When to Refer
What to Consider
If a nurse’s performance is suggestive of a Substance Use Disorder consider the following information:
- Review your facility’s policies and procedures before initiating action unless patients and/or staff are in imminent danger*
- Use your facility chain of command in addressing the issue
- If drug screening is requested, assure adherence to strict chain of custody protocols
- Use the 5 W’s Test in organizing your thoughts
- Who made the complaint? (i.e. Patient, Family, Peers, Colleagues)
- What is the nature of the complaint? (Under medicating, Documentation discrepancies, Excessive wasting patterns, Impaired on duty)
- Where is the location of the incident?
- When did the event occur?
- Why did the events occur? (Possible motivations, Causes)
Referrals should be made to the Board of Nursing when any one of the following situations arise:
- Positive pre-employment drug screens
- Positive results on a “for-cause” drug screen
- Signs and symptoms of impairment including the smell of alcohol on the breath, regardless of whether or not the impairment is alleged to be as a result of the nurse’s own prescription meds
- Reports of excessive use of controlled substances, increased wastage, sloppy or careless wasting, consistent failure to follow facility policies for wasting controlled substances, documentation discrepancies, manipulation of medication dispensing systems
- Any time there is a violation of the Nursing Practice Act
When in doubt, you may call the Board at (919) 782-3211 ext. 271 for further consultation.