What punishment should this nurse get?

Nurses General Nursing

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  1. Should THIS nurse be fired from her job

    • 24
      Yes, this nurse should be fired...no matter how excellent.
    • 372
      No, this nurse should NOT be fired, it happens...even to excellent nurses.

396 members have participated

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?

Who CARES about the hospital. I've never seen or heard of an institution going to bat for a nurse, why should we care about the hospital????

Good point

It could happen to anyone.Sounds catty if she was reported

Specializes in Tele, Dialysis, Med-Surg, ICU,GI.

I know I'm entering this discussion late,but I don't think the nurse should be fired. Where I work I see nurses taking turns, sleeping in geri chairs, and her co-workers must of been okay with it.

However, I do think it is dangerous to fall asleep beside a pt, because you don' t know how they will react to your presence. A co-worker fell asleep while watching a patient, he woke up and started choking her with the IV lines. She was sent home and was not fired.

Specializes in Med-Surg, Geriatric, Behavioral Health.

I think the poll echos much of what we have said so far.

Thanks everyone for your input. You're serving the original poster well.

Excellent thread and discussion.

It has generated some staff discussion as well.

Keep posting and keep voting if you have not already.

Close - served a very good discussion, and a good poll.

Although i am relatively new to this discussion I might add just a couple of points. When looking at this objectively one can see the following: a great nurse tried to help calm a restless patient down during the night shift (probably to aide other patients in sleeping I am sure), all of her required work had been completed up until that point, the patient was on a ventilator (which automatically alarms), and she inadvertently fell asleep while committing an act of compassion & caring. How often have we been able to actually sit at the bedside lately? Where I come from, not that often anymore. Too many tasks at hand. Although I am not a believer in sleeping at work I do feel that there may be other factors to take into consideration here as well. Lets face it, nursing is facing an extreme shortage, so for the sake of argument, lets say she kindly agreed to come in on her night off to help out her colleagues, because if she had not they may have had to work short. Secondly, ventillated patients are now on chronic floors as well, and as most of us know, they are not usually staffed so well since it is not such an attractive place to work. Very hard and physically challenging work - that is not to say other floors aren't as well. To say that a nurse must be fired over this when she has had not other strikes on her record is a grave error. Instead of looking to fire nurses, we must begin to empower them in order to keep them on the job. Retention is key to the livelihood and evolution of our profession. If we cannot retain the nurses that we have there is no future in nursing. Yes, the nurse made a mistake, but perhaps the circumstances were extenuating and I personally feel, this should not be treated so harshly and that organizations should seek to support their nurses in whatever way possible. I am not sure who commented on this but I strongly agree with the concept that we must stand up and support one another and not eagerly await for each other to fail. We must start caring for one another in order to nurture the profession that we all love.

I just finished nursing school in May 05. I was shocked to see how nurses treat nurses, I always wondered if what they said about nurses was an exaggeration or if it was true, "nursing eat thier young"...it is true. I cried a few nights after 12 hours of listening to the negative and watching the attitudes..but you know...I will find my nitch where I can be the kind of nurse I want to be. I work in telemetry in a suburban hospital. Once in a great while you get a patient that can ruin your day, I do not take it personally. First of all if they are miserable, I most likely had nothing to do with it and it was pre-existing, and if they are in pain or very ill...then I understand and again don't take it personal. Nurses give nurses a bad reputation. I will work there one full year and see if that is what I want to do. I take no part in back stabbing, ganging up on somone that is not like the crowd, older , a litle different, etc. I take the best care of my patients that I can, I can do no more. I come home so fatigued after 12 hours of constant pressure. It is quite unbelievable that I keep going back for more. I also got a job with a lot less pay 3 days a week working for a very king doctor with a kind nurse practitioner. That will have to be my balance. I will get the bulk of my money and my experience in the other two 12 hr. days at the hospital and will think about it for the next 7 months. If it isn't better, I will find my way somewhere else. I blame administration for most of the problems. If you are running short staffed then no one is happy and everyone is looking at who is close to take out their frustrations. Sad but true. Administration keeps piling them on you when you cannot take anymore. You have to have a little edge about you for your survival or you will get swallowed. It is difficult. I don't want to but I don't want to get steamrolled either. If you have caring for people in your heart...stick to it, you will find your way. The good thing is you will always have a job, you don't have to worry. So you can go where you are happy to go to work. School was difficult, students stabbed each other in the back to look good, work is the same. In both cases I would look up...it is administration for the dog eat dog atmosphere. Don't give up...one person can make a big difference...that can be you.

I too am very worried about starting Nursing School if this is what happens. I always wonder how they expect someone to not fall asleep and to fully function throught the night. This is very harsh. I think she should get a warning and if it happens again, then they would have every right to do what they have to.
Specializes in NA, Stepdown, L&D, Trauma ICU, ER.

Ok, I've been reading the first 5 pages with increasing frustration. I do agree that it was completely inappropriate for her to fall asleep. However, having worked night shift I can empathize. I've never met night shifter without some degree of sleep deprivation. All through the (rather heated, I might add) debate I've been picturing the scene. I've finally gotten caught up on my paperwork, and I'm relieving the PCT that's been sitting with my patient to keep him calm. I take a seat, and hold his hand quietly. After working most of a 12 hour shift, it is so nice to sit down. The woosh-swoosh rhythm of the vent in the background, the dim lighting... Given this set of circumstances, how can anyone think that she was being negligent? She didn't go into an empty room to take a nap, she was being a good nurse by taking the time to just sit and hold her patients hand because it calmed him! She dozed off while doing it. Having fallen asleep before I realized it (like, I erronously thought everyone did on occasion...) while watching a movie, or sitting outside, or any other calm, quiet place when I was tired, I know that it can happen before you even realize your eyes are closing. A reprimand is in order, but crucifixion is not. Heaven help those on the witchunt should you ever make a mistake

BTW, med/surg night nurse here. I too have never fallen asleep on the job, but I bet if I had been in a darkened room with the rhythm of a ventilator, I would have had some droopy eyes for sure.

