Indicators of Potential Impairment

1. Indicators of Potential Impairment • Isolation • Conflict with colleagues • Disorganization • Inaccessibility • Frequent absences; “Monday morning flu” • Rounding on patients at odd hours • Inappropriate orders • Intoxication away from the hospital • Prescriptions for family members • OD or suicide attempt • Does not have to be a pervasive pattern

2. Workplace Symptoms: Initially • Chaotic or labile personal and professional lifestyle • Poorly explained accidents and injuries • Family and marital discord • Long sleeves and tinted glasses • Deterioration in appearance/ hygiene • Significant weight change • Irritability or hostility when confronted • Increased use of cologne, perfume, breath fresheners • Resumption of tobacco use • Spending sprees, gambling, risky investments • Increasing medical problems and symptoms requiring medication Wm J Farley Center at Williamsburg Place 800.582.6066

3. Workplace Symptoms (later) • Deterioration in handwriting and quality of record-keeping • Diction delinquencies • Nonresponsive on call • Failure to adhere to schedule • Late mornings, midnight rounds • Failure to follow patients appropriately and consistently • Failure to make appropriate referrals or to request consultation when appropriate • Altercations with patients, peers or hospital staff • Poorly explained complications and misdiagnosis • Change in prescribing habits Inappropriate and inconsistent telephone interactions • Change in type of controlled substances kept in the office, ordered from vendors, or requested from pharmaceutical reps Wm J Farley Center at Williamsburg Place 800.582.6066

4. How You Can Tell Your Colleague Is “In Trouble”: The Six “I’s” • Irritability • Irresponsibility • Inaccessibility • Inability • Isolation • Incidentals