An impaired nurse requests return to duty after mandatory counseling. What action by the charge nurse is best?

• A. Allowed the impaired nurse to return to work and monitor medication administration.
• B. Deny return to work and place the nurse on leave.
• C. Place the nurse on administrative desk duty with no patient care duties.
• D. Transfer the nurse to a unit with minimal patient contact

Answer: (A)

The main idea is keeping patient safety at the forefront when a nurse who was impaired is returning after counseling, by pairing reintegration with safeguards that verify ongoing responsibility. Since the nurse has completed mandatory counseling and is requesting to return, the best move is to let them come back to work but under close supervision, with a plan to oversee a high-risk task like medication administration. Monitoring how medications are prescribed, prepared, and given provides a direct safeguard against errors while the nurse demonstrates the ability to maintain safe practice. This approach supports rehabilitation by allowing the nurse to re-enter the clinical setting in a controlled way, rather than complete withdrawal from practice.

Denying return would remove the nurse from practice despite completing counseling, which is not consistent with using structured supervision to manage risk. Assigning desk duties eliminates patient contact but does not directly address the nurse’s ability to perform essential patient-care tasks safely. Transferring to a unit with minimal patient contact reduces exposure but still leaves the same core risk; without ongoing observation of high-risk activities, safety cannot be ensured. By contrast, returning with supervision specifically focused on medication administration creates the immediate safety net needed while supporting the nurse’s transition back to full duties.