Today was our first day of clinicals for the new semester. In the morning our instructor seemed a little "off". She was kind of unsteady on her feet. She said that she was very tired. We did not see her for the first two hours of clinical. When it was time to pull meds we went to find her. She was in the break room sleeping.
When she was pulling the meds she was very unsteady on her feet and it took her over a half hour to pull meds for 1 patient. When she went into the room with one of the students to give the medication, she fell asleep sitting in the patient's chair. The nurses on the floor and all the students kept asking her if she was feeling okay. She just kept saying that she was tired.
At post conference she was swaying back and forth, almost falling out of her chair. She kept nodding off and when she would wake back up she would make strange, unrelated comments. I do not know what to do. The consensus of the students was to wait and see what she is like on our next clinical day. I was very uncomfortable today and did not feel like she was safe to be supervising us. I am concerned about reporting her to head of our nursing department for fear of repercussions. Any advice?
Yes people do fall asleep..I had one clinical instructor who feel asleep during post clinical conference..I did not think much of it..
I think it is absurd to think that this type of behavior from a nurse, never mind a clinical instructor, is acceptable.
Where then, does the line of acceptable falling asleep get drawn? With the cop who is tracking the armed burglar in a house while your mother/spouse/child is asleep upstairs?!? While a surgeon holds one of these same person's heart in their hands during surgery?!? While this instructor is observing a student inserting their first IV/catheter/NG tube?!?!
C'mon...there really isn't an acceptable excuse for this type of behavior, except maybe narcolepsy or extreme illness, and in either case the students and staff should be made aware.
I'll just reiterate that if I am found napping in my pt's rooms during this upcoming second semester, never mind falling asleep during post-conference, my a$$ will be in front of a whole bunch of folks who will be judging my behavior and weighing in on how appropriate it is. I doubt there'll be much wiggle room regardless of my arguments. I won't have the opportunity to do much falling asleep as a RN because I'll never get to the NCLEX stage.
Specializes in critical care, management, med surg, edu.
This should never happen. Call your program director immediately and report this. Do not pass meds or perform any procedures in this kind of situation.
I think it is absurd to think that this type of behavior from a nurse, never mind a clinical instructor, is acceptable.
Where then, does the line of acceptable falling asleep get drawn? With the cop who is tracking the armed burglar in a house while your mother/spouse/child is asleep upstairs?!? While a surgeon holds one of these same person's heart in their hands during surgery?!? While this instructor is observing a student inserting their first IV/catheter/NG tube?!?!
C'mon...there really isn't an acceptable excuse for this type of behavior, except maybe narcolepsy or extreme illness, and in either case the students and staff should be made aware.
I'll just reiterate that if I am found napping in my pt's rooms during this upcoming second semester, never mind falling asleep during post-conference, my a$$ will be in front of a whole bunch of folks who will be judging my behavior and weighing in on how appropriate it is. I doubt there'll be much wiggle room regardless of my arguments. I won't have the opportunity to do much falling asleep as a RN because I'll never get to the NCLEX stage.
You know why, I did not think much of it when my clinical instructor fell asleep during post conference? It is because I knew her for more than a year and this was an isolated incident...Reporting her for an isolated incident like this, would have been unapproprate..
As I said before, the OP needs to see the clinical instructor more to pass judgement on her..As the OP stated, the majority of the students thought that, they needed to see how she will act tommorow..It could be the difference between night and day on how she would act with a little rest..
Specializes in Critical Care, Pediatrics, Geriatrics.
Many factors could have contributed to this CI's behavoir: drugs & alcohol, reaction to prescribed medication, up all night with a newborn, fighting all night with a significant other, insomnia, narcolepsy, working the night before, etc. etc.
Who cares what her reasons for being tired are! She was not mentally and physically capable of safely performing her duties and should have been immediately dismissed that day. Her actions should be reported immediately to her supervisor, YOUR director of nursing.
State the facts as objectively and non-judgmentally as you would describe a pt's behavoir.
