How to confront one of your colleagues
You have a personal and professional responsibility to intervene if you suspect a colleague is abusing drugs, urges Liz Jazwiec, RN, a Crestwood, IL-based consultant specializing in staffing issues. "We all need to look out for each other," she stresses. "You will notice signs of substance abuse in a peer well before a manager will, because you work so closely together. Also, chances are if a nurse has a problem, they will mask it around a supervisor."
Here are some things to consider when intervening with a colleague:
• Don’t accuse.
Describe behavior instead of being accusing, advises Jill Pollock, RN, executive director for critical care and emergency services nursing at Loma Linda (CA) University Medical Center and Children’s Hospital.
"Approach it from the point of view of being really concerned," Pollock advises. "Point out a few behaviors you notice. Say something along the lines of, I’ve noticed you are so different; [you] used to be bubbly and happy, and now it seems like any little thing sets you off. Is there something I can do for you? Is there something that you need?’"
Typically a confronted colleague will give you excuses, but be persistent if you suspect abuse, advises Pollock. "The nurse may insist, I’m just having a tough time at home’" she says. "But if the staff nurse continues to see progressive behaviors, such as being gone for an hour at a time, people need to look at what is causing this person to be irritable."
• Expect impaired nurses to deny the problem.
"I’ve confronted many nurses about substance abuse, and almost all of them deny it. Very few have broken down and cried and admitted they need help, but that is a rarity," says Pollock.
"They deny it because they are so fearful that you are taking away their lifeline. They believe if they admit the problem, their life as they know it is over. "Understand that you could be saving a life, Pollock says. "Most nurses say, What if I falsely accused them?’ But you need to consider what happens when they continue to use drugs," she urges. "It could result in the loss of their life or a patient’s life."
• Intervene early.
"It’s very appropriate to ask people we care about if there is a problem," says Jazwiec. "There’s nothing wrong with having a frank conversation with that person and asking if they need help. You should do this as soon as you notice a problem."
"Early in my career, we terminated a nurse after a long period of time due to substance abuse," she says. "Six months later, the nurse came in as a DOA. That taught me that in that case, I was probably too understanding and too easy in the beginning and certainly didn’t help matters by looking away."
• Don’t diagnose your colleague.
"Don’t label or diagnose their colleague, because you really don’t know what the problem is," says Madeline Naegle, RN, CS, PhD, FAAN, associate professor in the division of nursing at New York University in New York City. "Never implicate someone or say they’re using drugs, because it’s not helpful to the situation. The best thing to do is identify a specific performance problem. Then the supervisor can refer this person to an employee assistance program or health service."
• Refer the colleague for help.
"If you don’t intervene, the nurse will just go downhill and get sicker and you could lose a friend and colleague," says Naegle. "Suggest the person seek help from peer assistance program or on their own. Let them know it’s really important to do something to improve their job performance."
• Be positive.
"Nurses may think they can’t get well, but remind them that research has shown that health care providers do better in treatment than other people," Naegle explains.
• Don’t hesitate to go to a supervisor.
"If you’re not comfortable approaching the nurse directly, go to a supervisor and let them know what you’ve been observing," Jazwiec advises. "Say, I’m just concerned. She seems to get secretive or funny when dispensing meds, and that’s not how she used to be.’"
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