Calling in for no sleep

Been there,done that, ASN, RN · May 27, 2016

Pepsimx5 said:
Nurses are ethically required to be fit for duty, and that includes being responsible to make sure you are fit for duty. If this happens once, you're OK, but it is your responsibility as a nurse to make sure you get the sleep you need before your shift starts.

OP worked until 3:30 AM on Saturday. She had 27 hours to adjust her circadian rhythm and be fit for duty on Monday morning. How would you suggest she she would " fulfill her responsibility"?

Corporate masters need to stop requiring nurses to work swing shifts. Now there's a responsibility.

Murse1975 · May 27, 2016

See comment below, pardon the posting error.

suzw · May 27, 2016

I have read only a few comments, but just wanted to say this reminds me of a night not long ago when I worked the evening shift in my SNF, which technically ends at 22:30 but no one ever gets out before 2330. Had a couple incidents that night and got out about 0100. Had to be back for day shift at 0600. 25 minute drive. Figured, well I should be able to get a couple hours anyway. Was so anxious from the crazy night (and knowing I only had a couple hours to sleep) that I just laid there in bed, dozing a little bit not sleeping...until it was time to get up. Zero sleep.

I don't remember how, but I did survive, and did just fine. Adrenalin and caffeine will take you a long way. I'm so busy, I don't have time to sit down and get tired. Oh, and I'm a new nurse.

Anyway, I see that you actually were sick and called in, so that was a good choice. But just wanted you to know that it is do-able.

On that note, I'm not sure it's legal for my facility to ask me to do that, but I did have the option to say no, I guess. So maybe it is. Anyone know?

roser13, ASN, RN · May 27, 2016

Murse1975 said:
While I don't like to be confrontational to other healthcare providers, I'm calling out this post. If it were YOUR family member in a critical situation, would you want the nurse who is so sleep deprived that he/she is having trouble focusing, grainy blurry vision, and reasoning that isn't terribly concrete due to fatigue? I'd much rather work a little harder to cover someones behind, especially if they usually don't miss work, than see someone have a bad outcome that was entirely preventable. This person did the RESPONSIBLE thing.
Now, the "you had time to sleep" comment. Really? As an almost two decade chronic insomniac (200mg trazadone might put me down for 90 minutes, ambien for about 3 hours, and benadryl... yeah, might as well be eating Tic Tacs), let me tell you, having time to sleep, and being able to sleep aren't the same thing. I envy those of you who can sleep whenever, or wherever. It takes me at least 4-5 days to rearrange my sleep pattern to the opposite of what I am used to. Factor in also that people who work nights are dealing with the sounds of mowers, chainsaws, construction, traffic, loud music, and the other bevy of daily life things that any of you who don't and have never worked nights don't understand all. If you want to understand, I'd be happy to crank up my guitar amp and give you my best metal riffs for a couple hours when you've only been asleep for about 2 hours yourself, and do that every 2 hours until you have to go back to work, let's see how you feel then? Some people also have anxiety about the change of sleep pattern, especially if sleep is a problem for them normally, further complicating things.
I called in last fall on my middle shift of 3 straight 12's for this exact reason, lack of sleep. Get off work at 0630, in bed at 8. Apartment maintenance knocks on door a little before 9 waking me, seeking a leak from the ceiling of the apartment below me, find nothing on initial inspection. I go back to bed. at 11 they're back with a plumber, find nothing again. Back to bed again. Within 90 minutes they begin ripping the ceiling out of the apartment below me with hammers and saws, and this continues until they knock off for the day at 5, 60 minutes before I have to work again. I got maybe 2 hours of broken sleep. Think that is safe to care for PICU level of care? Neither did I. Sometimes we also have to take care of OURSELVES.

When responding to another post, it is very helpful if you use the Quote button on the bottom right of the post. It is difficult to follow a rebuttal post if we don't know what you're rebutting :cheeky:

Murse1975 · May 27, 2016

CountryMomma said:
I have had a coworker call out for not enough sleep. She wasn't punished... it was her PTO...
...but none of us felt very kindly towards her after absorbing her shift, her excuse spread through the gossip channels, and people stopped being willing to trade shifts with her, cover for lunch, etc.
You had time to sleep.

While I don't like to be confrontational to other healthcare providers, I'm calling out this post. If it were YOUR family member in a critical situation, would you want the nurse who is so sleep deprived that he/she is having trouble focusing, grainy blurry vision, and reasoning that isn't terribly concrete due to fatigue? I'd much rather work a little harder to cover someones behind, especially if they usually don't miss work, than see someone have a bad outcome that was entirely preventable. This person did the RESPONSIBLE thing.

