What punishment should this nurse get? - page 11

Had an interesting situation that came up and thought I'd throw it out for discussion. One of our staff RNs was found sitting in a chair and sleeping at the bedside of one of our ventilator... Read More

  1. by   UM Review RN
    All I know is, at our facility we've had some discussions almost as heated as this thread became, and the Final Answer is: If this happened to me tonight, I would get canned immediately, no questions asked.

    Has nothing to do with whether or not the patient pulled his trach out (although I shudder to think what might've happened if he had....)

    Do I think the policy itself is right? Well, yeah, I kinda noticed that the docs have this huge fluffy bedroom all to themselves next to the ER, while nurses are NEVER allowed to catch some sleep on the job. However, docs work more than 12-hour shifts and presumably, that's why nurses became nurses--to have a life outside of work.

    So it wouldn't matter. Policy is policy and I don't make policy. If I'm in complete disagreement with a policy, the time to fight it is before, not after, it causes a problem. So I hope those of you who claim that this needs to be taken on a case-by-case basis, or that the policy is too harsh, take it up with management and get the policy changed. It can be done.
    Last edit by UM Review RN on Oct 13, '05
  2. by   CrunchRN
    She wasn't hunkered down in the break room with a blankie for heaven's sake! It was an unusual situation, and I think it is understandable that this could happen. If you have ever worked night shift you understand the 0400 crash that occurs. She was doing a good thing, and unfortunately the room needed to be dark and calm for the patient so it is totally understandable that this could occur. Shame on anyone that would throw away a good nurse over this.
  3. by   Spidey's mom
    Just have to respond to Karen, who mentioned part of the punishment being no overtime . . . . . that cracked me up because I see overtime as PUNISHMENT. I do not like to work more than my scheduled hours or days. Yesterday I worked almost 2 hours overtime with an OB - I was so exhausted I could barely speak and I had to drive 4 miles to pick up my son. Fortunately my mil fed me (I had not gotten lunch) and I perked up a bit.

    Please, take my overtime away, anytime you want. I hate it!!

  4. by   Hodge
    I say crucifixtion...........
  5. by   CrunchRN
    You are being ironic right?
  6. by   Hodge
    Why, do you think it is a little harsh?? Ok then how about just a flogging......
  7. by   CrunchRN
    Ha ha! I do love irony. Crucify, flog, run the nurse out of town on a rail.........:chuckle
  8. by   Aneroo
    Quote from Marie_LPN
    It is not up to the other "team members" to make sure she's doing her job. They have enough to do already.

    I'm all for supporting team members, but if i fell asleep on the job, i would not be expecting my co-workers to cover for me, nor would i want them to.
    Marie- I didn't feel like reading all 14 pages of this thread before I had the urge to reply again. But I totally agree with you!

    Rules are there for a reason. What good are they if they're not being followed and enforced!?
  9. by   SmilingBluEyes
    Why you ask what kind of punishment should be meted, I can't imagine.

    It sounds as if the dye is cast already.

    The facts are:
    She has been reported.
    The HR department is involved and policy has been broken.
    They get to decide what happens next, not you.
    They plan to notify the BON as part of policy.

    What happens is not in YOUR hands at all. Nor the hands, even, of your manager. It's a fait acompli. It will be up to HR and the BON what happens next.

    My opinion does not matter. The situation has been "handled" already.

    All you can decide to do is be warned and act accordingly.

    Let all your coworkers/colleagues take note and consider themselves warned. That is all you all have the option of doing now, right or not. Can you change policy? If not, you are left with no choice but to heed or expect similar action. Or go to work someplace where policies are not as "tough" and enforced as strongly as this one is.

    Like I said, my opinion does not matter. The facts are just that, the facts.
    Last edit by SmilingBluEyes on Oct 13, '05
  10. by   GLORIAmunchkin72
    No wonder there's nursing shortage. Fire an excellent nurse because she dozed off sitting by her patient's side? Buy her a box of NoDoze!:uhoh21:
    Quote from Daytonite
    Had an interesting situation that came up and thought I'd throw it out for discussion.

