What punishment should this nurse get?

Nurses General Nursing

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  1. Should THIS nurse be fired from her job

    • 24
      Yes, this nurse should be fired...no matter how excellent.
    • 372
      No, this nurse should NOT be fired, it happens...even to excellent nurses.

396 members have participated

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?

Specializes in Cardiac.
Really! In my experience there are some dangerous nurses walking around wide awake.Faulty reasoning? Please explain.

I did explain. To say that because you have not seen a situation occur in the past means it won't occur in the future is faulty reasoning. So when your spouse in the the hospital and you walk into the room and your nurse is asleep--that's OK with you?????

Yes, I agree that there are many poor nurses walking around awake. But your critical thinking skills are heavily impaired while asleep. Also, you should monitor you pt BEFORE your vent alarms tell you the pt has extubated himself. What if his vitals were trending downward? Nurses need to monitor pts before the alarms do! Come on! This is basic stuff...

Specializes in LDRP.

Well,what would you think if a nurse on night shift, while her paperwork was caught up and her patients were sleeping walked off the floor and was gone for 2 hours? If that was the case, there would be a lot more upset, i imagine.

same thing. she was, for all intents and purposes, gone for those 2 hours. Since she had a vent pt, i imagine this was an ICU or PCU, where hte pt's need frequent monitoring, but their nurse was unavailable for 2 hours.

I would fully support a nurse taking a nap on her break, on her OWN unpaid time. but to fall asleep onthe job is highly unprofessional and dangerous.

I am sympathetic to those who make mistakes. But I think this was a mistake of larger proportions-the potential for harm was great.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
But they weren't.

I am aware of that, and it doesn't change my opinion of this particular situation.

Specializes in ER.

This nurse would probably never make that mistake again. That is one good reason to keep her.

We need to take care of each other.

Specializes in RN, BSN, CHDN.
This nurse would probably never make that mistake again. That is one good reason to keep her.

We need to take care of each other.

I agree

with you I am sure she wouldn't ever make this mistake again, I bet she is distraught.By the way i have witnessed a lot worse happening to a member of my family I wish all they had done is fall asleep.

Specializes in Cardiac.
But they weren't.

You are a manager. The next time this nurse falls asleep and a pt has a sentinal event. How do you explain this to the big boss? How do you defend your actions? How will Goldberg & Osborn defend your actions? How will you feel knowing that if she does harm someone in the future that you could have prevented it?? Being a pt advocate means that you CAN'T SLEEP ON THE JOB! 2 hours!!! How long would she have slept had no one come and got her. And no one got hurt??? Who was monitoring her other pts? They all got no care. That is, again, completely unacceptable.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
why can I not ask?

Already answered this.

You say you would fire this nurse, period.

And that does not automatically make me a nurse that is not a team player who's unsupportive of my co-workers.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
I am sympathetic to those who make mistakes. But I think this was a mistake of larger proportions-the potential for harm was great.

I agree.

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Specializes in Cardiac.
This nurse would probably never make that mistake again. That is one good reason to keep her.

We need to take care of each other.

And while we are all taking care of each other, who is taking care of the pts? Her other pts were completely unmonitored for 2 hours, the oncoming shift had to get an oral report, her morning meds were late, and all of her morning work suffered. What if the person waking her up was a family member and not a staff member? Do we not care about safety and professionalism anymore?

That's a tough one. Being that she is an excellent nurse with I assume no prior disciplinary record, then perhaps everything could be handled internally with a reprimand and no report to the BON. Did the patient or any of her other patient's suffer because of this? If the answer is no, then I don't think it would be necessary to report her to the BON.

Specializes in RN, BSN, CHDN.
You are a manager. The next time this nurse falls asleep and a pt has a sentinal event. How do you explain this to the big boss? How do you defend your actions? How will Goldberg & Osborn defend your actions? How will you feel knowing that if she does harm someone in the future that you could have prevented it?? Being a pt advocate means that you CAN'T SLEEP ON THE JOB! 2 hours!!! How long would she have slept had no one come and got her. And no one got hurt??? Who was monitoring her other pts? They all got no care. That is, again, completely unacceptable.

Your presuming this nurse would fall asleep again. Did I say at any point in this thread that it is acceptable to fall asleep on duty, I think you would find that I havent. I dont believe the best way to deal with this situation is to go in and fire this nurse.Have you managed many wards and situations, believe me there are far worse situations occuring on a daily basis and if I sacked them all then we would have a worse nursing shortage than we have right now.

Specializes in RN, BSN, CHDN.
Do you not have a team nursing spirit in America? Do you not support your colleegues?

This was a generalised question not a personnal one. Just for the record

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