Which action is most appropriate when a staff member appears intoxicated or unsafe to care for patients?

• A. Relieve the staff member of assigned clients
• B. Interview the staff member after shift
• C. Confront the staff member about substance use immediately
• D. Ignore and document only

Answer: (B)

When a staff member appears intoxicated or unsafe to care for patients, the priority is to protect those being cared for while following proper procedures. The best approach is to have a private, nonconfrontational conversation with the staff member after the shift. This timing allows you to calmly describe what was observed, gather information, and assess whether impairment is present without creating a chaotic scene or risking patient safety in front of others. It also signals to the staff member that concerns are being taken seriously and will be handled through the proper channels.

During the after-shift discussion, you can document what you observed, seek the staff member’s input, and determine the next steps in coordination with a supervisor or designated authority. This approach supports accountability and ensures that any needed referrals or corrective actions (such as reassigning patients for the remainder of the shift and arranging formal review or support) are handled through the proper chain of command. Confronting immediately in the moment or ignoring the issue without escalation are less appropriate because they either risk escalating the situation or fail to address patient safety and policy requirements.