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THE ALCOHOLIC R.C. PRACTITIONER MANAGEMENT


By Bob Miglino MPS RRT I


t’s hard to imagine – in fact it’s almost unthinkable that a respira- tory Care practitioner might report to work impaired by alcohol,


or worse, out and out “drunk”. At first thought it would seem to be the absolute epitome of unprofessionalism and of irresponsibility. Yet, if we consider that 1 in 30 Americans has an alcohol problem, we can extrapolate that there are perhaps hundreds of R.C. practi- tioners who do just that – work with patients, medications and so- phisticated machinery while under the influence of alcohol. Do you as a R.C. director manage an employee with such a problem? If so, then you yourself could have your hands full. “Alcoholism is a disease,” Alcoholics Anonymous emphatically


states. Indeed, medical authorities try to treat alcoholism from the same medical perspectives as they would diabetes or tuberculosis. But it is not yet fully known why one individual will become alco- holic while another can drink moderately high quantities for years without incurring the physical addiction that marks alcoholism. AA defines an alcoholic as “any person whose indulgence in alcohol continuously or periodically results in behavior disruptive to nor- mal relations with his or her work, family, or society”. Managers can read volumes about the disease of alcoholism


and its treatment which goes beyond the scope of the article pre- sented here. FOCUS encourages managers to remember however, that all the experts say the problem is physiological having nothing to do with “moral weakness” or “self indulgent” behavior. It is of paramount importance then, not to look at alcoholics as “lushes” or “weaklings” with personal problems unworthy of our help, but instead to treat them as you would any other person who might have suddenly been stricken by a terrible disease or accident where they would be otherwise well. It is also important to keep in mind that the mental and emotional problems often seen in alcoholics are almost always a by product of alcoholism, not the cause. On a practical basis, managers should be aware of some im-


portant facts and statistics: Scientists at the Harvard School of Pub- lic Health estimated in 1990 that business and industry were now losing approx. $70 billion a year on alcohol-related problems. They found that a problem drinker misses an average of 22 work days a year and that their chances of incurring an accident were 2- 4 times greater than the nondrinker’s. It was found that four times as many medical benefits are paid to alcoholics and one estimate puts the average loss to a company at one third the drinker’s annual salary. Estimates of the number of “problem drinkers” in the U.S. range from 15-25 million with the National Institute on Alcohol Abuse and Alcoholism (NIAAA) breaking the numbers down to 25% white collar workers, 30% blue collar workers and 45% pro- fessionals and managers.


12 Focus Journal Winter 2012


WHAT TO DO AS MANAGER Experienced managers advise that promises on the part of the


employee that he or she CAN and do WILL control their addiction must, unfortunately, be viewed with suspicion. Many people af- flicted with alcoholism will not admit to themselves, much less their boss, that they have a drinking problem. Naturally a practitioner who is intoxicated has to be pulled


from patient care immediately – something within your own au- thority. What to do after that may be a matter of company policy and not up to you alone. You can literally have the employee sit in your office while you find out, preferably from the Director of Human Resources. (Go for that advice!) It might be appropriate in certain instances for the manager to call the employee’s family and have the employee picked up. Perhaps the manager might even drive the employee home. The spouse could be told then that the employee and manager will have to speak ASAP about where to go from there. Managers must balance their need to run a department where


everyone is working to potential (substance abuse free), with com- passion and a willingness to help the employee if at all possible. Remember that this problem, exerting itself on both the employee and the manager, is not the employee’s fault! Speaking in a hu- manistic manner then, (while being frank about your needs as manager) can in and of itself be a major contributor to helping the alcoholic see the light and get help. Testimonials from maintain- ing alcoholics as to the impact of the boss’ concern, bear this out again and again. These days it is the narrow minded and/or uneducated organ-


ization that will simply fire the employee and pass the buck on the problem. Studies conducted over the years show categorically that an actual investment to help on the part of the organization is often cost effective. Indeed many major companies spend huge sums on rehab programs for their top executives as a protection in the investment they may have in that employee. During the last ten years there has also been a large increase in Employee As- sistance Programs or EAP’s as a benefit to employees and (often) their families. A hospital’s EAP program is a valuable management tool and resource. Usually, the manager discusses the problem with the EAP coordinator who often takes over from there. In closing, remember to think “help” rather than “discipline”.


The manager and organization that is truly caring rather than just concerned about the logistical impact on operations, will reap much in the way of positive public relations from other employ- ees. When it comes to alcoholism – “There but for the grace of God go I”.


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