Checklist: Characteristics of an Impaired Nurse
Does your employee demonstrate the following characteristics? Check those that best describe the current situation.
I. Current Behavioral Patterns
Employee’s appearance
sloppyinappropriate clothing
Mood
withdrawnsad
mood swings, high and low
suspiciousness
extreme sensitivity
nervousness
frequent irritability with others
preoccupation with illness and death (morbidity)
Actions
physically assaultive (or threatening)unduly talkative
exaggerated self-importance
rigidity — inability to change plans with reasonable ease
making incoherent or irrelevant statements on the job
overcompliance with any routine (making it a ritual)
frequent argumentativeness
frequent outbursts of crying
excessive amount of personal telephone time
II. Job Performance
Absenteeism
multiple instances of improper reporting of time offexcessive sick leave
repeated absences following a pattern (Monday/Fridays)
excessive lateness in the morning or upon returning for lunch
peculiar and increasingly improbable excuses for absences
high absenteeism rate for colds, flu, gastritis, general malaise, etc.
frequent unscheduled short-term absences (with or without medical explanation)
frequent use of unscheduled vacation time
"On the Job" Absenteeism
continued absence from job location more than job requiredfrequent trips to water fountain or restroom
long coffee breaks
Accidents
physical complaints on the jobaccidents on the job
accidents off the job
Work Patterns and Production
current work assignment requires more effort than previously takenwork takes more time to produce
difficulty in recalling instructions, understanding office procedures, etc.
display of disinterest in work
increased difficulty in handling complex assignments
difficulty in recalling previous mistakes (although these have been brought to the employee’s attention)
general absentmindedness, forgetfulness
alternate periods of high and low productivity
coming to work in an intoxicated condition
missed deadlines
mistakes due to poor judgment
outside complaints about the employee’s work
improbable excuses for these poor patterns
carelessness
Employee Relations on the Job
overreaction to real or imagined criticismwide swings in job morale
borrowing money from co-workers
unreasonable resentments against co-workers
repeated and compulsive criticism of the company
persistent requests for job transfer
unrealistic expectation for promotion
abrasiveness with others (managers and/or co-workers)
Work Related Relationships in the Company
inappropriate behavior at company business meetingscomplaints from the community concerning the employee
III. Other
Things to look for:
illogical or sloppy chartingwears long sleeves at all times
comes to work early and stays late for no reason — hangs around
isolated; wants to work night shifts; lunches alone; avoids informal staff get-togethers
elaborate excuses for behavior such as being late for work
blackouts; complete memory loss for events, conversations, phone calls to colleagues; euphoric recall of events on the floor
calls in to request compensatory time at the beginning of the shift
Suspicious Behavior Concerning Controlled Drugs
consistently signs out more controlled drugs than anyone elsefrequently breaks or spills drugs
purposely waits until alone to open narcotics cabinet
consistently volunteers to be med nurse
vials appear altered
incorrect narcotic count
discrepancies between patients’ reports and other patients’ reports on effective medications, etc.
patient complains that pain medications dispensed by this nurse are ineffective
defensive when questioned about medication errors
too many medication errors
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