RN impaired at work

Nurses General Nursing

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I work at a small hospital with an RN with 20+ years seniority on the floor. From what I've heard, she's been reported and suspended numerous times for showing up intoxicated at work. She consistently leaves the floor for an hour or more at a time, rarely is in her patients rooms, does not give her medications on time or at all, etc. managers like her because she fills in 4 hour holes when they need coverage. This morning she showed up slurring her words, swearing loudly and overall belligerent. I reported it to the nurse supervisor who, along with our manager, came to "assess", FOUR hours later. Both coming to the conclusion she was perfectly fine. I'm being made to feel guilty and am completely discouraged and disheartened by the whole situation. She needs help, and her patients are not safe if she is impaired. Any advice?

Specializes in CMSRN.

I remember one case just like that, this was in the ED. A nurse pulled two Vicodin tablets, RIGHT IN FRONT of me she popped one in her mouth, put the other in a med cup, and per the Pyxis, she gave the patient two tablets. She was so used to doing it that she didn't even think twice about it anymore. The more they do it the more at ease they are doing it in the future.

Clearly, I stopped her dead in her tracks. She left the hospital in handcuffs that day.

Wow! I can't imagine being in so deep that it would become that blatant. That blows my mind. 😳

Specializes in Family Nurse Practitioner.

Little hospitals are known for not making a fuss out of things, they don't want it to get around that the incident happened and they don't want to lose a 20 year vet. Sad, yet many times true.

Thats crazy. I also wonder why the OP and other staff haven't notified the board of nursing if it is as presented?

Specializes in Hospice.

I can't get past the fact that we're reading a second-hand version of one side of the story. It seems pretty unlikely that facility gossip reflects a totally accurate version of events.

I agree with the advice to hold your water unless you are a direct witness. Then, if the facility doesn't address the issue - contact the BON.

Wow! I can't imagine being in so deep that it would become that blatant. That blows my mind. ������

I don't think I ever had any concept of how often it happens until it was my job to pull the reports. At first I really felt bad for these nurses, they had a serious problem but when their coworkers describe the pain their patients are in but just during that nurse's shift, you quickly lose sympathy.

You know who is really hard to catch are the anesthesiologists! They have a different type of set up and access. And the thing that really chaps my hide is that a hospital will have a nurse arrested for stealing narcotics but an anesthesiologist... many times it is just forgotten and nobody is to discuss it again, it was an error in judgement in the case of a doctor.

I can't get past the fact that we're reading a second-hand version of one side of the story. It seems pretty unlikely that facility gossip reflects a totally accurate version of events.

I agree with the advice to hold your water unless you are a direct witness. Then, if the facility doesn't address the issue - contact the BON.

Maybe I read it wrong but my take on the post was that the OP did indeed witness the event AND she's "heard" this isn't the first time.

Specializes in Registered Nurse.

I will just answer as if this is all true and accurate....

I'd say she may just be acting strangely but not intoxicated. No real proof as to if she was. At least you reported it, and they did "assess" her. If it happens and you suspect she is intoxicated, report it *again*...and so on.

When I was a brand new nurse many moons ago in my first year of hospital nursing, I reported a float pool nurse for smelling "like" alcohol to a RN in charge (I was a LPN), and they said, "maybe she had some cough medicine," but I am not sure what she actually did about it, if anything. I really only worked with her maybe one more time and she must have quit, retired, or got fired.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Thats crazy. I also wonder why the OP and other staff haven't notified the board of nursing if it is as presented?

Unless the OP is the manager, it really isn't up to her to notify the board of nursing.

The OP's role is to report to her manager what she personally has observed, without hearsay, gossip or opinions. "I observed Nurse Nancy slurring her speech and stumbling," not "Nurse Nancy came in to work drunk." Nancy could be having issues with controlling her blood sugar, or she could be having a TIA. It's up to the manager to investigate further and put Nancy on Medical leave, administrative leave, fire her, encourage her to resign and notify the board if that is required.

