Day of Reckoning

We have an FMLA/ADA case that will soon have,perhaps, a very unhappy ending. We have a nurse who is severely depressed and has been this way since August. She has been hospitalized, continued outpatient treatment, etc. She could not perform many of her functions because of stress, etc. We took several of these away to accomodate her until she was able to handle them. We tried re-introducing them, but she had anxiety attacks and had to be sent home. We were at the point of fearing for safety of patients due to her mental status. We would not allow her to come back to work and she is out on FMLA.
She is fast running out of FMLA and I know that this will qualify for ADA.

She did not like her psychologist's diagnosis, so she quit going to him (recommended hospitalization). Her primary care physician just wants to keep medicating her (with not good results). Anyway...you can see why we can't allow her to work around patients.

She, of course, wants to come back to work and thinks she is now "fine". We did this before and she was not "fine". Anyway...she has agreed to have a psychiatrist evaluate her as to whether or not she can perform the essential functions of her position. She agreed to this and is being very cooperative about the entire thing.

Unfortunately, I do not think this is going to be a good outcome for her. She will probably end up losing her job because I can't see how anyone is going to recommend that she can perform the essential functions of a nursing position, given her present state.

Can you guys see anything I am missing here? We have tried to be as compassionate and as sympathetic as possible, but we've reached the end of the line. There is nothing else she can do in the office due to her inability to focus on what is in front of her.

This is a very unfortunate situation, but I don't see what else can be done.

Comments

  • 3 Comments sorted by Votes Date Added
  • Nursing encompasses a wide range of activities, which don't necessarily include direct patient care; e.g., quality assurance.

    Firstly, while you are getting an evaluation of whether or not she can perform the essential duties of her nursing position, do you know what those essential duties are? I say that becsuse you said you eliminated some dutied. If you did and she still was considered in the same nursing position, I don't know if you are able to say that those duties were essential?

    Further, wait until the outcome of the evaluation. The question the psychiatrist needs to anwer is whether or not she is able to eperofrm the essential duties of the job with or or without reasonable accommodations and without being an undue risk to herself or others. Did you send to the psychiatrist a job descripton and information about the physical, enviornmental and mental demnds of the partiuclar nursing job? Don't be surprised if the psychiatrist does allow her to come back under certan situations which you may need to accommodate. From what you've posted, I'm going on the basis that you have determined that she is ADA qualified (she has a disability as envisioned by ADA).

    Finally, assuming she is able to return to work as a nurse, a reasonable accommodation could be reassigning her to a vacant nursing position, with lower duties and pay.
  • Find a loophole. A person with her issues should not be on the loose treating patients, especially, with access to patient meds. There do come times when we need to search for ways around regulations, rather than spinning our time and wheels and energy trying to figure out a way to make the employee fit into the workplace BECAUSE of government regulations. I opt for protection of the patient base and employing establishment.
  • Thanks for the comments guys. I have run the gamut with this one and am awaiting the evaluation.

    I can't see any way she will be able to perform her job duties with our without accomodation. What we accomodated before mainly involved temporarily relieving her of certain stressful situations such as working triage (emergency) cases in the office and working directly with the physicians in a clinical setting. It rapidly became obvious that even with temporarily reassigning these duties,she couldn't handle even routine, lower level nursing duties without anxiety attacks or going home and medicating herself. It then became a patient care/safety issue which we could not put our patients in the middle of.

    What's really sad is when we let her go,she probably won't have any trouble getting a job elsewhere.
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