What would you & handle this situation ?

[EMT001]

If it is not an everyday occurrence, I will normally ask them if they want to leave. If I cannot persuade them to leave on their own, then I would call the supervisor and let them deal with it.

[rocket]

Ask him are you sure your O.K. ... enough to work.. let him decide

It's at least gonna start with that.

-Trevor

[Alcomedicism]

As you know I've been in a similar situation with a close friend of mine.

I showed up at her house and she was in bed, and I was told by her boyfriend that she had been drinking tequila and she had been asleep for about half an hour. So I went in to check on her to make sure she hadnt vomited all over herself. Then I went into the living room to watch some TV then she told me to come in there and I did. I could smell the alcohol on her breath. Then about 10 mins later she got a call from work that she had to go in. I told her to call someone else and tell them you cant take the call and just say you are sick, well she couldnt get anyone else to take her call, so she got up stumbled around to get dressed and mind you the station is about a 15 min drive from her house. I told her she shouldnt go because there is a very real possibility that she could get fired for showing up while intoxicated. Well, I told her boyfriend that she was beyond working condition and I wasnt about to let her drive the ambulance drunk, there's too many lives shes responsible for. So he called into the station while she was in the bathroom and told the person that she was supposed to be coming in for that she couldnt come because she was prety well drunk. So she caught the tail end of that conversation and all shit hit the fan. So she called back to the station and said slurred her way through to say she wasnt drunk and she even said she would pass a breath test if need be. I tried to reason with her and I ended up getting pissy about the whole thing and I went out to her car and took her keys and locked them in my truck and kept my keys with me. Then the station called back about 10 mins later and said she better not come in, but she needed to show up early on Monday to talk with the supervisor and the director about it. Well all in all, she got a 5-day suspension w/o pay and lost a week of vacation. Then a week later she called me to apologize and things were hunky-dory.

So what would I do?? I'd tell the guy to lay down on the couch at the station (Im not letting him drive back home impaired, he risked enough driving to the station) then I'd fill in for his position on that shift, but I would NOT talk to him the entire shift and not allow anyone else to talk to him. Then of course I would contact the supervisor. So not only did he show up for work impaired, he's being ignored, he's at the station for his shift w/o pay and he's getting a lecture from the supervisor and likely will get a suspension or firing.

My two cents.

-Dix

[ladyfirefighter36]

There is NO way I would let him come on duty. I don't want to be hauled in for questioning after he has screwed up and the supervisor finds out I was aware of the situation. Send him home and let officers know.

[ReD]

it also depends on who it is. there are ppl at work that dont drink so if they came in after a night of drinkin, somethin else would have to be goin on, whereas the ppl i party with on weekends, id prolly just say ok bud, slap em on the shoulder and wish em a slow day.

[island emt]

As far who it is : IT DOES NOT MATTER ! if they are in any way impaired they should not even show up at the station period. There are too many things that could go wrong if they operate impaired. truck drivers ,pilots, train crews, subway + bus drivers all have an 8 hour rule of NO spirits before coming on duty as should we. If we want to be looked upon+ treated as professionals then we need to act responsibly. Imagine what would be the outcome if something happened during his/her shift and there was an accident or a med error that could have been avoided by simply not allowing the impaired person to clock in. I have been in this position in the past + would not let my relief clock in due to his inability to function @ 100 % of their ability due to a hangover and lack of sleep. :roll:

[Summit]

I'm going to talk with the person until I can get an idea whether or not they are impaired or ETOH or whatever. If they are OK, I'd make a mental note on it and be on my way.

If I thought their were intox or impaired, I would tell them to call in sick for however long. If this was an unusual thing I would even offer to cover for them if I could. There'd be no way I'd let them stand the chance of driving if I thought they were impaired. I care about all my EMS brothers and sisters in my service. I couldn't think of letting them endanger themselves or our friends, not to mention a patient or the public we are supposed to save.

If they really wouldn't back down and go home under my pressure and pressure of their peers, then and only then would I have to escalate it to command staff.

If it was a regular occurance and they refused to be helped, then command has to know for obvious reasons. If they then couldn't be forced to get help, then then command would obviously take appropriate actions.

Side note: We work 24s here. It is not at all unusual for people to work 48s or 72s. We have to in order to have coverage. I'm on a 72 right now. One time I worked a 96 (never again, I was a little bit insane at the end of that). Tired crews are common. We sleep when we can. Clearly lack of sleep can impair people as well, but what can you do if you are up all day and get sent on a 4 hour transfer at 2300? If someone is unable to function, they get sent to rest or sent home. They can request it or a captain order it. Once at 0400 on the last day of a 72 coming back from a 5 hour interfacility I pulled over and asked my partner to drive because I no longer felt safe to do so from lack of sleep.

[rocket]

Side note: We work 24s here. It is not at all unusual for people to work 48s or 72s. We have to in order to have coverage. I'm on a 72 right now. One time I worked a 96 (never again, I was a little bit insane at the end of that). Tired crews are common. We sleep when we can. Clearly lack of sleep can impair people as well, but what can you do if you are up all day and get sent on a 4 hour transfer at 2300? If someone is unable to function, they get sent to rest or sent home. They can request it or a captain order it. Once at 0400 on the last day of a 72 coming back from a 5 hour interfacility I pulled over and asked my partner to drive because I no longer felt safe to do so from lack of sleep.

Yup Yup.

That was the first thing that popped into my head when I read this poll post.

I've seen this occur as well. The relief crew that comes in for a 24 just got off of a 24 at another station, and you know by listening to the scanner that they've been busy all night. How can you tell if they are impared from lack of sleep? Sleep deprivation has been shown to affect judgment and coordination just as profoundly as intoxication (in some cases and individuals).

I suppose it boils down to what you want to recognize as "impairment" and how you want to prioritize your reaction(s) to it. Would a call to the Sheriff be appropriate for a sober but exhausted co-worker?

-Trevor

[Tibby]

I picked "Ask him are you sure your O.K. ... enough to work.. let him decide"

I've seen people work fine while a little bit out of it with 5 hours of sleep. I'd have to let him AND his partner decide. His partner has a right to know, and decide whether or not he thinks he can with with the guy in this state.

Now, if he was the driver, or if he is making a habit of this kind of behavior, that's a different story. If he did it again, I would have to draw the line. But if this is just a one time, party of the year kinda thing and all, his problem sounds like something a tall cup of coffee can fix.

[Just Plain Ruff]

I'd have went to command staff or the supervisor. This is not a matter of friendship or loyalty it's a matter of liability.

I think one simple question can address this issue: IMHO

Would you want him/her to take care of you if you were very sick or hurt bad? If the answer is yes then my prayers are with you and heaven help you. If the answer is no then don't let him work.

Simple as that.

The second question is do you want him driving you to the hospital or what not? If the answer is no then Supervisor time.

Give him the opportunity to take him off shift. I'd allow that only one time. If he/she came in that way again I'd go to the supervisor.

Remember, you are as responsible for the care and well being of your patient as your partner is.