What is the first step a nurse manager should take if they suspect a staff nurse has a substance use disorder?

When a nurse manager suspects that a staff nurse may have a substance use disorder, the first step should involve documenting unusual behavior. This approach is crucial for several reasons.

Firstly, careful documentation provides an objective record of the behaviors or incidents that raised suspicion. This could include specific actions, patterns of absenteeism, discrepancies in medication administration, or changes in work performance. By having this documentation, the nurse manager can ensure that their concerns are based on observable evidence rather than rumors or assumptions, making the situation more professionally credible.

Additionally, documented evidence can be essential if the situation escalates to require intervention from human resources or other authorities. It ensures that decisions made later on, whether it involves the nurse or the steps taken by management, are based on facts and can support appropriate actions to help the nurse involved.

In contrast, confronting the nurse outright without verification or documented evidence could lead to accusations of misconduct or even legal challenges, particularly if discussions become confrontational or if there is not enough evidence to support the suspicions. Reassigning the nurse without evidence may not only overlook the potential need for intervention but also stigmatizes the nurse unfairly. Discussing the suspicion with HR immediately, before gathering evidence, could lead to premature actions that may be seen