    One of our staff RNs was found sitting in a chair and sleeping at the bedside of one of our ventilator patients at 7am. She tells me that the patient was very restless and they had been constantly watching him throughout the night shift because of the fear of him pulling his trach out. They found he would settle down when someone sat with him and held his hand (how basic can nursing care get?). So, periodically during the night different staff members sat at his bedside. The nurse in question says that at 5am she had caught up on all her charting and told her co-workers that she was going to sit down in the room with the patient. She sat down, took his hand and he immediately quieted down. She sat back and the next thing she knew someone was waking her and telling her it was 7am. She jumped up and worked on giving her 6am meds and ended up giving an oral report to the oncoming shift (we tape report).

    A very serious decision has to be made here. This is a really excellent nurse and I'm afraid there will be no choice but to fire her and report her to the Board of Nursing. I understand that she did not intend to fall asleep and that she was helping the patient, but rules are rules, aren't they? How I wish this hadn't been reported. Our facility rules clearly state "no sleeping on the job". Our Human Resources Office and the Director of Nursing will make the final decision. What do you all think?
  11. by   Jolie
    Quote from stevielynn
    In the quiet of the nursery at 3 a.m. while rocking a baby, I've been very very sleepy. It would have been easy to nod off - I didn't, but I can see how it could happen.

    This nurse needs to be shown compassion, disciplined, and not fired or reported to her BON. For heaven's sake, there are worse med errors that we don't punish nurses for so that they can feel free to be truthful in reporting them - then we can see where the problem is and fix it.

    Don't fire her.

    You have hit upon a very important aspect of this case. It took our society years to reach the point where we acknowledged that med errors are not necessarily the "fault" of "bad nurses" but often the capstone in a series of unfortunate events involving physicians, pharmacists, nurses, administrators, third party payors, regulatory agencies, etc. And unfortunately, some healthcare facilities still don't get it, and seek to punish nurses for errors rather than find their root cause, a process which requires freedom of expression and honesty without fear of reprisal.

    This is a situation which BEGS for similar problem solving. How best to serve a restless, critically ill patient. How best to serve the staff members who come on duty at a time when their bodies are programmed to go to sleep?

    Instead of hanging this nurse, wouldn't it be more productive to use this incident as a stepping-off point to study ways to combat sleepiness in night shift workers?

    I don't doubt that at some point, (probably WAY in the future), hospitals will MANDATE sleep breaks for night shift workers.
  12. by   dorselm
    Right now I am taking my prerequisites toward becoming an RN. When I read some of these threads...it is quite scary and sometimes overwhelming. This is indeed such a tough issue because on the one hand I can understand the need to protect the patients from future negligence and of course to protect the hospital too. I mean, she did neglect her patients no matter how you look at it and I'm sure worse things happen on a daily basis but 2 hrs is neglect. But then you have a good nurse with presumably no priors who has a clean record and makes one mistake. With the shortage of nurses and with the fact that you find one who once again is presumably knowlegable in her field and has the compassion and patience to deal with people, then that's a hard call to just right there on the spot fire her with no if, ands or buts about it. I would not want to be in the person's position who has to make the decision to make or break her career. But whatever it is, she has to accept it. I don't like the fact that nurses are supposed to be superhuman and that there are no faults allowed and one mistake can cost all the years of schooling and sacrifice and dedication. This now if weighing heavily on my heart. It is also giving me much to think about which is why I like this site so much. I am scared right now because I am an accountant but I have so much compassion and patience for nursing(not to mention whenever I mention that I'm preparing to go to school for it, everyone always says I should have gone years ago because that's where I belong). I am paying for all of my prerequistes out of pocket and will have to take out major loans to go to school and have to quit my present job to dedicate time for school and to make this huge sacrifice and make a mistake only to have people waiting to snatch everything away from me is a lot to think about. I am going to pray on this because this is not the first situation on this site that I've read about. I pray that everything works out for this nurse and even if they have to fire her I hope that she can still practice nursing somewhere else and learn a great lesson from this!
  13. by   psychonurse
    When I worked in ICU about 17 years ago, the RN that I worked with and I use to break each other for a 15 minute sleep time and it was amazing how much that little bit of time could refresh you and make you feel like you can make it through the night.

    There are times when I didn't get a good nights sleep and it was really hard for me to stay awake especially when your patients are snoring and sleeping well. There are times that I might have nodded off for a couple of minutes but never 2 hours. There is a nurse that I work with right now and she has done that more than once to me and nothing has ever been done even after telling the power that be what is going on....

    I have a feeling if the nurse is union represented and she has had a good track record, there won't be any losing of jobs or anything...i mean this is only one time and there has to be more problems than one before they move from the counseling phase of punishment to losing your job.