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Duty to Report

In accordance with the Massachusetts Board of Registration in Nursing (BORN) Professional Standard of Conduct governing a Nurse’s Duty to Report 224CMR 9.03(26) and the MGH IHP Substance Abuse Policy, students are expected to immediately report to a clinical instructor and/or faculty member any instances where they personally observe abuse of a patient; the practice of nursing while impaired by chemical substances including alcohol or drugs, or both; or diversion of controlled substances.  Any concerns students may have about what they observe in the practice setting, particularly as it relates to patient safety, should be brought to the attention of the clinical instructor. 

  1. Should a student observe a nurse, nursing student, or other health provider engaged in behavior involving abuse of a patient, the student should immediately notify his or her clinical instructor.
  2. Should a student observe a nurse, nursing student, or other health provider practicing while impaired by chemical substances including alcohol or drugs, or both, or engaged in diversion of controlled substances, the student should immediately notify his or her clinical instructor.
  3. The clinical instructor is responsible for taking action as appropriate including investigating and reporting such student observations and concerns within the clinical setting.
  4. In addition to reporting their observations to the clinical instructor, students who are licensed as Registered Nurses are expected to comply with the Nurse’s Duty to Report such observations to the BORN in accordance with 224CMR 9.03(26).

    https://www.mass.gov/guides/nursing-mandatory-abuse-reporting

  5. In addition to notifying the clinical instructor, students are encouraged to discuss any clinical situation they find troubling with their course faculty, academic advisor, or Assistant Dean.

Abuse of a patient is defined by the BORN as “...contact or communication with a patient or resident, which in any way harms or intimidates, or is likely to harm or intimidate, a patient or resident.  Abuse may be verbal or non-verbal, and may cause physical, sexual, mental, or emotional harm” (EOHHS, 2000, para. 5).

Practicing while impaired “means the inability to practice nursing with reasonable judgment, skill, and safety by reason of alcohol or drug abuse, use of other substances, a physical or mental illness or condition, or by any combination of the foregoing.  The duty to report does not apply to impairment resulting only from a physical or mental illness or condition” (EOHHS, 2000, para. 7).

Controlled substance means “any drug or medication requiring a prescription in Massachusetts” (EOHHS, 2000, para. 10).

Diversion means “the unauthorized removal of a controlled substance from a patient or resident supply or care setting” (EOHHS, 2000, para. 9).

Massachusetts Executive Office of Health and Human Services. (2000). Guideline for compliance with the standard of conduct at 244CMR 9.03(26) – Governing a nurse’s duty to report to the Board of

Registration in Nursing. Retrieved from https://www.mass.gov/doc/244-cmr-9-standards-of-conduct-for-nurses/download

[Policy adopted May 2013, Reviewed April 2019]