Dear Joyce – Staff With Personal Problems

A nurse on the unit that I supervise is having trouble doing her job, because of problems at home involving her teenage daughter who is pregnant. The situation is really affecting her work, but she says that, as a single mother, she can't afford the time off. I don't want to insist that she take a leave, because I understand what it's like, but I'm beginning to think that's the only option. What do I do?

Sincerely,

Options?

As you know, in your position, your responsibility is first to your patients, and then to your staff and hospital.

Unfortunately, the reality is that if she really is as distracted as you say, she's in danger of making errors, or at the very least of providing substandard care, therefore putting patients (and her own license) at risk.

Other than taking leave, can she cut back on shifts without taking leave – or switch to per diem – thus leaving more time for herself? Can you switch her shifts around to be easier on her? Can she use her vacation time?

If none of these are possible, and she's putting patients at risk, "insisting" on leave is the only option.