I noticed the nurse slurring her words, stumbling, stuttering and yelling "I'm so ******* tired today!" at the nurses station in front of patients and visitors (Which she repeated four times until someone told her to stop). I happen to have been out with her socially and have seen her intoxicated, and she was acting similarly. What I said to the supervisor was "I noticed that RN was slurring her words this morning and I'm concerned she may not be in the correct state to be caring for patients. Could you come and assess?". I always learned to report any staff you suspect being unfit for duty. Another staff member who knows the nurse personally has said she has a problem with alcohol, has been reprimanded before, and that she has seen her drink from an alcohol bottle in her car immediately after the end of the shift. Never did I mention or even bring up what I, too, would consider heresay. I reported only what I observed.

Specializes in MICU, SICU, CICU.

The employer has a duty to treat an incident such as this as a confidential health matter and so do you.

You should only discuss this with the nursing administrator and HR rep.

An employee going through an investigation or treatment has a right to privacy.

If the gossiping starts you have to find the words to shut it down.

If you do engage in gossip the management will not be impressed.

I happen to have been out with her socially and have seen her intoxicated, and she was acting similarly.

Acting similar and acting the same are two different things. Maybe she WAS just exhausted. You have no idea what this person has going at home. Maybe she's doing complete care for an older parent who kept her up all night. I'm not making excuse for her. If she's impaired then it needs to be dealt with. But I wonder if you hadn't heard the gossip about this person, would this incident have stood out as much or were you just looking for something?

Specializes in Oncology; medical specialty website.
The employer has a duty to treat an such as this incident as a confidential health matter and so do you.

You should only discuss this with the nursing administrator and HR rep.

An employee going through an investigation or treatment has a right to privacy.

If the gossiping starts you have to find the words to shut it down.

If you do engage in gossip the management will not be impressed.

That would include not discussing it here, since time and again, people here have been "outed" at work for what they've said here.

You fulfilled your obligation to your employer. Allow them to take it from here, and allow this nurse to have the privacy she deserves. You may not like or disapprove of her actions, but she is still a fellow nurse and deserves the same confidentiality you would accord a patient.

I noticed the nurse slurring her words, stumbling, stuttering and yelling "I'm so ******* tired today!" at the nurses station in front of patients and visitors (Which she repeated four times until someone told her to stop). I happen to have been out with her socially and have seen her intoxicated, and she was acting similarly. What I said to the supervisor was "I noticed that RN was slurring her words this morning and I'm concerned she may not be in the correct state to be caring for patients. Could you come and assess?". I always learned to report any staff you suspect being unfit for duty. Another staff member who knows the nurse personally has said she has a problem with alcohol, has been reprimanded before, and that she has seen her drink from an alcohol bottle in her car immediately after the end of the shift. Never did I mention or even bring up what I, too, would consider heresay. I reported only what I observed.

And it would be on the charge nurse not to say, "could we talk in the other room for a moment" if the nurse was swearing, slurring, whatever-ing in full view of patients and visitors.

If you go out socially, people are known to drink alcohol. And yes, I can imagine at some point someone is intoxicated. But going out and work are 2 different things.

That "someone who knows her personally" said she has a "problem with alcohol" is just gossip. We do NOT know what our personal friend's troubles may be. It is an assumption.

And the alcohol that was drinking in her car (which is troubling in that she was driving--but no one thought to call the cops) was AFTER her shift.

No one really has any idea what ails this nurse. And I can not stress enough that for everyone to keep on adding fuel to the fire is wrong on a number of levels.

What would happen if next week, you become the enabler and beer buddy who goes out socially with this person, and stands by and just watches her make poor choices? And everyone just continues to gossip and carry on. And then the week after that you are any number of other issues that make you a poor nurse.....

And wouldn't ya'll feel horrible if in fact this nurse is a diabetic? Or has a mental illness?

And yet, your charge nurse did nothing about this? And allowed it to continue so ya'll could gossip and speculate even more?

Again, no one has any clue what ails this nurse. However, any intervention to minimize the impact of her behavior was not immediately employed. And in fact, she was allowed to work for the entire shift before management came in. There is something just so wrong about that, as well.

And equally as interesting, let's let the new nurse make the complaint....then when the chips fall, it will fall on her. Awesome. Just what you need is to be sued for slander.

Get , take your observations to your charge nurse. If patient harm, then pursue it more diligently. But be very, very careful on your assumptions.

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