"What if she gets fired?" I assure you that good clinical instructors are worth their weight in gold to a nursing program and your program director will do a thorough investigation before jumping to conclusions and firing her. If her circumstances require a second chance then she will be given one. If not, then she will be dismissed. Have faith in your director's experience that s/he can discern the correct course of action in this matter.
You are a paying customer. You deserve a QUALITY nursing education. Your patient's are paying customers. They deserve COMPETENT care. You are a student. You need SUPERVISION. The CI is an employee. She has to meet job performance STANDARDS. End of story.
Bala, you can try to spin this any way you want. If ONE person saw this CI behaving this way then that's enough! God forbid if a pt saw her behaving this way. It reflects poorly on the hospital, the school, and nursing as a whole.
And if I were a teacher and a student came to my class and fell asleep, they'd be out of the program; 4.0 or not.
I am appalled that there is even a question of whether the instructor's impairment should be addressed or not. Some people seem to think it is OK if it is just an isolated incident ... or if there is a reason for it that is respectable (such as being exhausted or having a disease.)
We are talking direct patient care here! Real patients were involved! It is NEVER acceptable to be so impaired in that situation -- regardless of the reason or the rarity. ANY nurse who is impaired in the clinical area MUST be removed from the patient care area immediately and assessed for her abililty to be responsible for the patients. The law does not make any exceptions -- and neither does morality.
The nurses on the unit should have reported it up their chain of command and it should have been addressed on the spot. I can understand that the students did not know what to do in that situation, but the hospital staff members who were aware of the situation should have stepped in.
I AM APPALLED AT THE LACK OF CONCERN EXHIBITED BY A FEW POSTERS ON THIS TOPIC!!!
If an instructor is with students, and a student makes an error, they have to report it to charge nurse and instructor IMMEDIATELY!! What's going to happen when you make an error and the instructor needs 20 mins to wake up from her "nap"? The patient dies in 10 mins due to lack of care...and student inability to communicate concern....
Here's the deal: If you go in so tired you can't focus, and fall asleep on the job you should be reported. If you are my co-worker, you may be a great person, but I'm not going to let you work on ANYBODY in that condition! I'd probably physically get in your way and be assertive to anyone who'd listen that you should NOT be giving care...
The problem too many people have is being overly concerned about the wrong thing. Patients come first, PERIOD! Then, feelings. Ethically, if you know of a problem and don't report it, YOU can be held liable for it....I'd call out there first thing Monday morning, 9AM and say "I need to talk to the dean of the program now!"
I'm just saying, people, that you have to prioritize what's the most important thing in every situation....that's called critical thinking and it's what you do everyday on the job....
For the OP, I wouldn't worry about it because, frankly, the rumor mill will get going a lot faster than this board will come to a concensus. (Admit it members, we know it's true!)
There is always someone in the group that is just cracking to get something to report to TPTB and become the brownnoser. You'll see that either she will be pulled, or she will be so wide awake she vibrates at your next clinical. If she's not you should all go as a group to the charge nurse, and let her take it to the hospital supervisor, who will know who in the school to call.
I'm in the "report it now" camp. Which seems to be comprised of more experienced nurses. I actually think it should have been dealt when it first occured to the students that things weren't exactly right w/the CI. This was NOT a safe situation, or even an appropriate learning environment for patients or students. If anything, it was a great example of what not do if you're a clinical instructor. Sheesh!
Students should have access to a chain of command when they are on a clinical--if something happens to the instructor (not just like this apparent impairment issue, could be a medical issue, heart attack, diabetic incident, instructor has a traffic accident on the way in, doesn't show, whatever), who do they call? Someone in the facility and/or @ the school? That individual should be able to respond to the situation and evaluate and deal w/it. Students should be either sent home or provided w/a substitute instructor.
