A nurse suspects a colleague is coming to work under the influence of alcohol. What is the most appropriate action?

IMPAIRED HEALTHCARE PROVIDER reporting is both a professional obligation and an ethical duty. The consequences of an impaired nurse providing care can include: medication errors (calculation errors, administering wrong drugs); falls and inadequate supervision; failure to recognize patient deterioration; direct patient harm.

Correct response: (1) REPORT IMMEDIATELY to the charge nurse/supervisor — this is not a betrayal; it is protection of patients, the colleague, and the profession; (2) DOCUMENT OBSERVATIONS objectively and factually: what specific behaviors were observed (slurred speech, unsteady gait, odor of alcohol, confusion); time and date; who else witnessed; avoid interpretation or judgment in documentation; (3) DO NOT MANAGE THE COLLEAGUE'S PATIENTS ALONE without reporting — the supervisor must be involved.

Why reporting matters: (1) PATIENT SAFETY — the primary obligation; (2) COLLEAGUE PROTECTION — early intervention can lead to treatment and recovery before career-ending consequences; (3) LICENSE PROTECTION — failure to report a known impaired provider can expose the reporting nurse to liability; (4) PROFESSIONAL OBLIGATION — the ANA Code of Ethics and most state nurse practice acts require reporting. NURSE ASSISTANCE PROGRAMS (NAPs) / PEER ASSISTANCE PROGRAMS: Available in most states; designed specifically for nurses with substance use disorders; allow nurses to seek treatment while maintaining licensure under monitoring agreements; alternatives to immediate license revocation.

Confrontation: Should not be done alone, in patient care areas, or in a way that embarrasses the colleague — the supervisor handles the confrontation professionally.