and so was the hospital administration. We ended up having to call his partner at home to explain that the doc wasn't able to give orders and have him work with the patients for the rest of the weekend.

The whole situation wasn't only dangerous, but embarassing for all the staff and the hospital as it was prime visiting time on a Sunday and family members all over the unit knew what was going on and that the man was a doc.

We haven't seen that doctor in a few months. The grapevine tells us he's been suspended from practicing at our hospital, and has hearings pending in several others.

:eek: :sniff: :uhoh21:

Specializes in Geriatrics, LTC.

Anyone of question should be off the floor. And then sent for or asissted in getting help, whether it is testing to prove it isn't drugs and alcohol or just plain old help to stop the substance abuse. My brother was killed by a drunk driver, I have no tolerance for endangering lives.

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