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Impaired Healthcare?

I think most people would agree that it’s not a good idea if a person goes into work drunk. An individual who’s drunk on the job has the potential of causing injury to themselves and others. Not to mention there’s the high probability of losing their job as well. Now what about impaired health care workers?

Most employers will have strict policies and other guidelines in place with regards to impaired workers. Various governing bodies that regulate their members will likely have policies and guidelines as well.

Both my former employer as well as my governing body, the Nursing Regulatory College (NRC), have such policies in place. In fact some NRC’s take this a step further by defining both mental and physical incapacity in their publications.

These were put to the test back in 2011 when I badly injured my back. The chair that I sat on at work broke and collapsed underneath me. I landed in a still seated position on an un-carpeted floor, jarring my entire spine.

In spite of my injury, the impaired effects of the medication, my doctor pulling me off of work to get further investigations done, I was instructed by the Worker’s Compensation Board (WCB) to go back to work in my nursing job.  In spite of my concerns with regards to my medication, the alleged specialist from the WCB, he documented, “He will try lighter med passes prior to the next FAF.”  

The employee health nurse witnessed both my physical and mental impairment. She indicated that from a health and safety perspective, she could not allow me to be at work.

The case manager that I had with the WCB was furious. She deemed me as uncooperative and terminated my loss of earnings benefit.

I was in one of those proverbial catch 22 scenarios. 

Either listen to the WCB case manager and run the risk of not only losing my job, but also my nursing license. Or, adhere to both the NRC and my employer and run the risk of being deemed un-cooperative and lose any kind of benefits such as earnings and needed treatments.

I chose the second option, yet was significantly punished by the WCB. In making my decision, unfortunately the NRC was not very helpful. I sent them a very detailed email outlining my dilemma and their email response was:

Though the situation you described in your email is unfortunate, it must be resolved within your organization. Nurses are responsible for their actions and the consequences of those actions. The College expects nurses to advocate for a quality practice setting that supports nurses’ ability to provide safe, effective and ethical care.”

To this day, the WCB appeals have not been resolved.

My personal example raises a very serious question. How many other nurses and other regulated professionals out there are choosing to, or are being forced to work, in spite of their impairments?

One interesting telephone conversation that occurred back in 2011 was with a Nurse Consultant with the WCB. He was very forceful in his comments with regards to me being at work doing modified work. I indicated, “You are a nurse, therefore you should know full well that a nurse is accountable as a nurse the second they step foot into their workplace”. He immediately went silent and ended the conversation.

I was eventually questioned by my former employer with regards to being at work and working some kind of modified work. I worked at a Long Term Care facility where the vast majority of the residents are elderly. I kept stating to the employer that once I step into the facility, I’m accountable as a nurse. I used an email from the NRC a few years prior to emphasize this fact.

Back then I questioned the responsibility of a nurse who comes across a person who is choking, yet that nurse due to their physical limitations cannot physically intervene. The NRC indicated in their email:

When the nurse discussed their modification with their employer issue of emergencies should have been brought up. With this information management would be accountable for ensuring that this nurse does not work alone. However if a situation arose where this nurse was the only person who could provide the Heimlich manoeuvre on a person choking they would be expected to provide this emergency measure to the best of their ability. To let a person choke and do nothing to assist would ne unethical and inappropriate.”

In other words, I could not say to that resident, “Hang on, I’ll get a Nurse”. I am a Nurse, so therefore I’m required to intervene and try to save that resident regardless of my impairment.

What was scary was that the employer continued to push me to go back to work, even though I continued to fight for the needed treatments in order to get my back corrected so that I could return to work safely. So the employer was more concerned about Long Term Disability costs than the safety of myself and the elderly residents. Once again, how many Nurses and other regulated professionals are forced into these kinds of situations and jeopardizing public safety?

Until next time, stay safe, healthy and strong.

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