EDX/20/1154
Date of prep: December 2020
Prescribing information and
adverse events reporting
For healthcare professionals only
EDX/20/1154
Date of prep: December 2020
Prescribing information and
adverse events reporting
For healthcare professionals only
The next day she wakes up and has a medium-strength (5.5%) beer at 11.30 am. She feels better and resolves to ride out the rest of her hangover. She goes to the shop and gets a bottle of wine and drinks this throughout the evening.
She is working the next morning. She drives the 10 miles to work.
Do you think she should have driven to work?
Yes 27%
No 73%
On arrival at work, she makes a coffee and again begins to focus on shaking off her hangover. You come into the kitchen when you arrive. You immediately smell stale alcohol. She explains that she had a heavy weekend. She does not appear intoxicated this morning.
What if any action would you take?
“Have a chat with her maybe call the area manager or owner.”
“Ask if she is well enough to be able to work.”
“I would notify the superintendent pharmacist or area manager about this and wait for advice.”
“Keep a close eye.”
“Contact the superintendent.”
“We have a professional obligation to uphold professional standards and tell her about the smell of alcohol as patients will also smell this. We also need to ask if she feels she has the capacity to work safely.”
“None if it was a first time. If it is continuous maybe mention that working hungover is a risk. May make mistakes etc.”
“Ask her if she is ok as you can smell alcohol.”
“Ask her about her drinking and gently suggest better alternatives.”
“Ask her if she’s okay and needs a longer break. Maybe some electrolytes.”
“I would offer a sympathetic ear and encourage her to talk to me.”
“Observe and assess.”
“Send her home.”
“Discuss with the staff member the potential of having a problem and offer assistance in finding help to overcome this problem.”
“I would ask about the weekend say gently about driving the day after drinking with the new lower levels as it concerns me but notes this and revisit if it happens again.”
“Suggest that she goes home for the rest of the day and returns to work tomorrow when she is in better shape.”
“Ask her if she’s ok.”
“None. If she is not intoxicated that is sort of OK. Perhaps a well placed talk on seeking help or at least bring up the subject of excessive drinking.”
“None.”
“Talk to the superintendent about suspicions.”
“Discuss the problem with her – advise it’s not acceptable to come to work in this state.”
“Monitor and discuss if it becomes a regular occurrence.”
“Support her and enquire why if appropriate.”
“I would advise her to not work in the dispensary today – seek help from another colleague.”
“None.”
“It would be best to discuss your concerns with the area manager or pharmacist superintendent.”
“I would closely monitor for signs of her still being over the limit.”
“I would raise my concerns with a senior. I would ask her if she thought everything was OK and would suggest she should not be here today.”
“Discuss the signs I’ve noticed and offer help, plus highlight smelling of alcohol is professionally inappropriate.”
“Suggest goes home.”
“Ensure not in a position of responsibility, eg accuracy checking of prescription.”
“None on one attempt. It is impossible to answer the above question about driving to work without more detail. When did she stop finish drinking the wine? What alcohol volume was it? Compare Cava at around 8 units to some potent reds and whites which well exceed 10.”
“Raise your concerns with her personally. Depending on result contact pharmacy superintendent.”
“Try and speak to her about her consumption. Offer to go with her or aa for help if she would like to.”
“MECC – she has mentioned that she had a heavy weekend, this provides a potential opening for you to ask whether this is something that concerns her or something/ a behaviour that she wants to change. She may say no she is happy as she is but she may have said it as she is already contemplating changing her behaviour and a few pointers or a signpost in the right direction might really help her. If she was to be the RP I would document the conversation and contact the pharmacy manager if they weren’t in that day (or speak to them if they were) so that they can appropriately deal with it. If the pharmacist signs in as the RP then they are saying that they are fit to practice which this person isn’t if they are still hungover.”
“Make a note of the incident in case it becomes a regular event. I would raise a concern if she is unable to function as a pharmacist.”
“Discuss it with her. What was a heavy weekend? any particular reason?”
“Keep an eye on her (decision-making), behaviour, etc.). Ask some questions about the weekend.”
“Check if she’s ok.”
“I would make a note of what happened to see if there is a pattern.”
“Keep her under observation to ensure she is safe to work.”
“None unless I felt she was a danger.”
“I would inform my supervisor as if she has been drinking heavily over the weekend her judgment may still be impaired and she may be a risk to patient safety.”
“I would confide in a colleague and perhaps seek the advice of an area manager. I would reassure them I did not have concerns over her ability at that time but more concern about her drinking.”
“None.”
“Ask if she’s ok.”
“Keep a close watch on her throughout the day.”
“Contact the manager to arrange a replacement pharmacist.”
“Keep an eye on her to make sure her performance is not affected.”
“Suggest she waits a few hours before starting work.”
How long would this type of behaviour have to continue for you to intervene and take action?
“Straight away.”
“Once a pattern had been established say 3-4 occurrences in a short space of time.”
“I would have challenged her when she walked in and asked her if she should be in work.”
“If it happens once more the Superintendent should be contacted. She may need support not castigation but she also needs to be safe at work.”
“Under the influence or smelling of alcohol once should be enough to take action.”
“Intervene immediately.”
“Maybe a fortnight.”
“I would approach the pharmacy manager after about a month, earlier if I noticed she her work was affected/she was making mistakes.”
“More than twice.”
“At any point if patient safety is compromised.”
“A few weeks.”
“Couple of times, quite close together.”
“If this happened regularly every week then I would encourage her to see her GP or speak to a counsellor.”
“After two or three recurrent episodes, I would discuss with their line manager.”
“Once.”
“More than a one-off.”
“Regularly happen for a few months.”
“I would see if it carries on over a few days then speak as concerned for her rather than attack.”
“After a couple of repeated episodes, it would require addressing.”
“Two to three occasions.”
“If it happened more than twice in a 6 month period.”
“More than once.”
“One more instance only.”
“It might depend on the circumstances and background.”
“Not more than 6 weeks.”
“A one-off is probably not too concerning, as everyone has probably overindulged at some point. If it becomes a regular occurrence or if you notice it happening at regular intervals it becomes more concerning.”
“Once. The likely hood is I would have known things weren’t going well for her.”
“Any period.”
“Twice.”
“If in a repeating pattern, and especially if lone drinking continued, low threshold for intervention, perhaps three weeks.”
“I would comment if it happened more than once.”
“Just that once.”
“It would depend if it was affecting her working ability.”
“I don’t know.”
“Another one incidence of this in a short space of time would raise concerns.”
“One or two months. There may be a transient issue in her personal life that she needs time to work out.”
“On more than one occasion.”
“If it was happening weekly for a few consecutive weeks.”
“If it became regular.”
“Once.”
“Not long. I would perhaps confide in someone after one or two events.”
“No more than twice.”
“After the second occurrence of a similar situation.”
“The first time would be plenty.”
“A couple of days then I would speak to her.”
“Once could attract a warning but any repeat requires intervention.”
You get on with the day and begin to talk about the upcoming night out with the team.
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