Sleeping Nurse = No Agency?

Specialties Private Duty

Published

We have (my husband and I on separate occasions) caught one of our night nurses sleeping. The first time it happened, DH saw her on the baby monitor (I was already knocked out!) and he didn't say anything. He just got up to the hall bathroom (even though we have the en suite) and made a lot of noise so she would wake up. I guess she got the hint, because the next morning when I relieved her she told me about how she was coming down with something and may not be back that night. Being a PDN myself, I understood and respected where she was coming from, and just told her to call the agency in enough time for them to find a replacement since I had no day nursing that day and would be exhausted. She ended up calling in sick, we got a new nurse and all was well. We never reported it, and asked her back because we assumed it was an isolated incident. We watched her, and the other nurses on the monitor as indicated for the next few days, and had no real concerns. I trust most PDNs are honest and do a good job. I know I've always tried to do a good job and I never want to be one of "those" parents. I try to see it from the nurse's POV.

Weeks later, I woke up with one of my other children and happened to glance into the room and see the nurse sleeping. Not just dozed off (which I admit, I have done in the past- but not on purpose- and never comfortably) but LAID OUT on the floor (off camera) with Gem's Minnie Mouse throw blanket over her! I took care of my other child, put her back to bed, and when I walked past again, the nurse was sitting up in the chair (red eyes, groggy looking, obviously just woke up). I offered her a cup of coffee, and asked if she wanted to sit in the living room with a monitor to have better lighting. She declined, so I kindly reminded her that there is no sleeping and Gem can turn on a dime, so we needed full eyes on at all times. I don't think I was nasty about it, and I told her I wouldn't report her because I understand sometimes it's hard to stay awake.

Third incident, two night ago (3 days later), on my birthday. I came in from my celebration and went straight to bed. I had been the night nurse the night prior and my family had my birthday full from morning to night. I was EXHAUSTED! Because I fell asleep around 9, I was awake again by 2. I got up to get a drink, looked at the monitor, and didn't see the nurse. When I went downstairs, the nurse was on the couch with the other video monitor, lights low, TV off, curled up on the chaise lounge. At this point, I woke her up and sent her home. I did the rest of the shift and called the agency Monday morning. They said they would take care of it, apologized profusely, and arranged to send more nurses out later this week to interview.

Well, yesterday I get a call from them telling me they would no longer be able to staff my case! We are foster parents. These children aren't mine legally, and I HAVE to have nursing coverage 60% of the week as part of my placement contract. I have 6 kids total. They are not going to allow a medically fragile child to stay in a home with limited nursing coverage! When I asked the nursing director for an explanation re: canceling our contract, she simply said because I overreacted with the nurse and it would be difficult to find nurses who are NEVER going to doze off on night shift. I advised her there had been other incidents, and it was NOT dozing off in the traditional sense. It was sleeping. She told me that being a nurse myself, I was already a harder case to staff because nurses don't want to work in homes with other nurses, and this was proof that I heldthe staff to a higher standard than most parents would. Whatever. I moved over to PSA full time, and some of the best nurses I've had are from there. I just wanted two agencies to try to keep my case fully staffed, which didn't work as planned, anyway.

OK, fellow nurses. Please help me improve. Did I overreact?

Specializes in Pediatrics.
I've always been taught falling asleep is patient abandonment. Immediate termination for it in all the places I've worked.

And it is patient abandonment. But in practice, unless a complaint is made to the BON, it is very rarely seen as such. In theory these rules are logical and ideal, but in practice companies are willing to let a lot of things slide. It's unfortunate but true. That nurse is still employed with that agency. Her license remains intact. Now, should she fall asleep at the wrong time and heaven forbid a child gets hurt or worse? THEN they'll cry patient abandonment on her part to save their butts. But not until...

Sleeping night nurses must be an epidemic. I have some friends in my agency that admit to me that they sleep on their night shifts. "Oh I took a 2 hour nap while little John Doe was sleeping." One of these nurses was caught sleeping and reprimanded but not fired. Another nurse I know, I have no idea how she is not caught because when she dozes off (and she has dozed off when we've been out, in my car, movies, etc), she really SNORES.

My night case is very stable. But I wont sleep because I believe it is patient abandonment, I am a honest person, I am a good person and I am an ethical and moral person.

Specializes in FNP/FPMHNP-BC.

When U works nights one needs a break. Even if it is half a hour. By law. Who in their right mind can work a 8 hour shift without a break? And talking about the hospital, We do get breaks.

Specializes in FNP/FPMHNP-BC.

I use to work as a PDN and the family was very nice. I work 12 hour shifts and they would make sure I got my break to take my nap. How could U function without a break. And the OP should know better being a nurse and all. How would the OP like to go to her job and work without getting a break?

Specializes in Complex pedi to LTC/SA & now a manager.
When U works nights one needs a break. Even if it is half a hour. By law. Who in their right mind can work a 8 hour shift without a break? And talking about the hospital We do get breaks.[/quote']

Not in all states unless you are under the age of 18 or belong to a union. A break does not = take a nap. Home care/private duty is different. These are pediatric clients that require constant monitoring. If you cannot work 8 or 12 hours without a break then this is not the best choice for you. There is down time but you are paid for all hours worked. The only exception is a 24 hour shift you are paid for 16 hours but not the 8 hours you are entitled to/expected to sleep.

The hospital or other facility is different there is a nurse you report off to and he/she cares for your patient while you are off unit. You usually are not paid for your break. Most facilities do not permit/condone staff sleeping on break.

