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?

I can only assume it's because they just don't care and want to get done as fast as possible so they can get back on their cell phone and text.

Specializes in Private Duty Pediatrics.

... But I want you to expect nurses and CNA's in Home Health to sleep during their shift. It's totally against the rules but happens every day. It's only wrong when you report it to the agency and most agencies will react the same way this one did.

No, no, no! Sleeping on the job is ALWAYS wrong!

Part of my job is to come to work prepared to work. It is my responsibility to be alert all shift. If a child needs a nurse at night, that nurse must stay awake and be alert all night.

I can tell you a lot of ways to stay alert at night, There are several good threads here that address this.

Urbanngrrl, you need to rethink this!

Specializes in Med nurse in med-surg., float, HH, and PDN.

When my Mom did PDN/nights, one of her elderly patients wanted her to go across the hall and lay down on the guest room bed; the patient's idea was to have my Mom tie a loooong string to her big toe and give the other end to the patient, who said she'd "give a little tug" if she needed something. Then she added,

"I do so hate disturbing you girls during the night; you need your rest, too!" :sarcastic:

PS This was long before any temp agencies; she worked through a "Private Registry".

When my Mom did PDN/nights, one of her elderly patients wanted her to go across the hall and lay down on the guest room bed; the patient's idea was to have my Mom tie a loooong string to her big toe and give the other end to the patient, who said she'd "give a little tug" if she needed something. Then she added,

"I do so hate disturbing you girls during the night; you need your rest, too!" :sarcastic:

PS This was long before any temp agencies; she worked through a "Private Registry".

Sounds like my kind of patient. More clients should be so considerate of others.

Maybe agencies can solve this by paying more $$$ for night shift.

I will say that some situations during NOC shift that encourage sleep.

There are some parents who refuse to allow a nurse to work on their own laptop or play games on their cell phone.

I am soy,but you cannot expect a nurse to just sit there and look at the twinkling lights.

Would you as a parent want to work at night in the dark staring at the patient and the wall?

Specializes in Med nurse in med-surg., float, HH, and PDN.
Maybe agencies can solve this by paying more $$$ for night shift.

I will say that some situations during NOC shift that encourage sleep.

There are some parents who refuse to allow a nurse to work on their own laptop or play games on their cell phone.

I am soy,but you cannot expect a nurse to just sit there and look at the twinkling lights.

Would you as a parent want to work at night in the dark staring at the patient and the wall?

We used to have shift and W/E differential pay, once upon a time. They cut that out when they instituted a 2.3% pay cut across the board. Pfffttt!

And there are certain cases where you are NOT ALLOWED to read or use cell or tablet. Yes, you are supposed to keep your eyes ON the patient, even if all they are doing is sleeping. Of course, I can see the necessity with SOME patients, but if there ever was a 'recipe' for falling asleep on the job, staring at the patient and the wall in the dark would be prime ingredients.

Specializes in LTC & Private Duty Pediatrics.

There are some parents who refuse to allow a nurse to work on their own laptop or play games on their cell phone.

Whenever I start a new case, I make sure the parents are ok with me hitting the books/laptop at night. If not, then let me know, and I will find another assignment.

I work PDN as the night float, and also go to NP school. Thus, I hit the books while the kid sleeps. Fortunately, nearly all of my cases are stable, and I can get a good 6+ hours of studying in on an overnight 8 hour shift.

Yup you did!!

Specializes in LTC.

No, you weren't overreacting at all! You sound like a decent/really nice parent to work for. You even gave her another chance, which is something most parents wouldn't do.

I did a nightshift case for a little over a year, and I'll admit it was super hard to stay awake sometimes but I never fell asleep. I remember that patient's mom telling me they had a nurse once that locked his door at night during her shift! The only reason she found out the nurse was doing it was because she had set herself an alarm to wake herself up, and one night she forgot to turn it off and it ended up waking the house up.

Specializes in LTC and Pediatrics.

Reading through this thread has been interesting. I do not fall asleep when working nocs as I am being paid to watch the child and make sure they are safe and receive the meds and treatments ordered. I have only had clients where I could watch tv, use my computer, etc. when the child was sleeping for which I am grateful as it does help keep you awake. If I were to ever have a family not allowing this, I would have to refuse further assignments.

This also has me thinking this is why the agency I work through has this policy that we must chart something q 2 hrs and our charting is on a tablet that is synced q 30 mins. We are to log on and have 30 minutes to begin the assessment. I can see how this system would slow down the temptations to sleep. I have a tendency to chart when I have done a diaper change, administered meds and a few other things, so I end up charting more often than the q 2 hrs minimum required.

I once worked for an agency where chart every two hours turned into chart every 15 minutes. Hard to change around the fact that the patient was sleeping every 15 minutes. Aggravating.

Specializes in LTC and Pediatrics.

If I chart something early as in a I&O or a feeding, I then reset the 2 hours. If nurses are that paranoid about getting the minimum charted, then maybe they should set an alarm to remind the to chart. Every 15 minutes is too much.

I once worked for an agency where chart every two hours turned into chart every 15 minutes. Hard to change around the fact that the patient was sleeping every 15 minutes. Aggravating.
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