[Daytonite]

Had an interesting situation that came up and thought I'd throw it out for discussion.

One of our staff RNs was found sitting in a chair and sleeping at the bedside of one of our ventilator patients at 7am. She tells me that the patient was very restless and they had been constantly watching him throughout the night shift because of the fear of him pulling his trach out. They found he would settle down when someone sat with him and held his hand (how basic can nursing care get?). So, periodically during the night different staff members sat at his bedside. The nurse in question says that at 5am she had caught up on all her charting and told her co-workers that she was going to sit down in the room with the patient. She sat down, took his hand and he immediately quieted down. She sat back and the next thing she knew someone was waking her and telling her it was 7am. She jumped up and worked on giving her 6am meds and ended up giving an oral report to the oncoming shift (we tape report).

A very serious decision has to be made here. This is a really excellent nurse and I'm afraid there will be no choice but to fire her and report her to the Board of Nursing. I understand that she did not intend to fall asleep and that she was helping the patient, but rules are rules, aren't they? How I wish this hadn't been reported. Our facility rules clearly state "no sleeping on the job". Our Human Resources Office and the Director of Nursing will make the final decision. What do you all think?

[land64shark]

Originally Posted by Daytonite

but rules are rules, aren't they?

Rules are rules, but there's got to be exceptions. If this ruins the career of an excellent nurse, I will need to rethink my decision about going to nursing school.

[Aneroo]

Rules are rules, and are not there to be broken.
Sounds like this nurse did realize what happened was wrong, and did what was needed to best fix the situation.
Boards of Nursing do not jsut yank a license away. There needs to be a horribly serious offense in order for that to be done. The BON would need to investigate it, they might not even come to the facility, they may do telephone interviews. Most issues can be dealt with out of court instead of having to go all the way to the board.
This nurse might be punished, but I seriously doubt she would lose her license. Her job though...I don't know. -Andrea

[ckh23]

Originally Posted by land64shark

Rules are rules, but there's got to be exceptions. If this ruins the career of an excellent nurse, I will need to rethink my decision about going to nursing school.

I agree. What happened to taking care of our own? Sure she really messed up and I'm sure she knows she did, but to fire her over seems very extreme for a first time offense. I'm thinking maybe a suspension and then a probation period? I think it is very extreme to fire her over this. The main reason being this could happen to anyone, and if say it wouldn't you're lying. We all work hard during a shift and if any of us were put in a quiet room with lights down after a long shift we may be nodding off as well.

[dorselm]

I too am very worried about starting Nursing School if this is what happens. I always wonder how they expect someone to not fall asleep and to fully function throught the night. This is very harsh. I think she should get a warning and if it happens again, then they would have every right to do what they have to.

[hrtprncss]

Getting fired is a bit too much I think. Good nurses are very hard to come by. It probably would have been better if the charge nurse spoke to the physician to get a sitter for this patient, or if there's a family member to sit with the patient. IMHO.

[rogramjet]

The first question that will be asked is- Was anybody hurt? Did she neglect her patients? Yes the meds were late, but that happens. I really doubt she will lose her liscense over this. Things like this happen. Nobody was hurt because of it.

[Marie_LPN, RN]

If she gets fired, i would not be surprised. It's sleeping on the job (she wasn't on a break), no matter what the circumstances are.

[Katnip]

I'm just wondering why there's no medication protocol to keep a vented patient calm so he doesn't pull out the trach.

[mtymom]

First of all; why didn't anybody come looking for her sooner. That was 2 hours that she was in there, surely someone would have missed her before then. Also, I don't see where this could not have been neglect. She was not on the floor working for 2 hours. She also inconvenienced the other shift because everything was late. Also how could she give an accurate report on her patients? She did not know what was going on for 2 hours,IMO.