Sleeping Nurse = No Agency?

Specialties Private Duty

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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 Complex pedi to LTC/SA & now a manager.
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

There is NO mandated break in NJ unless you are under the age of 18. The only mandate is that if your break is less than 20 min you must be paid as quoted above from federal labor law .

If the family gives you a bed and you are working less than 16 hours you need to check with your agency. Generally if working less than 16 hours and you are caught sleeping = patient abandonment.

Generally if working less than 16 hours and you are caught sleeping = patient abandonment.

To clarify, in most state's Nurse Practice Acts and BoN position statements, patient abandonmentis is leaving the area of assignment prior to the completion of the shift. Sleeping in an area of assignment is unprofessional conduct. An agency policy might define things differently, but that doesn't mean the BoN is going to agree.

Arguing with a supervisor might be grounds for termination and not the best conduct to advance a career But the BoN is not going to discipline a nurse's license for "Unprofessional Conduct" for arguing with a boss behind closed doors. In the same way, just because one's opinion or policy manual equates sleeping with abandonment, it does not mean the BoN is going to discipline a nurse for "Patient Abandonment" for falling asleep at the bedside.

One of the best tricks for sleeping I ever saw was a nurse who slept with a bottle of Visine in her hands folded in her lap. When caught, she would claim, "My eyes are sore. Allergies I guess. I just put in some drops and was keeping the lids closed for a minute."

Specializes in Peds/outpatient FP,derm,allergy/private duty.
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've seen that happen with adult clients who were verbal and even been offered a bed to sleep on but I never sleep anyway. If you fall asleep and don't hear an alarm or a call from the patient the fact that they offered you a place to sleep will have no effect on your responsibility for your patient.

When there was a constant staffing crunch this would happen as many nurses worked both day and night shifts. As far as the break thing - if you are the only person there with a patient who cannot be left alone I don't see how it would be possible to have a half-hour break, so there may be written exceptions in state laws.

I recall once I was asked to sign a "meal waiver" but having worked years in pdn it only happened once in my state so I doubt that is mandatory.

Specializes in HH, Peds, Rehab, Clinical.

It's hard to stay awake working a night shift when its just you and a sleeping client, I'll be the first to say it. I tend to drink a lot of water---nothing like frequent bathroom trips to keep you sharp, LOL! But not much snacking! I also do wall pushups every time I walk to the kitchen for formula for the Joey bag and do sets of lunges after everytime I am up doing a once over.

Specializes in peds palliative care and hospice.

ColleenRN2B, I like how you think!

I did private duty night shift regularly a few years ago, and I would always bring several cans/bottles of soda in the home with me. That way, between the caffeine to stay awake, and the subsequent peeing, you were up and down at least once an hour :)

Specializes in Pediatric.
It's hard to stay awake working a night shift when its just you and a sleeping client I'll be the first to say it. I tend to drink a lot of water---nothing like frequent bathroom trips to keep you sharp, LOL! But not much snacking! I also do wall pushups every time I walk to the kitchen for formula for the Joey bag and do sets of lunges after everytime I am up doing a once over.[/quote']

Awesome idea!

As far as being offered a bed, I can't imagine anyone offering their night nurse a bed... I mean unless you were working there the next AM and slept during an off duty period between shifts?

If I work a NOC shift I usually sip on water all night, it keeps me awake. Ill save my energy drink for when I think I'll need it most. I watch Netflix episodes and that will keep me awake.

I am currently working private duty night shift, and I can't imagine sleeping on the job! It never even crossed my mind!

I am responsible for the life and well-being of the child I am caring for when I am on the clock. And as we all know, even a seemingly stable child can go down hill quickly.

If I had serious trouble staying awake, I wouldn't do night shift.

My agency would fire me on the spot.

Specializes in Pediatrics.

I signed back up with an agency yesterday after spending some time away doing the foster care. I already have a case because my experience gives me a unique perspective that they believe would be beneficial for a new and very raw client. On the paperwork it said, no less than four times, "Sleeping on any shift is not tolerated." It almost made me want to scream. That should be a given!

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Lucky family to get you, kiyasmom. You can really help them. There is so much to learn and so many emotions to process for these families.

Specializes in pediatrics; PICU; NICU.
I signed back up with an agency yesterday after spending some time away doing the foster care. I already have a case because my experience gives me a unique perspective that they believe would be beneficial for a new and very raw client. On the paperwork it said, no less than four times, "Sleeping on any shift is not tolerated." It almost made me want to scream. That should be a given!

I agree that should be a given. However, as Dr. Phil always says, common sense ain't all that common!

Specializes in LTC, Memory loss, PDN.

OP, i know you mean well by trying to cover for or excuse the sleeping

my question to you, if something happens to the pt. while the nurse is sleeping and you know this is going on

aren't you (going to feel) responsible?

to everyone who thinks it's ok to nap, sleep, rest: are you going to be ok with the fact this happened on your shift

of course it's hard to stay awake, but i'd rather sit on a thumbtack than having to explain why i don't know when the

pt stopped breathing

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