Now, the "you had time to sleep" comment. Really? As an almost two decade chronic insomniac (200mg trazadone might put me down for 90 minutes, ambien for about 3 hours, and benadryl... yeah, might as well be eating Tic Tacs), let me tell you, having time to sleep, and being able to sleep aren't the same thing. I envy those of you who can sleep whenever, or wherever. It takes me at least 4-5 days to rearrange my sleep pattern to the opposite of what I am used to. Factor in also that people who work nights are dealing with the sounds of mowers, chainsaws, construction, traffic, loud music, and the other bevy of daily life things that any of you who don't and have never worked nights don't understand all. If you want to understand, I'd be happy to crank up my guitar amp and give you my best metal riffs for a couple hours when you've only been asleep for about 2 hours yourself, and do that every 2 hours until you have to go back to work, let's see how you feel then? Some people also have anxiety about the change of sleep pattern, especially if sleep is a problem for them normally, further complicating things.

I called in last fall on my middle shift of 3 straight 12's for this exact reason, lack of sleep. Get off work at 0630, in bed at 8. Apartment maintenance knocks on door a little before 9 waking me, seeking a leak from the ceiling of the apartment below me, find nothing on initial inspection. I go back to bed. at 11 they're back with a plumber, find nothing again. Back to bed again. Within 90 minutes they begin ripping the ceiling out of the apartment below me with hammers and saws, and this continues until they knock off for the day at 5, 60 minutes before I have to work again. I got maybe 2 hours of broken sleep. Think that is safe to care for PICU level of care? Neither did I. Sometimes we also have to take care of OURSELVES.

Libellule · May 27, 2016

Yup rain

Maevish, ASN, RN · May 28, 2016

I still find it absurd that two full nights/days aren't enough to get the required amount of sleep. She asked if it was ok to call out for that reason and yes, it's ok to call in. "Not getting enough sleep" when you've had two days/nights to work yourself out is lame. She doesn't have to tell whomever she calls they WHY, but if she says that, she should be prepared for backlash of some sort because everyone can use that excuse at any time. However, if it's only happened a couple times, then I don't see what the concern is.

After the OP got a few responses it sounded more like she called in because she was ill as well, which is another story. I work ICU and I also have sleeping problems (that's why I work nights, really) since high school. I rarely get more than 3-4 hours a day and I have to work at getting THAT much so I don't have as much sympathy as I maybe should for people who need 8-12 hours a day. :bored:

Of COURSE no one wants tired and/or overworked nurses taking care of their loved ones, but guess what? A lot of us do that on a regular (if not daily) basis and nothing bad happens. No one will ever be able to schedule all nurses for their preferred shifts so it will continue happening and the world will go on. :up:

xo

luvsltcrn · May 28, 2016

I guess I have a different view point on this topic. As someone who has been on call there have been many times that I have gone in to cover a shift without having had any sleep. If I work day shift and the night shift calls off because she doesn't feel she had enough sleep I get to go back to work and work night shift. How is this any safer? That puts me at being awake 24 hours or even 32 hours if I have to work the next day shift too.

tcquilter0707 · May 28, 2016

You had Saturday and Sunday to sleep. Studies have shown you can't "make up" for lost sleep. Sleeping 12 hours after you only slept 4 hours the night before doesn't average out to 8 hours of sleep. Your sleep schedule is your responsibility, and should not affect your unit. You will not earn the respect of your team by calling off for this reason.

marie.rn2419, RN · May 28, 2016

Never mind :)

kikaymeh · May 28, 2016

Sleep is very important!

I did call in because of lack of sleep and never felt guilty about it.

My health is more important than work.

crazin01 · May 28, 2016

Been there,done that said:
OP worked until 3:30 AM on Saturday. She had 27 hours to adjust her circadian rhythm and be fit for duty on Monday morning. How would you suggest she she would " fulfill her responsibility"?
Corporate masters need to stop requiring nurses to work swing shifts. Now there's a responsibility.

From Saturday at 0330 until monday at 0700 is over 48 hours, not merely 27. As evidenced here I am very far from the only one to function while not getting enough rest. Not just in nursing, but in all facets of life, people deal with normal life events, and sometimes (I'd risk a guess to fairly often) folks do NOT have the 8 hours of recommended sleep. Yet, they go to work, take the kids to music lessons, care for aging parents, take their evening college courses and live life, because that's the way it is. Yes, as nurses, we do risk our licenses everyday by working. This is why folks need to adapt & learn how they function best and double check things that could have an adverse effect with serious repercussions.

As anything, in theory we can hope for and try to fix the myriad of problems that exist in nursing. But, sadly it seems healthcare is becoming more a money business, as most things and thus customer service & press ganey are going to be the driving factors behind change in policy & procedure (or lack of change). Until the almighty buck is NOT the driving force behind healthcare, corporate responsibility won't mean jack.

I think OP had a one time event she was asking about, versus a pattern. Hopefully we're all just debating over nothing & it's an isolated incident. Restful sleep to all!

Also: to the poster whose employer allowed 3 excused unplanned absences every 3 months (and numerous other awesome allowances) WOW!! That is incredibly generous compared to what I'm used to. (use more than 3 in one YEAR and start the write-up process). The only exception was FMLA, of course. Death? Car accident? Sorry, "unplanned is unplanned" after I totaled my SUV in the snow, driving TO work. And so it goes...