Professional Documents
Culture Documents
Scenario: Johnny is a Warehouse Operator and has been for the past
5 years. Over the past 2 months, hes been late 6 times and is on a
first written warning for tardiness. Johnny has never been written up
before to your knowledge, so you are worried about him. Johnny is
late to work again today so you are prepared to provide him with a
second written warning. Once Johnny shows up to work, you sit down
and start talking to Johnny about your concerns with his attendance
record. As soon as Johnny starts speaking, you notice a strong odor
coming from his mouth that smells something similar to alcohol. You
try to ignore the smell and focus on the conversation. As Johnny
continues to talk, you notice his eyes are glossy and he starts to
stumble over his words. He is not making much sense with stories and
you start to wonder why he is acting so different. You begin to
question Johnny and ask him to clarify what he is trying to say. Johnny
becomes irritable and starts arguing with you for no particular reason.
You try and calm Johnny down, but he doesnt seem to listen. Instead
he pushes the table back, and stumbles out of the office. He trips
over the lip on the door and almost falls. You realize, Johnny may be
under the influence of alcohol and/or drugs.
Using the scenario above, complete the Intoxication and Substance
Abuse Checklist with your partner. Please be prepared to explain why
or why not the situation below could be classified as a potential crisis
situation and what actions you would take next. Additionally, please
be prepared to demonstrate how you would hold a constructive
confrontation conversation with the associate regarding his behaviors.
BUSINESS UNIT
CLOCK #
SHIFT
DATE
COST CENTER
OBSERVATIONS
Breath
None
Strong
Faint
Moderate
Bad Breath
Burnt rope
Eyes:
Bloodshot
Normal
Glassy
Fixed Pupils
Glazed
Watery
Difficulty focusing
Dilated Pupils
Heavy Eyelids
Speech:
Confused
Stuttered
Thick Tongued
Accent
Lacks Continuity
Loud
Slurred
Mush Mouthed
Talkative
Incomprehensible
Garbled
Normal
Cotton Mouthed
Mixed or Rapid Subject Change
Other ________
Unusual Action(s):
Difficulty Sitting
Hiccuping
Belching
Vomiting
Fighting
Sobbing / Crying
Laughing
Rigidity
Absenteeism
Unexplained Accident(s)
Bizarre or Reckless Behavior
Other _______
Swaying
Staggering Falling
Needs support
Other _________
Wobbling
Suspicious of:
Alcohol Intoxication
Substance Abuse
Yes
Suspected
Slight
Obvious
No
Yes
No
Decline
Additional Comments:
HR Specialist Name:
__________________________________________________________________
Supervisor: ______________________________
Witness(es):
______________________________
Signature: ______________________________
______________________________
Time:
______________________________
______________________________
Revised 5/2010