GUEST COLUMN
Plan for dealing with an impaired colleague
By Colleen Bock-Laudenslager, RN, MS
Bock-Laudenslager and Associates
Redlands, CA
If a colleague is demonstrating behavior that indicates impairment, dare to care! Concerning patterns may include: irrational thought processes, frequent medication errors, poor clinical judgment, tardiness, absenteeism, blaming others, mood swings, including withdrawal, and depression.
Recognize that the typical profile of an ED nurse makes us so vulnerable to impairment issues: the adrenaline rush, the caffeine infusions, the rollerblade work style, and working at more than two workplaces for the extra cash.
If you don’t dare to care, then be aware as a nursing professional you are obligated to care. The Code for Nurses from the Washington, DC-based American Nurses Association suggests we are required to safeguard clients when health care is affected by incompetent, unethical, or illegal practice. Failure to adhere to the code of nurses places us in a position of censure, reprimand, and expulsion from a state’s nursing organization.
The clinical nurse has a moral and ethical responsibility to report behavior that suggests impairment and a threat to the well-being of clients/patients. Critically observe the behavioral nuances of impaired colleagues, but reserve judgment. Listen to those peers. What are they trying to tell you? What are they trying to hide? Feel their sadness, and interact in a sensitive, professional manner. Consider these other suggestions:
• Shake and shout.
Denial is often the natural reaction with an impaired colleague. If you are aware of impairment issues with a peer, do something! When a nurse I worked with was showing signs of impairment, he offered me only a glimpse. I was too afraid it was none of my business, and I was afraid I wouldn’t sustain healthy boundaries in the workplace. I did keep checking in to ask, "Are you OK?" But when he said yes, I took it as the correct answer. My gut told me otherwise.
If you dare to care and you are considering a confrontation of an impaired colleague, consult the impairment experts at your facility or your nurse management team. Remember, as nurses cozy with the caregiving role, we often enable our colleagues. It is so easy to be part of the tremendous emotional dysfunction and not report behavior truly unacceptable or concerning. Somehow our needs get wrapped up in their needs. It is at this point we are no longer helping them. Refer your colleague to the proper place for help. Set aside your role of chief counselor and problem solver. Encourage the peer to seek help from the institution’s employee assistance program or counseling center.
• Maintain the integrity of the airway.
If you have the opportunity to minister to a colleague in a healthy dare-to-care way, keep the information to yourself. Talking about others creates a negative environment, especially concerning such sensitive subject matter. Don’t gossip or discuss the peer’s behavior with your colleagues. The end result is damaging and serves no purpose.
Talking about others creates triangles within a work unit and enhances tension and work distrust. If your impaired peers are open with you about their stories, create an environment of trust whereby baring their souls creates no risk for them. Keep your mouth shut to those not part of the confrontation team.
I challenge the readers of this publication: If you or someone you know suffers from a substance, process, or relationship addiction, first know that there is hope. I encourage you to deal openly and honestly with these most difficult issues. Our addictions are killing us — both personally and professionally. Acknowledging our weakness may reflect strength. Allowing ourselves to be vulnerable to others offers us a clearer option of choosing to live.
Source
For more information about confronting a colleague with a substance abuse problem, contact the following:
• Colleen Bock-Laudenslager, RN, MS, P.O. Box 7303, Redlands, CA 92375. Telephone: (909) 798-4969.
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