The lesson here is that we're all human, even instructors. That said, it is not always appropriate to "wait and see". You have to take care of yourselves, too. Homework assignment: Find out who is designated Plan B if something happens on your clinicals. Incredible (and really sad) that it seems to be necessary, but guess so.
you all need to check your nurse practice act, because in florida, our law says that (boldface & highlighted text added) the teacher should not have been there. you should not have been working under her license. not even once.
(1) the following acts constitute grounds for denial of a license or disciplinary action, as specified in s. 456.072(2):
(j) being unable to practice nursing with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, or chemicals or any other type of material or as a result of any mental or physical condition. in enforcing this paragraph, the department shall have, upon a finding of the secretary or the secretary's designee that probable cause exists to believe that the licensee is unable to practice nursing because of the reasons stated in this paragraph, the authority to issue an order to compel a licensee to submit to a mental or physical examination by physicians designated by the department. if the licensee refuses to comply with such order, the department's order directing such examination may be enforced by filing a petition for enforcement in the circuit court where the licensee resides or does business. the licensee against whom the petition is filed shall not be named or identified by initials in any public court records or documents, and the proceedings shall be closed to the public. the department shall be entitled to the summary procedure provided in s. 51.011. a nurse affected by the provisions of this paragraph shall at reasonable intervals be afforded an opportunity to demonstrate that she or he can resume the competent practice of nursing with reasonable skill and safety to patients.
I can see why a bunch of students would say wait...they are ( as I am) students. If this happened to me I can only imagine my first thought would be what the heck? Do we say something?
I mean I can only imagine the confusion and considering the lack of experience...a student could EASILY not know what to do. Just because students decided to wait..doesn't mean it's the correct response. I mean COME ON...this one is a no brainer. Students on the floor are the direct responsibility of the instructor..hence the reason we CANT be on the floor doing duties without an instructor on duty.....hence the term.. on duty. An instructor who is sleeping while students are unattended is appalling.
If she's a clinical instructor she has experience. She should know darn skippy that she was in NO WAY able to do her assigned duty. She was irresponsible and dangerous.
I AM APPALLED AT THE LACK OF CONCERN EXHIBITED BY A FEW POSTERS ON THIS TOPIC!!!
If an instructor is with students, and a student makes an error, they have to report it to charge nurse and instructor IMMEDIATELY!! What's going to happen when you make an error and the instructor needs 20 mins to wake up from her "nap"? The patient dies in 10 mins due to lack of care...and student inability to communicate concern....
Here's the deal: If you go in so tired you can't focus, and fall asleep on the job you should be reported. If you are my co-worker, you may be a great person, but I'm not going to let you work on ANYBODY in that condition! I'd probably physically get in your way and be assertive to anyone who'd listen that you should NOT be giving care...
The problem too many people have is being overly concerned about the wrong thing. Patients come first, PERIOD! Then, feelings. Ethically, if you know of a problem and don't report it, YOU can be held liable for it....I'd call out there first thing Monday morning, 9AM and say "I need to talk to the dean of the program now!"
I'm just saying, people, that you have to prioritize what's the most important thing in every situation....that's called critical thinking and it's what you do everyday on the job....
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WDWpixieRN, RN
2,237 Posts
I think it is absurd to think that this type of behavior from a nurse, never mind a clinical instructor, is acceptable.
Where then, does the line of acceptable falling asleep get drawn? With the cop who is tracking the armed burglar in a house while your mother/spouse/child is asleep upstairs?!? While a surgeon holds one of these same person's heart in their hands during surgery?!? While this instructor is observing a student inserting their first IV/catheter/NG tube?!?!
C'mon...there really isn't an acceptable excuse for this type of behavior, except maybe narcolepsy or extreme illness, and in either case the students and staff should be made aware.
I'll just reiterate that if I am found napping in my pt's rooms during this upcoming second semester, never mind falling asleep during post-conference, my a$$ will be in front of a whole bunch of folks who will be judging my behavior and weighing in on how appropriate it is. I doubt there'll be much wiggle room regardless of my arguments. I won't have the opportunity to do much falling asleep as a RN because I'll never get to the NCLEX stage.