The impaired nurse. Part II: Management strategies.

The perioperative nurse manager faces an ethical dilemma when faced with an impaired colleague. An effort to support impaired practitioners and to ensure patient safety and quality of care seem incompatible. To facilitate both, violations of the state nurse practice act must be reported, and the employee terminated if your documentation is adequate and treatment options you offer are not pursued. This harsh approach is necessary when the impaired practitioner puts patient care at risk. Kindness promotes chemical dependency, and the harsh action may be the only event that breaks through the denial. Fifteen percent of impaired practitioners who receive coordinated, supportive, and confrontational management are not motivated to seek treatment. Nurses must remember, however, that the remaining 85% respond positively to an established and comprehensive chemical dependency policy. Defined decision-making strategies concerning chemical dependency at the state and local level motivate practitioners to seek treatment to avoid licensure action. Perioperative nurses must meet the challenge to effectively manage chemical dependency. Employing recovering nurses in a structured framework is creative resource management. The ability to conserve talented and skilled practitioners preserves the nurturing strength of nurses and increases professional cohesion.