Drunk colleague

Your registrar is behaving like they may be under the influence of drugs. He's supposed to be doing a list.

How do you proceed?

Issues

  • Patient safety
  • Professionalism
  • Trust in the profession
  • Colleague wellbeing

Seek information

  • Talk privately immediately with the registrar - directly ask if they are under the influence, be non-confrontational

Patient safety

  • Unfit to operate safely
  • Have they done anything already before you met them that needs to be addressed as they may have done it poorly

Initiative

  • After asking colleague directly, express my concerns about patients safety, explain they need to return home, check they have safe method to get home, not driving

Escalate 

  • Escalate to suitable senior colleague

Support 

  • Support patient: Explain there may be a delay, find cover for the surgery or if not reschedule or appropriate time
  • Support colleague: Be non-confrontation, non-accusatory, don't jump to conclusions, don't tell the patient exact reasons, offer support to colleague if having a difficult time, do not gossip, signpost to occupational health or counselling services in the hospital
  • Support team: Be flexible, help where needed, ensure cross-cover arranged to maintain safe staffing-levels

Document 

  • DATIX

Reflect

  • Meet with educational supervisor to discuss my management of the situation
  • Document as a reflection in portfolio

What would you do if the registrar asked you not to escalate it further, that he is just going to tell the team he is unwell and go home but he reassures you he will not do it again?

  • Re-iterate that I must still raise the issue with a supervising consultant
  • Important to resolve through proper channels to ensure he gets the support he needs
  • If a future incident were to occur were patients come to harm it would be indefensible that I did not raise concerns at an earlier point
  • His actions raise probity concerns: asking to implicate me in covering up his behaviour

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