I can tell you from experience, it will get worse if you don't act immediately. Maybe, depending up the relationship of you and your boss, you could say that you have had some personal problems that have led to your work behavior, but you are actively seeking assistance and perceive that the situation can only improve with this direction. Then FOLLOW THROUGH!! If you don't, your credibility will drop in the eyes of your boss and the consequences of that can be devastating to your career. The nature of your work doesn't allow much tolerance to being wasted and tending patients. I am an EMT, and to go to a scene of an accident drunk (which honestly, I have done,) can not only put yourself in danger (by driving,) but also to the patient you are administering medical procedures. It just doesn't fit in with the job.
Make some firm decisions and do your best to follow, eventually everything will self-correct.
Padraic