As an integral part of the delivery of quality healthcare, the functioning capabilities of the nurse must be on par with the standards required by the institution and the position within that institution held by the nurse. An impaired nurse, by definition, is lacking in the ability to perform their duties at a level sufficient to successfully provide their patients with quality care and meet the standards defined by their position. The complete technical definition, according to Dunn considers a nurse to be impaired “when alcohol or drug use affects their cognitive, interpersonal or psychomotor skills to the point where they can no longer satisfy their professional code of ethics or standards of practice”. As a management leader, the quality of the decisions made regarding the identification of a nurse impaired, whether due to drug abuse or the use of other mind-altering substances, is vital to the success or failure in the ability of the staff to provide their patients with proper care. Since nurses represent the largest discipline within the healthcare infrastructure, strong leadership is vital to a healthy work environment, job satisfaction, improved patient safety outcomes, lower turnover rates, and positive outcomes for organizations, patients and healthcare providers. (Curtis, de Vries, & Sheerin, 2011). The primary requisites for successful management and leadership, as depicted by Marquis & Huston (2012), are decision making, problem solving, and critical thinking, which are considered to be learned skills that improve over time and with consistent use. The overall imperative of nursing, like all healthcare practices, is to provide optimal care to patients to help cure or better their conditions and, since the ability of the impaired nurse to achieve this function degrades according to their degree of impairment, it is vital for nurse leaders and managers to address these issues. Impaired nurses pose a significant risk to the health and safety of patients and it is essential that management and leadership staff members have accurate information regarding the prevention, identification, investigation, and reporting of a nurse with a substance abuse or chemical dependency problem so that they are able to assist in the referral of a nurse with a substance abuse or chemical dependency problem for appropriate assessment and monitoring (Colorado Board of Nursing, 2003). In addition, seeking help for the impaired nurse can potentially enable the nurse to eventually return to their duties once they have completed their recovery. Each year, statewide monitoring agencies receive thousands of complaints against RNs and LPNs, and a significant number of these complaints are regarding suspected drug/alcohol/chemical dependency issues, which makes the condition of the impaired nurse a significant national problem. For this reason, the topic of managing the impaired nurse is of significant interest and is one I feel should be addressed.