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facilities policy and procedure) • Document the behaviors, times, witnesses, and outcomes • Report your suspicions to your supervisor and if applicable to the appropriate reporting agency Approaching your colleague in a safe place and caring manner, may be the impetus he/she needs to admit the problem and ask for help. It is important to understand, that the colleague may be defensive or angry; therefore, a non-confrontational stance and willingness to help may help defuse the situation. Specific examples of suspected behavior and respect for prior practice will help you demonstrate that you are not making judgements. In Florida, you have the responsibility to call the Florida Department of Health or the Intervention Project for Nurses (IPN). If you determine your colleague is already in a treatment program, then you can call a trained substance use disorder professional. If you have or think you have a substance use disorder, call the IPN for a confidential consultation. IPN can be reached by calling 800-840-2710. If your institution has an Employee Assistance Program, call them. Test Your Knowledge You notice that Sandy, an experienced, well respected nurse in the ICU has been making medication errors and that she appears to be really exhausted lately. You know she has had some medical issues in the past and want to believe that this might be the case. However, you know that at least one of the medication errors had the potential to cause serious harm to the patient if it had reached the patient. What do you do? A. Tell your supervisor that Sandy has a substance use disorder B. Approach Sandy in the middle of the unit and ask her if she is taking drugs C. Tell your colleagues not to ask Sandy for help because she can’t handle it D. Talk to Sandy in a quiet, safe place about the errors you have seen and ask her if there is an explanation Rationale: What are your responsibilities? • Know the signs and symptoms of impaired behavior • Know the factors that put healthcare workers at risk for impairment • Know the reporting laws in your state • Know your facilities policies and procedures • Approach the healthcare worker and ask about the behavior (if within your facilities policy and procedure) • Document the behaviors, times, witnesses, and outcomes • Report your suspicions to your supervisor and if applicable to the appropriate reporting agency Approaching your colleague in a safe place and caring manner, may be the impetus he/she needs to admit the problem and ask for help. It is important to understand, that the colleague may be defensive or angry; therefore, a non-confrontational stance and willingness to help may help defuse the situation. Specific examples of suspected behavior and respect for prior practice will help you demonstrate that you are not making judgements. Self-reporting a substance use disorder may reduce the healthcare workers’ risk of disciplinary action under Florida Statute 456, Section 076. Implementation of alternative-to-discipline programs has reduced the incidence of discipline to those individuals who do not participate or fail to complete the programs. Barriers to Self-Reporting Participation in treatment programs has been associated with positive outcomes; however, it is necessary for the person with a substance use disorder to enter the program. Barriers to treatment such as individual characteristics, lifestyle elements, and system factors, often make taking the step to treatment difficult. Rarely do healthcare workers seek help on their own because of fear, embarrassment, and concerns over losing their nursing license (Cares et al., 2015). Barriers include: • Not wanting the spouse/family to know about the substance use disorder • Wanting to solve the issue on my own • Lack of insurance or funding for treatment • Fear of treatment • Bad treatment experiences • Aversion to specific treatment practices • Embarrassment • Denial that a problem exists • Too ill to seek assistance • Concerned about losing licensure Employer Initiatives It is tantamount to excellence in healthcare that employers understand substance use disorders in the workplace. Substance use disorder is treatable, particularly when it is addressed as a chronic disease. Reducing
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