Position Statement

Fitness for Duty

The intent of this position statement is to define fitness for duty as it relates to registered professional nurses’ ability to perform assigned duties.

Position

It is the position of the New York State Nurses Association that:

Registered professional nurses have an obligation to protect the public and therefore, must be fit for duty.
Fitness for duty is determined by effective job performance and absence of signs and symptoms of impaired practice.
When a registered professional nurse is unable to self-assess impaired practice and take corrective action, employers are obligated to intervene and protect public safety.
Employers have an ethical and legal obligation to report an impaired registered professional nurse to the appropriate legal and regulatory authorities in order to safeguard the public.
Nurses have an ethical obligation to address impairment of a colleague.
Employers are responsible to ensure employees are fit for duty and need to have policies and procedures in place to 1) assess nurses for fitness and intervene when necessary and 2) monitor and supervise nurses returning to the workplace.

Background

A registered professional nurse practicing while impaired violates the standards of professional practice. Fitness for duty is the requisite knowledge along with the physiological and psychological ability to carry out the role and responsibilities of a registered professional nurse. Physiological and psychological fitness relates directly to the ability to perform assigned duties.

Impaired practice can be related to physiological and psychological factors. Fitness for duty shall be determined by a designated person based upon reasonable and observable considerations and in good faith. Behaviors must be objectively described. Signs and symptoms of impaired practice can include: time and attendance irregularities, smell of alcohol on breath, witnessed alcohol or drug use, careless documentation, somnolence, and emotional lability.

Recommendations

The New York State Nurses Association recommends that:

When an employee’s fitness for duty is in question, the designated person (i.e., nurse manager or supervisor) shall initiate an evaluation that takes place in accordance with the facility policy and procedure, and at a location that assures confidentiality of the employee.
If the employee is deemed unfit for duty, the employee shall not be allowed to return to the workplace. The employer must ensure the employee’s safety while at work and enroute to the recommended destination.

Please refer to NYSNA’s Model Statement: Alcohol and Other Drug Policy for RNs in NYS Employed in Healthcare Facilities for more information about laws, regulation, employer policy formation, education, confidentiality, drug testing, treatment, recovery, and safe return to work.

Additional information and sample return to work contracts are accessible under Peer Assistance on NYSNA's web site.

Developed by the Statewide Peer Assistance Committee, January 2008. Approved by Board of Directors, 11 June 2008