Addiction and psychiatric illness affect a significant number of health care professionals. Many health care professionals do not receive the appropriate intervention and treatment needed, due to the lack of proper identification by employers. The first step in assisting an employee is recognition of the signs, symptoms and behaviors that are often displayed as a result of problems that can impact a professional’s ability to practice safely. Often, employers feel uncomfortable when there is a chemical dependency or similar problem that can impact the workplace. The most common barrier in employer identification is lack of knowledge.
Reasons why peers, supervisors or employers do not identify health care professional addiction include:
- Not knowing that chemical dependency is a primary disease with signs and symptoms and a specific course that can be identified, documented and treated
- Lack of knowledge about signs and symptoms of problems in the workplace.
- Fear—what if I am wrong.
- Not understanding employer’s obligations under Boards, Statutes.
- Hoping that “things will get better”.
- Lack of awareness of resources available for employer and employee assistance
Physical and Behavioral Indicators of Alcohol or Drug Addiction and Psychiatric Illness
- Observable decline in physical or emotional health
- Atypical weight changes
- Inability to mentally focus and keep track of a conversation
- Shakiness, tremors of hands, agitation
- Unsteady gait, falls
- Unsatisfactory documentation performances and/or illegible written communication
- Defensive if questioned or confronted
- Alcohol on breath with attempts to cover with mints or mouthwash
- Missed deadlines
- Questionable practice judgment
- Increased interest in patient pain control
- Frequent absences or illness
Barriers to Workplace Intervention:
Many employers do not understand their role in identifying the signs and symptoms that indicate an employee may have a problem with addiction or psychiatric disorder. There may be a misconception that they must be able to prove that there is a substance use issue or psychiatric illness prior to intervening. The goal of intervening is to make sure a problem is recognized and dealt with for the well-being of the professional and to assure safe practice in the workplace. Some basic principles of workplace intervention include:
- Document specific observations, including date, time, place and practice or conduct concerns
- Become familiar with the employee’s practice baseline
- Follow workplace policy on reporting of practice or conduct concerns
- Do not discuss suspicions with colleagues