fell asleep during night shift.

Meriwhen, ASN, BSN, MSN, RN · Jul 2, 2010

Tough one since you got caught sleeping by the client...

If he told the agency, then you have no choice IMO but to be honest with the agency and own up to it. Yes, there is a chance you may lose your job...but you were at fault here even though you didn't mean to fall asleep. Making excuses or trying to fib your way out of it can backfire on you because if the agency catches you in a lie you WILL lose your job and damage your reputation in the process.

If he didn't tell the agency, sincerely apologize to the father for this and promise him that you will never allow it to happen again...and be damn well sure to keep that promise.

Either way, you should also tell this agency (or the next agency) to never schedule you for doubles again.

I hope it all works out for you.

Epona · Jul 2, 2010

Night shift is terrible. And doubles.... even worse. My heart goes out to you. I hope it all works out...

mamamerlee, LPN · Jul 2, 2010

Apologizing is appropriate, and did you explain that you did a double? And how 'late' could the meds have been?

Sorry this happened to you. Best wishes.

CNL2B · Jul 2, 2010

I used to work in home health as a PCA years back and had vented/trached patients (no idea how much responsibility I had gotten myself into at the time at the tender age of 20!!!!)

I had two patients primarily during different time periods. With one, I did sleep. I was the only one there with the patient and the patient didn't care. I worked the day shift and I would get up, get to his place and let the night shifter go home (who was sleeping) and promptly go back to sleep on the couch until about 10 when my patient would call me. I would get up if the vent alarmed, which was within earshot in the next room. When I got hired, the agency did not tell me this wasn't acceptable, and I had no nursing experience or training, so I thought it was the norm.

After I left that agency, I went to another home with another similar patient with another agency. I usually covered evenings but would occasionally do a night shift, and it was NOT ok to sleep.

Sometimes clients are ok with sleeping. Usually the agencies are not even if the clients are though. I think the agencies all have similar policies stating that you can't sleep. I am sure it happens periodically though and this wouldn't be the first time the agency you had to deal with something like that. I'm not sure that you would lose your job unless they have a no tolerance policy or you live in one of those states that they can fire you for no reason (I think it's called "at will" employement?) They may not let you go back to work with that client, however.

I think that your schedule was definitely part of the issue and I would see that as part of your defense. Were you routinely scheduled for the 3-11, and then the 11-7? That is overtime. Did they schedule you that way, or did you ask for the hours? If they did it, that might be against their own policies. Most places say they can't schedule you that many hours without your express consent. And, if you haven't done those kind of hours before, it's REALLY hard to work that long all the way through into the morning without getting really tired. A lot of night-shifters (either 7P to 7A or 11P to 7A) sleep right up until they have to get up and go to work. Getting up at 2 PM and having to stay up until the next morning is rough, and I wouldn't recommend doing that again, especially if you know you can't hack it now.

elkpark · Jul 2, 2010

Since the family member witnessed you sleeping, there isn't really anything you can "tell the agency" to make things better. Trying to wiggle out of the situation rather than simply being honest about it and accepting responsibility will only make your situation worse. You may want to avoid working overnight doubles in the future (or have a good plan for how you're going to stay awake) -- that is a really rough assignment for anyone. I hope this will work out okay for you -- best wishes!

klone, MSN, RN · Jul 2, 2010

If you fell asleep for 30 minutes, how were the meds late?

caliotter3 · Jul 2, 2010

If you fell asleep for 30 minutes, how were the meds late?

I agree. Even in home health, there is a window for med administration. Best make certain this doesn't happen again with this client. I had a client one time who complained to me that the other night shift nurse slept regularly, they would find her fast asleep at 0630 in the morning. They spoke to her about it and were giving her a chance, but she kept on, and with another incident, finally they had had enough of her. Sounds like you have had your first chance with these people. If you have to, set consecutive alarms on your cell phone to warn you. Or find an activity that requires you to get up and walk around. And turn down doubles from the agency. Good luck.

SitcomNurse, BSN, MSN, EdD, RN · Jul 2, 2010

this also happened to me, 18 month old, and vent, trach, blous gt.

father walked in to wake me and ask if i wanted coffee, because he ws goinng to 7-11.

what a nice family. i did tell my agency the next conversation on the phone(within 48 *) but first, i stood shot up, eyes wide, omg! i whispered. i am so sorry! i didnt realize how tired i was when i sat down. that was completely unacceptable and i apologize.

he said, thats alright.

i said. no, it isnt. its not alright or acceptable. i assure it wont happen again.

i accepted his offer of coffee.

it didnt sleep again. i wasnt on a double shift, i wasnt "comfortable" with the family(thinking they were relaxed with me). i had just completed a full assessment and the boy was fine. i sat down, did my docu. and closed the chart & my eyes. 20 minutes. that was all.

i was awake the rest of the night.

the family was appreciative of the apology and the non pleading strength in my voice.

should this ever happen again, it is a mistake. use my words. they are true!

they are true for anyone that falls asleep without malice-intent.

for me....

i forever after that set my cell phone to ring ever hour on the hour with an internal alarm, set once, with a 1 hour snooze.

:jester: :nurse:

allnurses Guide · Jul 2, 2010

It depends on the individual family member's personality of course, but most people will understand an apology and explanation that it was a lesson learned-- you can only be alert and effective for a finite amount of time, and don't let the agency guilt you into working longer ours. Unfortunately, the agency is self-interested, and you will pay the price.

There are so many nurses who work insane hours on purpose, thinking they'll get some shut-eye at the expense of the night shift client. These families rightfully resent it, and honestly, I do, too. They aren't paid any less than I am to sleep and sleep through alarms! :eek:

Some are very laid back with night shifters, and some will even have a cot for the nurse to sleep on, but it can't effect your responsiveness when the patient needs something.

imintrouble, BSN, RN · Jul 2, 2010

Same situation with me. Overnight, vent, trach, TF, child. I had never fallen asleep before, even though I was more sleepy during that time than I've ever been in my life. I sat down and fell asleep for 30 min. No one saw me, not even the client. But I knew what I'd done and I was horrified. After that, when I was afraid I'd fall asleep, I'd stand and lean against the door frame of the room. Just stand there. Looked pretty weird I'm sure. Probably would have scared the kid if he'd seen. But I was more worried about falling asleep than scaring the client/family.

I'd stay away from doubles.

icuuci · Jul 3, 2010

I am jealous you work on a unit where you might even get a chance to sit down! Sleep...simply unimaginable. Do all you can to hold onto this job!