This situation is also referring to a nurse sleeping for more than a half hour while a medically fragile client who requires direct monitoring is left unattended.

I use to work as a PDN and the family was very nice. I work 12 hour shifts and they would make sure I got my break to take my nap. How could U function without a break. And the OP should know better being a nurse and all. How would the OP like to go to her job and work without getting a break?

Over my dead body would I allow a nurse to sleep on a break. I would make sure that someone was with my son so the nurse could heat up her food. If you can't handle 8-12 hours of private duty then you have no business taking that job.

Specializes in Complex pedi to LTC/SA & now a manager.

Here is a reference to state laws regarding rest & meal breaks:

http://www.dol.gov/whd/state/rest.htm

http://www.dol.gov/whd/state/meal.htm

For most industries (transportation is one of the few with regulations requiring rest breaks for safety reasons) there is NO mandatory break (rest or meal) requirement per federal law (only 7 or 8 states have requirements for adults, minors are different). The only federal labor rule is if your break is less than 20 min you must be paid for it.

If one cannot stay awake overnight then perhaps reconsider working overnights. If you worked NICU and were paid for your break since you had to be available to respond for a patient emergency would you use your break for a nap? Would you take a nap if you were an insomniac that worked day shift?

The whole point of an overnight PDNs is someone to stay awake and monitor/care for a medical fragile or technology dependent client. I can't see ever consider taking a nap while on duty...

Specializes in Peds/outpatient FP,derm,allergy/private duty.
I use to work as a PDN and the family was very nice. I work 12 hour shifts and they would make sure I got my break to take my nap. How could U function without a break. And the OP should know better being a nurse and all. How would the OP like to go to her job and work without getting a break?

So a family member had to get up in the middle of the night for a half-hour while you sleep for a half-hour? I've never heard of anything like that before and I think it would be disruptive to the family's sleep schedule to do that.

Night shifters in hospitals don't typically get a half-hour to sleep. The physical demands on your body are much less with one patient. You can usually read or study while monitoring your patient. I think most of us find the trade to be worth it.

Specializes in Pediatrics, Emergency, Trauma.

Nursel56 and JustBeachyRN hit the nail on the head.

I get appalled at how many nurses use night shift as a means to "get paid while you sleep." And I did nights for MANY years as a PDN..and as recent as last year, while I studied for the NCLEX (I was a LPN)...I would rotate shifts, depending on my cases. I understand how it could be hard, I totally do, however, this is NOT the position where even a "sleeping break" is allowed. I found myself reading, studying, playing on my iPhone to keep me busy during down time. There are too many quiet activities available...iPhones, iPads, kindles, good books, knitting, sketching, puzzles, etc. that can help with PDN downtime. :yes:

Specializes in Pediatric Private Duty; Camp Nursing.

I have never received a break working PDN. The idea has never even been breached, by anyone. That being said, I've never had a client where I didn't have copious amounts of down time anyway. I always have time to sit and eat my packed lunch. In rare moments when I have that "falling asleep at the wheel" feeling, I sit up in my chair, set my phone alarm for 5 minutes, and close my eyes. I've done this maybe 2-3 times ever. All I need is a tiny blip of sleep to feel recharged, just like turning off and restarting a computer right away. It's not ideal of course, but it's a survival technique that prevents me from dozing indefinitely.

It's best to know oneself and how they can deal with working overnights. You need to know what works best for you, and develop a sleep schedule that works best for you and then stick with it. You can't burn your candle at both ends, and I suspect that's what work-sleepers do. I work full time 7 months of the year and I stay strictly on overnight living, even on my days off. If I try to diverge from that schedule I get messed up. During the other 5 months of the year, I work weekend nights only, so I stay up until 2am Friday, sleep in on Saturday, take a 2 hr nap early Sat evening, and then pull the all-nighter with extra coffee. I sleep all day Sunday, and then do my Sunday night no problem. But then, I only allow myself about 5 hours of sleep Monday, then go back to bed at a normal evening time. And then I'm back to day living for 5 days.

Now, I'm a good sleeper and I can flip flop my circadian rhythm quite easily, so I'm lucky that way. I'd make a good flight attendant. Some people just can't mess around around the clock w their sleep like that. A person that HAS to take a nap, or sleep for hours during their shift really has no business considering overnight shifts at all.

Specializes in HH, Peds, Rehab, Clinical.
Nursel56 and JustBeachyRN hit the nail on the head.

I get appalled at how many nurses use night shift as a means to "get paid while you sleep." And I did nights for MANY years as a PDN..and as recent as last year, while I studied for the NCLEX (I was a LPN)...I would rotate shifts, depending on my cases. I understand how it could be hard, I totally do, however, this is NOT the position where even a "sleeping break" is allowed. I found myself reading, studying, playing on my iPhone to keep me busy during down time. There are too many quiet activities available...iPhones, iPads, kindles, good books, knitting, sketching, puzzles, etc. that can help with PDN downtime. :yes:

I do PDN night work with a sweet little girl. Once she's asleep I break out my laptop (slight pinterest addiction), pop in a DVD, read my Nook, do crossword puzzles, etc. The day nurse who relieves me makes fun of my bags (purse, messenger bag will all nursing related items and a tote for my "stay awake" activities. Um, yeah, I don't get to interact with her for 10 hours like you do, so I need to do something to pass the time!

Interesting topic.

Mine is a twist: What if the parents provide you with a bed to sleep in?

Can you still sleep?

Also,about breaks.

Why dont we pdn get breaks?

In Nj its mandated,you neen at least 1/2 hr break per8 hrs of work.

i

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