THE IMPAIRED INDIVIDUAL

1. THE IMPAIREDINDIVIDUAL Recognition of the Signs and Symptoms of the Impaired Individual

2. Impairment can be defined as the inability to practice or perform a job with reasonable skill. Impairment can be caused by a physical or mental illness, including deterioration through the aging process, or excessive use or abuse of drugs including alcohol.

3. The Impaired Individual • Impairment affects people regardless of age, size, race or sex • Impairment might be the result of drug or alcohol use and/or abuse • Impairment may be caused by the aging process where the person loses ability to perform tasks or use reasoning processes effectively • Impairment could be temporary or permanent

4. Who might be impaired? • Students • Graduates of professional schools; such as, Pharmacists, Doctors, Nurses, Physical Therapists • Transporters, Unit Secretaries, EVS Workers • Bottom Line --- any one of us can be impaired

5. Reasons for Impairment • Physical Reasons • A change in physical condition • Surgery or the diagnosis of a potentially fatal illness • Pain and use of pain medication • Social Reasons • Availability of drugs (legal or illegal) to an individual during a time when he or she might be vulnerable to their use • Social or peer pressure • Emotional Reasons • Severe clinical depression may accompany major losses incurred during separations, divorces or the illness or death of a loved one • People under stress for any reason could be impaired

6. Reasons for Impairment, Cont’d • Job Related Stress • Being named in a lawsuit • Opening a new program • Being involved in a sentinel event • Working more than 1 job or “moonlighting” • Other Considerations • Stressors may also include being in the “sandwich generation”, needing to attend to the needs of children and parents and not being able to “keep up” • People under stress for any reason could be impaired • The staff member may begin to use, abuse or become addicted to alcohol, prescription drugs or illegal “recreational” drugs

7. Behaviors that might indicate an impaired colleague can include: • Periods of unavailability when on call or on duty • Accidents, errors, or unusual interactions with patients, students, residents or coworkers stealing medications • Impaired judgment • Change in appearance and/or personality • Mood changes • Inappropriate anger • Aggression • Cries easily

8. Staff Interpretation of Signs and Symptoms • Often staff will notice signs or symptoms that a colleague is demonstrating odd behavior, but say to themselves “I am not really sure” or “I don’t want to get him/her in trouble.” • Because many individuals take pains to hide their symptoms from other staff, by the time symptoms are realized in the work place, the individual is often already “in trouble”, but unable to seek help.

9. Intervention with the Impaired Individual • Once concerns about a staff’s performance are identified, intervention becomes critical. • The most important goal is to prevent harm to patients and other staff. • Carebridge, GBMC’s Employee Assistance Program (EAP) exists to provide an opportunity for employees who are experiencing personal, emotional or substance abuse problems to obtain professional assistance. • EAP is only one option for an impaired colleague to use. There are many other forms of help available. The earlier help is offered, the better the chances of that help being utilized by the staff member.

10. Treatment Works • Doctors, Psychologists and Nurses, among other professions, have rehabilitation programs for impaired or potentially impaired staff. • The goals of these programs are to aid in retaining or regaining optimal professional functioning consistent with protection of patients. • Many treatment programs are available to non-professional staff.

11. When you see behavior you believe is impaired in the work setting: • Notify your supervisor (if he/she is not immediately available, then call for another manager or the Administrative Coordinator) • Be prepared to document for your supervisor the date, time, location and circumstance of the behavior as well as a description of the impaired behavior itself.

12. Final Thoughts…….. • Help your colleague: • Protect our patients • Help insure your safety Discuss your observations with a Supervisor, your Department Chair or the Chief of Staff when you have concerns.