Would you call in because you didn't get any sleep?

[Elvish]

I was trying to sleep the other day and somebody rang my doorbell at 1130 just as I was gettting there :angryfire. Made me so mad I couldn't go back to sleep for a L O N G time. I called in sick because I wouldn't go to work on no sleep. Turns out I finally DID go to sleep so I called back & said I'd come in if they needed me.

So I got curious: Have you called in sick (or would you) because you hadn't gotten any sleep (after trying, of course) by the time you're required to call in for your shift?

[sinsay]

I have went to work before sleep deprived. I worked a 12 hour night shift and had only slept 3 hours that day. I went back to work at 7 pm. I felt horrible and unsafe. I could not think straight. It was hard for me to calculate IV drips and drug doses. I was very disorganized and forgetful. I will not do this again. It is to RISKY!

[annie4747]

I,would certainly call in if I had not enough sleep to safely care for my clients. I wouldn't want someone impaired caring for me not for all the tea in Boston.

[nursemike, ASN, RN]

I've called in for lack of sleep, although, usually, if I don't get five-six hours, there's probably another health problem going with it. Couple times, though, it was my Dad's health that kept me awake.

Our P&P says you're unfit for duty if nodding off at work. Sounds right to me. That said, there have been times I've been wide awake while up and moving, but barely able to keep my eyes open while charting, despite a more-or-less reasonable amount asleep. Once also woke up in the middle of recording report--I was talking away, but no idea what I was saying.

On a related note, once when I was called to see if I would come in extra, I said I would be happy to, but they'd have to send someone to pick me up, because I was way too drunk to drive. They didn't bug me again for awhile.

[azhiker96, BSN, RN]

:monkeydance: I'm responding to the poll about calling in sick for lack of sleep. I absolutely would call in. A sleep-deprived nurse is a danger to her patients. Having said that, I'd try to rectify the reason for not sleeping.

I agree!

[cardsRN]

depends. every friday night i go in for a 12 having been up all day with my son. then go back in for 12 sat and sun noc. but you better believe i sleep like a rock sat and sun day. lack of sleep becomes a natural state for a mom. you learn to deal. but there have been times i probably should have called in because i was really out of it at work. it's not safe, but as you all know, management is not receptive to call outs for any reason. the coroner could call out for you and they'd probably argue! lol

[steelcityrn, RN]

no sleep = unable to concentrate..... better to miss that day

[ralt099]

As a lead nurse on nights I have sent nurses home because they had not gotten enough sleep, and I felt that they were a danger to the patients. This rarely happens, but new babies, sick kids, fights with significant others happens to everyone at some time or another. I work in the ER where fatigue is common, but exhaustion can be dangerous. When a person has not slept their critical thinking skills can be effected, med errors can easily occur, and I have put out more fires with unhappy patients because an overtired nurse was cranky with them than I care to count. You can't let this happen on a regular basis, but yes if you have not slept and are overtired call in. I wouldn't want an airplane pilot to fly if they hadn't slept in over 24 hours, and I sure don't want a nurse who hasn't slept in over 24 hours taking care of me either.:)

[Diploma'82]

My last nursing manager would call me up and give me heck if I called in for being sick (IE: coughing til I puked) because there were only 2 of us on night shift for ICU coverage (including tele). I told her several times that I wasn't able to sleep and felt overwhelmed (getting more depressed and diabetes out of control). Her response was to write me up and assign new employees to be oriented by me...plus the ward clerk was out from having an MI...this left only me and an orientee to do it all, including tele monitoring!

[ralt099]

I recognize that adequate staffing is a major concern, but as a leader I have always felt that it was important to take care of your staff. That understanding that they are people, not robots, that it creates an atmosphere of teamwork where you don't want to call in except when you really need too. I did keep track of who I sent home and why. And I did write them up if it became a habitual problem...but not for the occasional illness or sleepless day/night. Its a fine balance that must be kept. But patient safety has to be the number one priority.

[ralt099]

Oh and BTW...when all of your staff is sick...thats when the nurse manager puts on her scrubs and comes to work after calling the staffing office to start getting her some agency or float pool staff.

[palesarah]

I didn't call out once and I should have. The story:

I work 50/50 days & nights. We self-schedule and I was scheduling myself all over the place, to get long stretches of days off. I had worked 4 nights in a row, 1 or 2 days off, worked 2 days, then had 5 off. I never got my sleep right and had 3 day shifts in a row coming up. The night before the first of the 3, I couldn't sleep. Around 2am I called to see if there was a need for me to work the night instead of the day shift (often there is). Nope, needed me on days. Tried to sleep. Tried really hard. Got about 2 hours. Went to work.

I have a 1 hour commute and work 12s. It took a lot of caffeine to get through the day. I asked & called everyone I could to see if anyone could take my next 2 day shifts for nights, usually there's always someone wanting to work a day shift instead of nights! But not that day. At lunch my coworker noticed my left eye was twitching, which was weird. I got through the day on nerves & caffeine, considered staying at a hotel instead of driving home but was so overtired that I was fully awake. Drove home without incident.

Tried to sleep. It never came. I was so overtired that I was wired and just couldn't fall asleep. Took an Ambien, couldn't sleep. Took 2 Benadryl. Still couldn't sleep. Around 11/11:30, when I had basically been awake for 34 hours with just that 2 hour "nap" the night before, I apparently told my husband that I "felt funny". I don't remember that, because minutes later I had 2 grand mal seizures within a minute of each other. All I remember of that, is my husband being incredibly mean to me by making me get dressed in the middle of the night before he drove me to the ER.

I haven't been able to go to work since. That was the end of January.

I had 3 seizures when I was a teenager, and had been stable for 13 years on medication. It's believed that the 2 seizures I had that night were triggered by lack of sleep, low medication levels (when my schedule gets screwy I don't take it as consistently as I should; I've changed that habit) and the benadryl (which can lower the seizure threshhold).

My doctors don't know why, but something triggered that night in my brain and for 2 months, I had numerous partial seizures every day, and a total of 2 more generalized convulsions. It's taken this long to find the right combination of medications to control them. And I can't help but wonder- if I had just called out and gotten some sleep that first day, would any of this have happened? I have no way of knowing. But I could have seized when I was holding a baby (I work in the NICU!) or on my long drive home. Luckily it happened int he comfort of my own bed. And hopefully, I'll be cleared to return to work at the end of the month. But I am VERY protective of my sleep now. I'll still be working rotating shifts but will be doing it in 2 or 3 month blocks.

[quitahug]

I work a midshift....11a-11p Friday, Saturday, and Sunday in the ER. Strangely enough, my charge nurse spoke with all of us weekenders and directly told us that if we were having some personal problem that kept us from sleeping, she'd RATHER we called in than come to work. Of course, we all understood that this should be for true personal emergencies, not just an excuse because we went out with friends. So, YES, I would call in if I hadn't gotten enough sleep. It's too dangerous to not call....for the patient and for me.