This is absurd.

MORRISVILLE – A nursing home’s failure to assess the impairment of a charge nurse who came to work “smelling very strongly of alcohol” one night last August put it at risk of losing its federal reimbursement, a state report says. The nurse, who failed to respond to patients’ requests for pain medication, was responsible for a unit of 40 residents.

An additional factor contributing to the enforcement action was the nursing home’s lack of policies and procedures directing employees in how to deal with another staff member whom they suspect of being impaired by drugs or alcohol.

Morrisville Center Genesis Healthcare has corrected the conditions that led to a finding of “immediate jeopardy” and won a temporary reprieve from losing its Medicare certification. The 90-bed nursing home is in the process of correcting other problems uncovered in the September investigation, which was triggered by a complaint resulting from the incident.

(The unnamed licensed practical nurse was fired and her conduct reported to the Vermont Board of Nursing.)

Let’s hope she was fired, and let’s also hope she loses her license.

Here’s what happened, according to a report on a three-day investigation by nurse surveyors from Vermont’s Division of Licensing and Protection. (CMS contracts with the state to determine whether facilities are meeting federal standards.)

On Aug. 20, a night charge nurse arrived at work more than an hour late and “smelling very strongly of alcohol.” When the evening charge nurse, who worked the previous shift, asked her whether she been drinking, she replied, “Yes, but I stopped when I found out I was working.”

The evening nurse left, and then, realizing that it was not safe to leave the “potentially impaired night nurse,” returned to the unit. An argument took place between the two, and the night nurse blocked the evening nurse from phoning the unit nurse manager.

After the evening nurse left, the night nurse called the manager and told her she would probably be hearing from the evening nurse because “I was late and she could smell alcohol on my breath.” The nurse manager spoke to the aides and the nurse from the other unit, but never went to the center to evaluate the allegedly impaired nurse herself, although one of the aides said she should come. After the conversation, she turned off her telephone. (She was available by beeper.)

Typical of a nurse manager who doesn’t want to take responsibility for her unit. When an aide feels a charge nurse isn’t able to perform the duties required- the nurse managers should TAKE ACTION immediately.

The nurse manager confirmed that after receiving the call from the night nurse, she made no attempt to contact the evening charge nurse and turned her telephone off. The nursing home reported both the nurse manager and the evening nurse to the Vermont Board of Nursing – the nurse manager for failing to go to the nursing home to evaluate the night nurse’s condition, and the evening nurse for not contacting the nurse manager by telephone or beeper.

So what did she do? Go to bed all safe and snug, not worrying about the residents who were not safe? Bad call, boss. BAD CALL.

When a nurse takes on the responsibility of being in charge of a unit, they MUST accept this with seriousness. It’s not a job for everyone. You have to be willing to come in on a dimes notice and take control of situations that are not safe for residents. It might mean acting as a charge nurse for a shift, or making a lot of phone calls to various agencies. Whatever. Turning off the phone isn’t an option but we see it happen all the time. I feel bad for the aides working that night- they must have felt very taken advantage of. And I’m sure they kept an eye out on all the residents whenever this drunk nurse was around.

A manager needs to do just that: MANAGE. Not pass the buck or let things “go” until the morning.