A fellow preceptor and I were sent an email that we were to start precepting a nurse from another local hospital in our unit.
Through the grapevine and a check with our state LLC, we find out our new nurse was fired and is on probation for recent drug abuse (within the past six months) for a drug we use frequently a shift EVERY DAY.
None of this information was disclosed to us through our supervisors!
We cannot find our state laws for nursing how to manage someone on probation except that she must be supervised at all times and it is up to directors discretion as to what drugs she may be around.
How can I protect my patients and MY license? I feel it is too recent a time and the higher up opinion is "everyone needs a second chance".
Any suggestions?
Amanda
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June 5th, 2008 at 5:16 pm
Your state BON will determine where and when a nurse in recovery may practice, and what restrictions will be in place. I am assuming that the nurse is being monitored by either the BON, or alternative program in your state.
June 7th, 2008 at 12:15 pm
The fact that you were not informed of this means that, as far as managers are concerned, this is not your business. The fact that you are engaging in ‘grapevine’ gossip is also a sad tale. The fact that you went sourcing information on someone else is further unpleasant to me.
Despite my rantings on previous posts on this topic, this nurse has been through due process as determined by her governing body. Her reinstatement and the reasons behind it are of no concern of yours or mine. This is why we have governing bodies. To govern.
If she were a danger to patients – she would not be permitted to practise.
As for being a danger to your license – unless you are worried you may suddenly become corrupt or drug addicted or professionally inept by her presence – I would suggest your license is at no greater peril than it was before. Those who need to know obviously will know of her recent history and they have taken responsibility for that.
Simply put: You have not been asked to manage a nurse on probation; you have been asked to precept a new nurse. What is wrong with that?
If it should pass that this nurse engages in untoward events – it is not your responsibility other than to report anything that may occur in your witness.
If you wish, however, to optimise this opportunity as her preceptor I would suggest the following:
1. Treat her as a regular nurse and only as you find her.
2. Discuss it with your line manager or, preferably, your clinical supervisor if you have one. The purpose of this is to allay your own fears rather than to discuss how to ‘manage’ the new nurse. Only use what is public or official knowledge – not hearsay.
3. If the information about her probation is public knowledge AND YOU ARE SURE YOUR KNOWLEDGE IS GOOD AND TRUE then there is no reason you cannot tell her you are aware of this – therefore, as a preceptor, it would be acceptable for you to raise the matter in a non-judgmental way with her;
“I understand from public record that you have been placed on probation for some recent drug issues. I would like to know, as your preceptor, what you feel I can or should do to support you in this area”. Give her an option to discuss with you, to think about it, to return with a support person or to not discuss the matter any further.
4. Do not gang up on her with the other preceptor (or other staff) in a “we are watching you” fashion. This will cause her to fail and by your own doing.
5. If she does engage with you in discussing her drug issues and how she is managing them – I would encourage the use of a clinical supervisor to provide you guidance and support. Unless of course you are a drug rehab counsellor then you should be ok.
6. If she doesn’t wish to engage with you in this matter on any level – that’s her prerogative. However, if her drug use status is public knowledge, and if you feel that her behaviours are of concern to you – not just based on fear but on tangible events that are observed and warrant intervention (not – “oh she looks tired today; she must be stoned” – more “she’s avoiding me a lot today and doesn’t want to meet for our regular preceptor session”) then you have a responsibility to reassure patient and colleague safety. You have a responsibility as her preceptor to ensure her transition into the workplace is safe and professional. If you have concerns then raise them as they occur – as you would any other matter.
Above all, I would remind the role of being a preceptor is to assist the new nurse to blend into their role as easy as possible – not to catch them out.
June 8th, 2008 at 8:01 pm
Mr Ian, a heartfelt Thank You for your insight in this post. I am a recovering nurse, and am grateful to be one. I am grateful because I no longer engage in character assassination, or any other behavior that is not supportive of others.