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Reporting suspected impaired practice or narcotic diversion in the workplace

Case study about duty to report

Nursing is demanding work, in which impairment could result in direct and significant risk of injury to clients.

If you have concerns that a colleague is impaired at work, you have legal and ethical reporting responsibilities. Early recognition, reporting and intervention are crucial for client safety and helping colleagues recover.

A nurse, practice concerns, and risks for clients

A nurse struggles

​Kelsey isn't sure how she got to this point. After a difficult separation, and then a car accident, she began taking narcotics prescribed by her doctor for a back injury. When her prescription ran out, she began using narcotics from her workplace that should have been wasted. Now, Kelsey is taking (diverting) narcotics intended for clients. Keep reading»

A colleague acts

Justin is working with Kelsey for the first time in a few months, and he’s worried about the changes he sees in her. He knows Kelsey’s been dealing with a lot—a marriage breakup and a significant back injury—but her behaviour during the shifts makes him concerned for client safety.  Justin's not sure what to do. He doesn’t want to make an allegation without proof or cause Kelsey to lose her job. But he knows he has a responsibility to ensure the safety of clients by reporting Kelsey’s behaviours to his manager. Keep reading»




A manager reports

Ranjeet knows her first duty is to protect clients by making sure staff are providing safe care. Given the safety implications from the health record audit and Kelsey's observed behaviour, Ranjeet knows she will need to put Kelsey on leave while she investigates. She sets up an immediate meeting with Kelsey, her union representative, and a human resource liaison to review the concerns. During the meeting, Kelsey asks for a medical leave. Keep reading»

What are your thoughts?

  • Have you ever found yourself in this situation?
  • What would you do if you observed behaviour like this in a colleague?

Reporting to BCCNM: your responsibilities

BCCNM can only act when we receive a report. Keep reading»

What happened to Kelsey?

After we shared this case study in our newsletter, we heard from a number of people who wondered: What happened to Kelsey? Keep reading»

Thank you to National Council of State Boards of Nursing for permission to adapt some of their materials.