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Recognizing Impairment in the Workplace: The Florida Requirement

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CE1014FL | Contact Hours: 2


The purpose of this course is to educate health care professionals on impairment in the workplace. Upon completion of this course, the health care professional will be able to:

1. Understand the scope of workplace impairment and recognize risk factors for substance abuse in health care professionals.
2. Identify signs and symptoms of impairment in the workplace.
3. Discuss initiatives to promote safety and provide assistance for those impaired in the workplace.
4. Understand essential steps for reporting workplace impairment based on requirements by Florida law.
5. Describe treatment programs available for health care professionals who have been impaired in the workplace.






Sara Hilgenberg, LPN


Learners must review the course material, complete the post-test and score 70% or better and complete the evaluation to receive contact hours.


CE Leaders is Florida Board of Nursing Approved with CE Provider Number (#50-33450).


This course fulfills the Florida requirement for 2 hours of continuing education in Recognizing Impairment in the Workplace.


No one with the ability to control content of this activity has a relevant financial relationship with an ineligible company.


The impairment of health care professionals in the workplace is unfortunately common. It is thought that as much as 15% of all health care professionals are impaired or recovering from alcohol or drug use (1). Workplace impairment occurs when a health care professional is unable to provide proficient and safe patient care due to their impairment by any substance such as alcohol, prescription or nonprescription drugs, or any mind altering substances. Impairment may also be the result of a psychological or neurological condition that affects the health care professional’s judgment and thus adversely affects their job performance. According to the American Nurses Association (ANA), health care provider impairment can be caused by a broad array of conditions including mental or physical illness, fatigue, substance abuse, and other personal circumstances (2). As a result of a health care workers impairment of any nature, the potential for unintended patient harm is exceedingly high. There is also potential for personal injury accidents in the workplace. Additionally, impairment can result in excessive absenteeism or tardiness which places additional strain on staff, affecting patient care and safety as well. Health care professionals must be able to recognize an impaired colleague and understand the necessary steps to take within their institution and state to address this serious issue. It is important to understand that it is not always easy to recognize an impaired health care professional. It can be difficult to differentiate between the often subtle signs of impairment and stress related behaviors. It is also important to note that health care professionals are intelligent and very well trained, especially on medications and potential side effects, therefore will compensate for these warning signs and symptoms. When signs and symptoms of impairment are noticed by colleagues, the problem has usually been occurring for quite some time. It is crucial to be able to identify workplace impairment as soon as possible, to not only preserve patient safety, but to protect the personal safety of the health care professional as well.


1. Florida Statues:

2. Florida Health Care Complaint Portal to file:

3. Florida's Intervention Project for Nurses
P.O. Box 49130 Jacksonville Beach, Florida 32240-9130
Telephone: (904) 270-1620
Toll free number: (800) 840-2720
Telefax: (904) 270-1633


1. Toney-Butler TJ; Siela D. Recognizing Alcohol and Drug Impairment in the Workplace in Florida. Website Updated January 4, 2022. Accessed April 6, 2022.

2. Code of Ethics for Nurses. Website Published 2015. Accessed April 6, 2022.

3. Esptein, P. MS RN; Burns, C. PhD ARNP; Acree Conlon, H. DNP MPH ARNP-BC COHN-S. Volume 58, No 12. Substance Abuse Among Registered Nurses. Published 2010. Accessed April 12, 2022.

4. Webster, A. Drug and Alcohol Rehab for Nurses Near You. Updated April 12, 2022. Accessed April 12, 2022.

5. Trinkoff A. ScD, MPH, RN, FAAN; Selby V. PhD, CRNP-PMH, PMHNO-BC, CARN-AP; Han, K. PhD RN; Edwin H. RN, MSN, NPD-BC, PCCN; et al. The Prevalence of Substance Use and Substance Use Problems in Registered Nurses: Estimates from the Nurse Worklife and Wellness Study. Volume 12, Issue 4 P35-46 Published January 1, 2022. Accessed April 12, 2022.

6. Nurses and Workplace Substance Abuse Risk Factors. Website Accessed April 14, 2022.

7. Berge K.; Dillon K.; Sikkink K.; Taylor T.; et al. Diversion of Drugs Within Health Care Facilities, A Multiple-Victim Crime: Patterns of Diversion, Scope, Consequences, Detection, and Prevention. Mayo Clinic proceedings, 87(7), 674–682. Published July 2012. Accessed April 14, 2022.

8. Nyhus J. MSN, FNP-BC; Drug Diversion in Healthcare. Website Published May 6, 2021. Accessed April 14, 2022.

9. A Guide for Assisting Colleagues Who Demonstrate Impairment in the Workplace. Website Published March 2016. Accessed April 27, 2022.

10. A Nurse’s Guide to Substance Use Disorder in Nursing. Website Published 2018. Accessed April 18, 2022.

11. Gärtner FR., Nieuwenhuijsen K., van Dijk FJ., et al. The Impact of Common Mental Disorders on the Work Functioning of Nurses and Allied Health Professionals: A Systematic Review. Int J Nurs Stud. 2010;47(8):1047-1061. doi:10.1016/j.ijnurstu.2010.03.013. Published May 5, 2010. Accessed April 27, 2022.

12. Florida Board of Nursing. Who May Make a Report to the Intervention Project for Nurses? (IPN) Website Accessed April 18, 2022.

13. Florida Nursing Law Manual. The Intervention Project for Nurses. Substance Abuse, Rehabilitation and Discipline. Website Published 2018. Accessed April 26, 2022.

14. Florida Board of Nursing. Will Participation in the Intervention Project for Nurses (IPN) Protect my Nursing License from Discipline by the Florida Board of Nursing? Website Accessed April 22, 2022.

15. Florida Board of Nursing. A Tool to Report Health Care Provider Complaints. Website Updated July 28, 2016. Accessed April 22, 2022.

16. The Impaired Nurse: Would You Know What to do if You Suspect Substance Abuse. Website Published August 11, 2011. Accessed April 18, 2022.

17. The 2021 Florida Statues. 456.076 Health Professions and Occupations: General Provisions. Website Accessed April 20, 2022.

18. Smith L. ARNP, MN M. Div. CARN-AP Executive Director. Alternative to Discipline Programs: Florida’s Intervention Project for Nurses. Website Published January 26, 2017. Accessed April 27, 2022.

19. Patient Safety. Website Accessed April 27, 2022.

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