From the Research
The anesthesiologist should immediately report the resident to the Program Director (PD) to ensure patient safety and address the potential substance abuse issue. When encountering a colleague who smells of alcohol (ETOH) while on duty, especially in a critical role like anesthesiology, patient safety must be the immediate priority. Reporting to the Program Director is the appropriate professional action as it follows the proper chain of command and ensures the situation is handled by someone with authority to intervene. The Program Director can assess the situation, temporarily remove the resident from patient care duties if necessary, and arrange for appropriate evaluation. This approach protects patients from potential harm, addresses the resident's possible substance abuse issue, and maintains professional standards. While it might seem reasonable to confirm your suspicion with another colleague, this delays appropriate action and could put patients at risk. Healthcare professionals have an ethical obligation to report impaired colleagues through proper channels rather than attempting to manage such situations informally 1.
Key Considerations
- Patient safety is the top priority in this situation
- Reporting to the Program Director ensures the situation is handled by someone with authority to intervene
- Delaying action or attempting to manage the situation informally can put patients at risk
- Healthcare professionals have an ethical obligation to report impaired colleagues through proper channels
Relevant Evidence
The provided studies discuss the effects of ethanol on human health, including its metabolism, toxicological effects, and potential interactions with other drugs 2, 3, 4, 5. However, the most relevant consideration in this situation is the potential risk to patient safety and the need for immediate action to address the situation. The study on activating the Hospital Incident Command System Response highlights the importance of clear lines of accountability and expedited decision-making in crisis situations 1.
Next Steps
The anesthesiologist should:
- Immediately report the resident to the Program Director
- Cooperate with the Program Director's assessment and evaluation of the situation
- Prioritize patient safety and well-being above all else
- Follow proper channels and protocols for reporting and addressing substance abuse issues in the workplace.