The Drunk Responder

Greg Friese, over at Everday EMS Tips, has written a post in observance of Drug Free Work Week – Oct 19-25th, 2009 entitled When a Coworker is Intoxicated”In it, he asks what we would do as EMS professionals and Firefighters in cases where we suspect that a coworker is under the influence. This originally started as a comment to his post, but it went long enough that I thought I could get a post out of it. Here it is:

Ewww, I hate these situations. I’ve worked full-time EMS for a long time, but I’ve volunteered for longer than that. One would think that this is a problem that I’ve encountered more often in the volunteer services, however I’d have to say that the few times I’ve actually noticed it are about equally distributed.

Thankfully, these situations havebeen few and far between. However, EMS and Fire people like to drink sometimes (ahem) and the potential exists for this to happen more often than you’d think.

In a volunteer service, the classic example is someone showing up for an emergency call after consuming alcohol. Often, these people sincerely did not want to “show up drunk” but thought that the need was great enough for them to show up after having “Just one or two”.

For thepaid services, aside from the absolute taboo of consuming alcohol while on duty, the classic example would be spending a late night out at the bar and then showing up for work in too short of a time for the alcohol to be removed from the person’s system. If you’ve ever had a coworker show up complaining of a hangover, this may indeed be the case.

Both are unacceptable. Personally, I know that my career depends on never doing this. I also know that my patients deserve a caregiver who is on top of his (or her) game. I subscribe to the FAA’s rule governing pilots, or the “8 hour from Bottle to Throttle” rule. I take myself out of the response roster for at least 8 hours if I have had one sip of ETOH and I stop drinking a minimum of 8 hours before having to go on duty.

There’s no excuse for a provider having any amount of alcohol on board while performing any aspect of EMS. If the patient smells even a whiff of ETOH on their provider, that provider is drunk until proven otherwise. Even if the provider is under the legal limit the patient loses confidence.Our patients deserve better. If you had EMS come for a family member and smelled alcohol on the responding ambulance crew, you’d think the same thing and would probably become very angry or fearful for the actions of the responding crew.

Remember, each “drink” defined as one ounce of alcohol, raises your BAC (Blood Alcohol Content) by roughly 0.02%. That amount of alcohol takes approximately one hour to be removed from your system by your liver. Each person is different, and other factors come into play… however if you’ve been drinking you need to leave hours between your personal fun and your professional care.

The problem here, of course, is the percieved effect on the person who reports a coworker for possibly being under the influence. In some agencies there may be fear on the part of the coworker who notices the smell of ETOH or other intoxicant that they will be ostracized by the group for blowing the whistle and turning the offender in. In reality, it is your duty to your future patients and the reputation of your agency to turnsomeone in no matter the percieved ill effects. However, to make this easier I have some tips:

  1. Act immediately – If this person gets activated for a call or otherwise interacts with a patient, they could cause that patient harm. This is unacceptable.
  2. Enlist the aid of a coworker if you’re uncomfortable immediately going to a supervisor – Get someone else to nonchalantly speak to the person or linger in their vicinity to see if they notice what you do. Go together to report the suspicions even if the other person doesn’t notice what you do. It’s that important.
  3. Remember that someone’s life may very well depend on your actions – Friendship among coworkers is one thing, but a drunk firefighter or EMS provider may very well kill someone. You or another coworker may be injured or killed by their actions on the fireground or emergency scene. Your patients may suffer at their hands because their decision making ability and reaction times are impaired. Can you stand that on your hands for not reporting it?
  4. You may be helping the person through a real problem – Is the coworker an alcoholic? Could they be? Being at work drunk, especially in such an important job as EMS and firefighting is indicative of a real problem with alcohol. Turning them in maybe the first, and biggest influence in getting that person help or in allowing them to help themselves.

This is a tough situation, but is an easy call. Keep alcohol and other drugs out of the emergency services. Keep yourself sober and sharp while on-duty or responding. It’s just not worth losing everything over a couple of beers. Have your fun and enjoy yourself while off duty but remember,alcohol can be a wonderful servant but is a terrible master. Do yourself, your career, and your patients a favor and leave ETOH in your personal life, far away from your station.

