Scenario
You reach work at 8am and meet one of the other dentists. There is a strong smell of alcohol coming from them and they appear to stumble a little. How would you handle this situation?

Take a few minutes to consider your answer to this and then compare to the suggested answers below.

Which issues/standards are involved?

Remember to consider general issues as well as GDC/CQC standards:

  • Put patient’s best interests and safety first (GDC Standard 1) – Patients must be protected from any harm from a drunk colleague and additionally, your colleague’s clinic may need to be cancelled.
  • Communicate effectively with patients (GDC Standard 2) – Careful communication with the patients is necessary to inform them of any delays/cancellations in clinics.
  • Complaints procedures and handling (GDC Standard 5) – Patients may complain due to cancellations of clinics
  • Working within the team (GDC Standard 6) – To handle the situation appropriately for patients and staff, careful organisation and co-operation is needed.
  • Maintain, develop and work within professional skills and knowledge (GDC Standard 7) – This may be a situation you haven’t dealt with before.
  • Raising concerns (GDC Standard 8) – Patients may be coming to harm from your colleague, therefore concerns may need to be raised.
  • Protect the confidence in the profession (GDC Standard 9) – Patients must maintain their trust and confidence in the profession.
  • Other issues such as general professionalism and fitness to practice.

What is your short-term management?

You short-term management is to manage the colleague and then ensure minimal impact to patients:

  • Speak to your colleague first to establish the background – you must be careful not to jump to any conclusions. You first need to assess if your colleague is actually drunk. Are they aware that this is not safe or acceptable?
  • Speak to your supervisor – you may not feel comfortable handling this situation or may need further support so speak to your supervisor.
  • Arrange for colleague to go home – a taxi/colleague needs to take your drunk colleague home. They, obviously, cannot drive themselves and they are not fit to be at work. Their safety in getting home is still important.
  • Handle the colleague’s clinic list – the dentist will have had a clinic booked and patients may be attending. It will be important to work as a team to manage this situation. Options would include:
      • Cancelling the entire clinic and contacting patients with offers to rebook – apologise that the dentist is unwell and the appointment has to be cancelled
      • See the few patients that may have attended but cancel the remaining patients
      • The team may split the patients between themselves so that they are seen, but apologise that the dentist is unwell and there may be a delay in being seen
      • Consider getting a locum dentist at short notice to cover for your colleague
      • Is there a practice nearby that may provide any emergency care needed?
  • Refer to the complaints procedure – patients may be unhappy with the situation and you may have to direct them to the complaints procedure. Settling these in-house would be ideal.
  • Discuss with your indemnity provider
  • Document complete, concise, clear and contemporaneous notes – especially in a situation of complaint, thorough documentation is very important.
What is your long-term management?
  • Discuss concerns with colleague (or ask supervisor to) – further information is needed from the colleague as to why they were drunk. It may be that they are having a difficult period in their life/stressed and they need further support – in this case they need to be referred or signposted onwards. You need to ascertain whether the colleague understands that this was inappropriate and not professional. If they appear to not understand the implications of their actions, or feel they didn’t do anything wrong, then there may be grounds to escalate this further. Ultimately, this could end up at the GDC with a fitness to practice case.
  • Arrange appropriate cover – if the colleague is likely to be off, appropriate cover needs to be arranged for their clinic or clinics need to be cancelled.
  • Handle complaints – handle any complaints in accordance with practice and GDC policy. Involve indemnity providers if needed.
  • Reflection and portfolio – reflect on the situation and how you approached it – would you do anything differently?
  • CPD – the practice could look at general CPD on these topics.
  • Team meetings – this may be a good opportunity to discuss complaints handling etc with the rest of the team in a meeting as well as arranging cover for your colleague.

Attempt some other scenarios to help you prepare here.

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