Hospital pharmacy employment considerations for the chemically dependent health-care professional.

Experiences and decisions of a pharmacy services management team involving two chemically dependent individuals, one an existing pharmacist employee and the other a pharmacist applicant, are described. Because our standing on chemical dependency was to rehabilitate rather than terminate, we chose to develop a systematic approach to dealing with this problem in our employees. In the case of the existing pharmacist employee, we decided to initiate rehabilitation by intervention, a process that involved direct confrontation of the individual by his spouse and mother, immediate supervisor, a certified alcohol and drug abuse counselor, and a representative from the hospital's employee assistance program. The employee was treated by psychological/behavioral therapy on an inpatient basis. After discharge, the employee returned to work under specific terms outlined in a return-to-work contract covering the first 24 months; support structures at the workplace to guard against relapse were also instituted. Factors that might precipitate relapse were identified, and a policy for dealing with relapsing employees was developed. The pharmacist applicant was assessed like any other applicant, but a few other factors relevant to her recovering status, such as the length of continuous abstinence she had attained, were considered. An employment contract resembling the return-to-work contract also was developed. Experience with the chemically dependent employee led to the creation of a model for dealing effectively and fairly with employees afflicted with the disease of chemical dependency. We continue to support our institutional decision to rehabilitate and not terminate such employees.