Wow, soooo many posts, can't believe I read (or at least skimmed) them all. I quoted the above because one thing that kept going thru my mind was my personal experience as it relates to this. There is no more difficult job than to sit in a dark room in the middle of the night and watch someone sleep. I have worked nighs for almost all of my nursing career (including my time as a student) and can say that I always got a good day's sleep prior to work, and it just didn't matter when I had to do a 1:1 suicide watch in a pt's room (although I'd be doing this for 8 hrs). I go in alert; come out dizzy from exhaustion. To the best of my recollection I never fell asleep, although I'm sure I've dozed for moments at a time. Point being that what happened to this nurse could happen to everyone of us in a similar situation. That being said, I don't think anyone is saying it couldn't happen to them; and I believe the people who are advocating for dismissal admit that if they were the nurse they should be fired.

IMHO, this post says almost all that needs to be said about this subject:

https://allnurses.com/forums/1354463-post120.html

Also, I'm curious if anyone who wanted to terminate the nurse initially has since redirected their thinking (but take this case as an in general example and disregard the policy for this specific situation)?

And finally, as much as I enjoy union debates, I'm so glad this thread didn't continue to go down that tangent.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Gosh, there is making a mistake, and there is sleeping on the job!

If you are not able to stay awake during your shift, then you should not be working! Your responsibility is to be a safe practioner to your pts. If the night is too hard to work, then speak up to your boss and get traded to days. Gees, imagine being the agitated pt: Imagine looking over and seeing your nurse asleep!! And, BTW, this wasn't a little nap-this was a 2 hour nap! Someone had to wake her up! Totally and completely unacceptable...[/quote

Cardiac,

I must share that there are times in a ICU when intubated patients truly want to feel a physical presence in the room so they know they are alive.:saint: I am sure that when she first went into the room it was not with the intent to fall asleep. A dark quiet warm enviroment can make anyone doze off. The rhymic soumd of the vent and finally the patient who had been the bane of everyone existance that night is finally quiet.:sleep: Share if you have ever not known how you got home after working 2 -12 hour shift in a row, made dinner, washed a couple loads of clothes and baked cookies for your 6yo's party. Have you ever been driving after a night shift and had to open the window in a blizzard just to stay on the road! Or don't remember if you stopped at the traffic light?:confused: I know I have actually fallen asleep behind the wheel at a RR crossing or at a dead stop in traffic in chicago on the dan ryan or on 128 in boston.:eek: Only to be rudely awaked by some irate driver blowing their horn furiously and flipping me off!! Should have been driving? NO! but I also needed to get home to meet the bus! Man is not NOCTURNAL it is not a natural state. I agree it is not "acceptable" but it is not such a grevious act that she should lose her liscence.!! "TO ERR IS HUMAN TO FORGIVE DIVINE" Even as a supervisor when I finally sit down in the morning to do staffing with the staffing sec. We have both closed our eyes, not realized it pencils in hand bolt upright in the chair... to be awakened by the ringing phone.:eek: It is the responsibility of the charge nurse to be aware of her staff and to check upon them if they are missing. I will lay a paycheck on the line that the rest of the staff was so relieved that the patient was finally quiet and stopped being disruptive :yelclap: that they never noticed until the nurse who actually had the patient did the one last check and found her...asleep:sleep: (been there done that) I am sure that if she went in after "several staff members" had been ther also her patients were being watched as they would if she went on break or lunch. If I traded everyone to days that c/o of being tired I would never have a night shift!! You will be entering the profession soon and I need you to feel compassion and understanding to your peers because that shows me that you will be able to show compassion to your patients from a diversified background. You WILL encounter things and ways of life or someones decision that you do NOT agree with and goes against your very core of beliefs.:scrying: ......it is compassion and understanding that you need to have...it's TOLERANCE that is imperative!!!! Serious offenses are serious but it is our job to help change them or help them through whatever it is they need. To help them realise the gravity of what they have done....remorse is huge with me. I agree that there is a level of expertise that we need or a standard that needs to be followed but.....we also need to stop eating each other alive!!!! Just food for thought.....I'll get off my soap box.:chair: Besides if the patient was that agitated I and intubated I bet you that even if he looked over at the nurse he was just relieved that someone was ther holding his hand!!!! :redpinkhe

To all,

This still says it all!!!! Talk with her don't crucify her!! I even find it sad that she got suspended.....seems that someone went out of their way to get her in hot water:idea:

lost in boston

How could you say that a person should get fired. Have you ever been fired do you know what it's like? It's a cruel person that says a person should get fired just for falling asleep. Humans do make mistakes. If you have never made a mistake, than you deserve to be fired, because you're not human.

Specializes in LDRP; Education.
Sorry, there has to be standards. You fall asleep on the job for 2 hours, someone has to wake you up, you get fired. IF, she does fall asleep in the future, and IF harm comes to her pt, THE HOSPITAL is at fault for letting her continue to work. I would not take that chance.

I agree completely.

Sleeping on the job, I'm confident, is in direct violation of hospital policies. If this one were to be "let go", what other policies should we let slip and where do we draw the line? This wasn't a late-night McDonalds she was sleeping at, this was a hospital with a vent patient!

And yes, who in the world would be relying on alarms to monitor your patient's status? For heaven's sake...

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