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Nurse Chemical Dependency

As a coworker in Florida, if I believe one of the nurses I work with has a problem with chemical dependency, I am required by the Florida Nurse Practice Act (NPA) to report my suspicions. Section 464.018(1)(j) of the NPA states that the Board of Nursing can take disciplinary action against a nurse’s license if they have “impaired practice due to…addiction or dependency on alcohol or any controlled substance” (Toney-Butler & Martin, 2019). According to the NPA, any coworker who witnesses potential signs of impairment has an ethical duty to report their observations to management

My obligation as a coworker is to respectfully inform my nurse manager or director of nursing about any objective concerns I have regarding another nurse’s fitness to practice (ANA, 2019). I must cite specific observed changes in the nurse’s behavior, job performance, or appearance rather than subjective opinions. Examples of objective signs could include “increased rate of medication errors, abnormal vital signs, altered mental status, or unusual behaviors” (Coffa & Snyder, 2019). The documentation of any report must focus solely on factual observations (Domino et al., 2005). Reporting follows approved organizational channels to maintain confidentiality and protect due process rights as outlined in the NPA (Toney-Butler & Martin, 2019).

As the nurse manager, I have further responsibilities under the NPA. If a coworker reports concerns to me about a nurse under my supervision, I am required to promptly investigate in a thorough yet discreet manner (Toney-Butler & Martin, 2019). This involves examining records for errors or omissions, obtaining witness statements, and meeting privately with the nurse in question. I document my investigation process to comply with the rules for due process outlined in section 464.018 of the NPA.

Suppose I develop reasonable suspicion of impairment after evaluating objective evidence. In that case, the NPA mandates that I schedule a confidential meeting to recommend the nurse consent to an evaluation by a qualified professional (Toney-Butler & Martin, 2019). Refusal can lead to disciplinary action against their license per section 464.018. Failure to complete the recommended evaluation upon a finding of reasonable cause could constitute grounds for disciplinary action by the Board (Coffa & Snyder, 2019).

Should an evaluation determine the presence of a substance use disorder, I must assist the nurse in complying with any recommended rehabilitation or monitoring program (ANA, 2019). This includes tracking treatment plan adherence and monitoring work performance indicators. Ultimately, my goal is to protect patients while supporting the nurse’s recovery, as many can safely return to practice with ongoing management (Coffa & Snyder, 2019). Regular screening and strict monitoring protocols are often recommended during the initial recovery phases (Domino et al., 2005).

In conclusion, the Florida Nurse Practice Act establishes a structured yet compassionate process for identifying and addressing potential issues of chemical dependency among nurses. It balances the crucial aims of ensuring due process, patient, and practitioner safety, as well as rehabilitation support. Both coworkers and nurse managers are given clearly defined responsibilities under the NPA to work collaboratively towards these goals. Coworkers objectively document and report any reasonable concerns through appropriate channels while respecting nurse confidentiality. Nurse Managers then promptly and privately investigate before recommending medical evaluation if needed. For nurses diagnosed with a substance use disorder, managers assist in upholding treatment plans to facilitate a safe return to work whenever possible.


American Nurses Association. (2019). Code of ethics for nurses with interpretive statements. American Nurses Association.

Toney-Butler, T. J., & Martin, R. L. (2019, June 3). Florida Nursing Laws and Rules.; StatPearls Publishing.

Coffa, D., & Snyder, H. (2019). Opioid Use Disorder: Medical Treatment Options. American Family Physician100(7), 416–425.


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