Your co-worker has come to duty in an intoxicated form . This is the 3 times he is doing this in a single month as a principle of safety for the pt. What will be your best action regarding this incident along with preserving the dignity of your co - worker ? .

1. A

   Directly confront co-worker. / realise his behaviour

2. B

   Raise safety concern in general meeting

3. C

   Ignore the co-worker behaviour and watch for pt. safety under his care

4. D

   Report the incident to the supervisor.

Appeared in: NORCET 10 Mains

Explanation

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• The nurse's primary ethical and legal obligation is to ensure patient safety, which supersedes all other concerns.
• Reporting an impaired colleague to a supervisor follows the correct chain of command, which is the standard procedure in healthcare settings.
• This action ensures that the impaired nurse is removed from patient care, immediately mitigating the risk of harm.
• Reporting to management allows the situation to be handled formally and confidentially, which can facilitate getting the co-worker the necessary help while protecting patients.

Why Other Options Were Wrong

• Option A: Direct confrontation with an intoxicated person is often ineffective and can escalate the situation. It does not guarantee the immediate removal of the safety threat to patients.
• Option B: A general meeting is the wrong forum for a specific, urgent, and confidential personnel issue. It breaches confidentiality and does not provide an immediate solution.
• Option C: Ignoring the behavior is professional negligence. It knowingly allows patients to be exposed to potential harm, which is a serious breach of nursing ethics and standards of care.

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Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Professional responsibility and ethics in nursing as background academic context rather than a clinical decision trigger.
• Nurses have a legal and ethical 'duty to report' colleagues whose behavior is impaired and poses a threat to public safety. Failure to do so can result in disciplinary action against the reporting nurse's license.
• Healthcare institutions have policies and employee assistance programs (EAPs) to manage impaired professionals. Reporting is the first step to activating this support system.
• What if you only suspect a co-worker is impaired but are not 100% sure? The correct action is still to report your specific, objective observations (e.g., 'I smelled alcohol on their breath,' 'their speech was slurred') to your supervisor. It is the supervisor's responsibility to investigate, not yours to make a definitive diagnosis.

How to Approach the Question

• First, identify the core issue in the scenario: an intoxicated nurse on duty, which is a critical patient safety risk.
• Next, analyze the question's primary goal: find the 'best action' that prioritizes patient safety while also considering the co-worker's dignity.
• Evaluate each option against the principle of patient safety. Does the action immediately remove the threat to patients?
• Eliminate options that are unsafe, unprofessional, or ineffective. Ignoring the problem (C) is negligent. Raising it in a general meeting (B) is inappropriate and slow. Confronting an intoxicated person (A) is unreliable and potentially risky.
• Select the option that aligns with professional standards and the chain of command. Reporting to a supervisor (D) is the correct procedure that ensures safety and initiates a formal, confidential response.

Concept Tested & Keywords

• Concept Tested: Professional responsibility and ethics in nursing.
• Stem keywords: co-worker, intoxicated, duty, patient safety, best action
• Lead-in keywords: best action
• Clinical cues: The behavior is repetitive (3rd time in a month), indicating a pattern that requires formal intervention.

Question ID

Q0MawkSQDESfbUwZbUoNnb

Copy ID

Reference Book

E6 Pharmacology Nursing Lilley 11e Part 1 p. 84-86

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 8727-8729