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Reporting suspected impaired practice or narcotic diversion in the workplace

Case study about duty to report

Nursing is demanding work, in which impairment could result in direct and significant risk of injury to patients.

Health care professionals who have concerns that a colleague is impaired at work have legal and ethical reporting responsibilities. Early recognition, reporting and intervention are crucial for patient safety and helping colleagues recover.

A nurse, practice concerns, and risks for patients

A nurse struggles

Kelsey isn't sure how she got to this point. After a difficult separation, and then a car accident, she began taking narcotics prescribed by her physician for a back injury. When her prescription ran out, she began using narcotics from her workplace that should have been discarded (wasted). Now, Kelsey is taking (diverting) narcotics intended for patients, and attempting to conceal this diversion from her colleagues and supervisors. Keep reading »

A colleague acts

Justin has worked with Kelsey for the first time in a few months, and he’s worried about the changes he sees in his colleague. He knows Kelsey’s been dealing with a lot—a marriage breakup and a significant back injury—but Kelsey’s behaviour during the shifts makes him concerned for patient safety.  Justin's not sure what to do. He doesn’t want to make an allegation without proof or cause his colleague to lose her job. But he also knows he has a responsibility to ensure the safety of patients by reporting Kelsey’s behaviours to his manager. Keep reading »

A manager reports

Ranjeet knows her first duty is to protect patients by making sure staff are providing safe care. Given the safety implications of the concerns from the health record audit and observed behaviour, Ranjeet knows she will need to put Kelsey on leave while she investigates. She sets up an immediate meeting with Kelsey, her union representative, and a human resource liaison to review the concerns. During the meeting, Kelsey requests a medical leave. Keep reading »

What are your thoughts?

  • Have you ever found yourself in this situation?
  • What would you do if you observed behaviour like this in a colleague?

Reporting to CRNBC: your responsibilities

CRNBC can only act when we receive a report. Keep reading »

What happened to Kelsey?

After we shared this case study in our September 2017 newsletter, we heard from a number of people who wondered: What happened to Kelsey? Keep reading >>.

Thank you to National Council of State Boards of Nursing for permission to adapt some of their materials.

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