HR Solutions: Health care facilities vulnerable to drug abuse

Lynne Haggerman is president/owner of Haggerman & Associates, a firm providing outplacement, retained search and management consulting/training on human resource issues.

Statistics show that 10 percent of health care staff abuse prescription drugs or controlled substances. Unfortunately, medical professionals are more vulnerable than any other profession for drug abuse. As a result, employers in the industry are faced with additional challenges to maintain a drug-free work environment and implement an effective drug-related policy. Constant contact and easy access to drugs in the workplace present opportunities to self-medicate, enhance job performance or simply escape the high-stress, high-pressure responsibility of caring for patients.

The Drug Free Workplace Act of 1988 applies to some federal contractors and all federal grantees; however, most health care facilities are required by accrediting agencies to have a drug-free workplace policy. The best policies send a strong, clear message regarding employment action and legal consequences, yet strike a balance by encouraging employees to seek assistance. Medical employers must create policies prohibiting the unlawful manufacture, distribution, possession or use of controlled substances, and state the actions that will be taken against violators. A copy of the policy should be provided to team members with adherence as a condition of employment.

A program should be established publicizing dangers of workplace drug and alcohol abuse, the organization's policy, and, although not required, any available counseling, rehabilitation or employee assistance programs. Employers should require notification by a worker of convictions under criminal drug statutes within five days, take disciplinary action and mandate participation in rehabilitation programs within 30 days. For those required to comply with the Drug Free Workplace Act, informing a contracting federal agency of convictions must occur in 10 days. For those covered by the act, violating the act or failure to comply could result in suspension or termination of a grant or contract, as well as being barred from bidding for up to five years.

To minimize liability, employers should create a release of liability form to release the hospital of liability due to decisions from testing. In addition, develop a for-cause testing checklist of behaviors to justify testing an associate suspected of drug abuse.

To assist in recognizing and documenting potential abuse, supervisors should ask themselves the following questions: Are there absences from the clinic without notification? Is an excessive number of sick days being used? Are there frequent disappearances away from the work site or long trips to the restroom? Is an excessive amount of time being spent near a drug supply area? Is the staff member volunteering for a lot of overtime and working when not on the schedule? Does work performance vary between high and low productivity? Are mistakes happening because of inattention, bad judgment and poor decisions? Is there confusion, memory loss, and difficulty concentrating? Do ordinary job duties require more effort and time? Is there heavy "wastage" of drugs? Is documentation sloppy, are there ledger entries and drug shortages? Are there inappropriate prescriptions for large narcotic doses?

Begin taking steps to ensure the drug-free workplace program is designed to work well in the organization.