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Policy# U3305: Impaired Student- Undergraduate

Description: To provide faculty and/or clinical preceptors with guidelines to assess an undergraduate nursing student for impaired function when the student is demonstrating behaviors of a concerning nature. Behaviors of a concerning nature include the inability to perform essential classroom functions or clinical activity.


Definition: Impairment is defined as a condition in which a student is unable to function or their level of functioning is compromised due to a mental or physical condition. Examples may include acute medical condition such as an insulin reaction, ingestion of illicit drugs or prescription medications, used in an inappropriate manner; or symptoms of mental health changes. NOTE: If a student’s behavioral change suggests an acute health condition, emergency measures should be taken.

University Statement: South Dakota State University prohibits the consumption, possession, distribution or chemical impairment during any student activity associated with the college of nursing including but not limited to clinical activities, laboratory and classroom. Therefore, students are not permitted to test positive for alcohol or drugs during these times. For questions regarding preadmission drug screens and past illegal drug related activity, please see College of Nursing compliance requirements.

1. Identify Impairment

When a faculty member and/or clinical preceptor identifies an impaired undergraduate student, the following steps should be taken:

  1. Contact another faculty member, management, or agency personnel and attempt to validate that the student’s behavior is concerning. Behavior of a concerning nature means that the faculty notes such changes in behavior that may include, but are not limited to: sleepiness, disorientation, rapid or slurred speech, poor bodily hygiene habits, breath/body odor, staggering gait, pupillary changes, bloodshot eyes, tremors, verbal/physical outbursts, suicidal/homicidal threats, absenteeism and erratic behavior.
  2. Remove the student from the learning situation (classroom or clinical area).
  3. Discuss your concerns with the student regarding his/her behavior in a private environment and in the presence of a witness (other faculty member if possible).
  4. Allow the student to give an explanation.
  5. Determine whether it is necessary to keep the student out of the clinical area or allow the student to return to the CON activity.
  6. Contact the clinical agency’s nursing administration when chemical impairment is suspected and follow the agency’s internal procedure for chemical testing. The CON is responsible for the costs of screening for “reasonable suspicion. “Testing positive” means the original testing detects any level of illicit substance, presence of prescription medication without appropriate documentation and/or alcohol.

2. Follow-up Process if Impairment is Identified

When a faculty member/preceptor identifies a student as potentially or actually impaired, the following steps should be taken:

  1. Instructor
    1. Notify immediate CON supervisor/leadership personnel within 24 hours.
    2. Submit a written report within two working days detailing the student’s conduct, a summary of the behaviors or observation that lead to the concern, witnesses, and contact information of those involved (student, client if applicable, witnesses, etc.)
  2. CON Leadership Personnel
    1. Give a copy of the written report to the leadership personal in Nursing Student Services
  3. Nursing Student Services
    1. Notify the appropriate administrators to determine the best course of action. The office of the Undergraduate Nursing Department will ensure confidentiality of results by making the information available only to the student and appropriate College of Nursing Administrator.
    2. Collect the data and convene a meeting with management to discuss the student’s return.

3. Verified Health Conditions Follow-up

  1. The student must provide the CON with a primary care provider’s release stating that he/she is cleared to attend theory and clinical courses. The statement should include any limitations required based on the health condition but which will not prevent the student from full participation.
  2. The Nursing Student Services leadership personnel, in conjunction with CON administrative personnel, will review the documents and determine if and when the student may return to class or clinical.

4. Verified Chemical Impairment Follow-up

  1. The leadership personnel within Nursing Student Services will refer the student to Student Health for counseling and possible referral to the Health Professional Assistance Program. The student will be required to show proof of counseling.
  2. The student will be required to sign an agreement to undergo appropriate treatment. If the student refuses treatment and/or professional counseling, he/she will be removed from the Nursing Major and not be reconsidered for readmission.
  3.  If the student refuses to sign the agreement, they will be subject to dismissal from the program. Within five working days, the student will receive written notice of the dismissal from the Department Head of Nursing Student Services.
  4. During treatment, the student will receive an “incomplete” or “withdrawal” depending on the amount of clinical time completed. While in treatment the student will be given adequate leave of absence from the college. The student will be asked to sign a release of information so that the College of Nursing can receive updates ensuring compliance to treatment and readiness for re-entry into the program.

5. Prior to readmission into the College of Nursing, the student will complete the prescribed treatment, and if appropriate, submit to a random drug screening at the student’s expense. Any positive results or treatment refusal/failure will lead to dismissal from the College of Nursing.

The University has a Faculty and Staff Behavioral Intervention (BIT) Guide to reference for guidance on how to make a referral, what your role might be, and warning signs.  See link: Faculty & Staff Behavioral Intervention (BIT) Guide 

Reviewed by the Bylaws and Handbook Committee 11/17/2015; 3/2018
University links updated 1/06/2016 mtd