  • http://twitter.com/gfriese Greg Friese

    Great post and thanks for reading my post on this same topic.

    I think we should ask around about the “taboo” of drinking in the fire station. Maybe Fire Geezer or STATer 911 has some knowledge of this. My hunch is that there are still fire stations that serve beer in the station post call or training.

    Thanks again for encouraging us all to better understand the connection between off time and on time.

  • emschick

    We have a member that moved from another state who constantly talks about how his old station had alcohol in the radio room. We have a strict no alcohol on the premises policy and do not allow drinking and running calls. I used to think that maybe he was talking about the “good ol' days” until I visited the state he was from and found out that a station there just stopped pizza and beer nights a few years ago. I was floored.

    Unfortunately the fire department in my town allows a member have up to 4 drinks and still run calls.

  • emschick

    We have a member that moved from another state who constantly talks about how his old station had alcohol in the radio room. We have a strict no alcohol on the premises policy and do not allow drinking and running calls. I used to think that maybe he was talking about the “good ol' days” until I visited the state he was from and found out that a station there just stopped pizza and beer nights a few years ago. I was floored.

    Unfortunately the fire department in my town allows a member have up to 4 drinks and still run calls.

  • medic1518

    Tradition.

    This word seems to allow many events to happen even if they don't make sense. My Granfather, father, and uncle all served as volunteer fire fighters. I remember many stories of parties at the fire house through the 1950's and well into the 80's. This is when firefighters were “MEN”. They didn't wear SCBA, that was for “MEN”. They rode the tailboard and hung on like “MEN”. They drank beer, because that is what “MEN” did!

    Alcohol is associated with attaining adult status in the American society. The thought of having an alcoholic beverage when we are out doing adult “MEN” things has always been acecpted, tradition.
    Alcohol and the firefighter is one tradition that needs to end. There are many more but we will stay on track with this one.

    What would think if you knew that your hospital allowed a surgeon to have a “few” drinks before surgery? How about your fleet mechanic that is about to do a brake job on your ambulance? Most of you would speak up and not allow this to happen. Yet, when a brother or sister comes into the firehouse for a call and you can smell the ETOH you question yourself. Why? This is really a question of respect.

    Your brother or sister firefighter/EMT has displayed a great disrespect for you and your mission statement. They need to be helped. You as their crew member owe it to them. Tell them that you are very displeased with what has happened yet you are still there to help them.

    Tradition.

  • medic1518

    Tradition.

    This word seems to allow many events to happen even if they don't make sense. My Granfather, father, and uncle all served as volunteer fire fighters. I remember many stories of parties at the fire house through the 1950's and well into the 80's. This is when firefighters were “MEN”. They didn't wear SCBA, that was for “MEN”. They rode the tailboard and hung on like “MEN”. They drank beer, because that is what “MEN” did!

    Alcohol is associated with attaining adult status in the American society. The thought of having an alcoholic beverage when we are out doing adult “MEN” things has always been acecpted, tradition.
    Alcohol and the firefighter is one tradition that needs to end. There are many more but we will stay on track with this one.

    What would think if you knew that your hospital allowed a surgeon to have a “few” drinks before surgery? How about your fleet mechanic that is about to do a brake job on your ambulance? Most of you would speak up and not allow this to happen. Yet, when a brother or sister comes into the firehouse for a call and you can smell the ETOH you question yourself. Why? This is really a question of respect.

    Your brother or sister firefighter/EMT has displayed a great disrespect for you and your mission statement. They need to be helped. You as their crew member owe it to them. Tell them that you are very displeased with what has happened yet you are still there to help them.

    Tradition.

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Chris Kaiser aka "Ckemtp"

I am a paramedic trying to advance the idea that the Emergency Medical Services can be made into the profession that we all want it, need it, and know it deserves to be.
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