Alex, a public health nurse, packed files into her workbag and paused to make sure she had everything she needed for her afternoon visits. She was feeling distracted by a conversation she’d had that morning with Robin, a close friend and colleague.
Robin had talked to her quietly at the office, confiding that her physician had diagnosed her with significant clinical depression. She had started medication and was going to counseling, but the meds would take a while to work and she was feeling pretty awful. Alex knew Robin had been diagnosed with depression in the past and had noticed lately that Robin didn’t seem like herself. She’d been off a lot, had stopped joining Alex for their daily walk at lunch, and was quiet when she was at work.
During the conversation, Robin confided that she hoped she could lean on Alex. “Of course you can count on me! Let me know what I can do to help.” Alex had replied as she hugged Robin.
As Robin was leaving, she had turned and asked “Please keep this to yourself. I know I don’t have to ask you, but I really don’t want anyone else to know.”
On the way to her first visit, Alex mulled over her conversation with Robin. She was concerned for Robin and wanted to be supportive, but felt uncomfortable. She wondered if this was having any effect on Robin’s practice. She reflected on the last few weeks and couldn’t recall any situations from Robin’s work that jumped out at her, but Alex wondered if maybe she just hadn’t noticed.
She had agreed she wouldn’t tell anyone, but now she wondered if she had a duty to do something.
Duty to Report Practice Standard sets out the expectation that nurses report unsafe or incompetent practice. On the basis of this direction, it may seem that Alex has a responsibility to report Robin. However – and this is the important point – only if she believes Robin’s capacity to practice appropriately is impaired. Alex uses the questions from the standard to decide what to do.
Robin said she “feels pretty awful” but Alex doesn’t have any evidence that Robin is failing to provide safe, competent, ethical care. Alex knows Robin is receiving treatment for her depression. If Alex had concerns, she feels she could discuss them with Robin. Alex concludes, given the current situation, that she doesn’t have an obligation to report Robin. Alex decides that she will check-in with Robin to see if she is having any challenges in carrying out her work.
Alex knows that if the situation changes and Robin’s practice is affected, she has several College resources she can use:
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