How tired is unsafe for work?

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Specializes in NICU.

Hi all. Here's my scenario:

I'm doing my senior preceptorship in a NICU. Because of some family stuff happening on the opposite coast (i.e. three hours earlier than me, hence late night phone calls), the last three nights I've gotten a total of about nine hours of sleep combined. I've also been pretty much unable to keep any food down, probably because of stress and reflux (doctor's on it). So as of this morning, I was running on almost no calories for the last 36 hours, and about to start my third consecutive 12 hour shift. When I got up to get ready today, I was literally shaking and bumping into things, and feeling very fuzzy in my head (still am, actually). It wasn't even that I felt that sick, but I really felt like it would be unsafe for me to go in, as I'm towards the end of my time and doing a lot of actual, semi-independent patient care and assessment. I was really scared I might miss something or hurt a baby somehow. So I called off sick. Now, in the midafternoon (after a little more sleep and some straight sugar water) I'm feeling really guilty. Like I should have just sucked it up and soldiered on. I know everybody has different reserves of strength, and I'm still new to the whole 12 hour shift thing, but would you have felt safe going in this morning?

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

From what you described, that's a definition of sick.

I did that once a few years ago, called in sick, and said "I can't work". It was the truth, i couldn't work like that.

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Specializes in ER/Trauma.
Now, in the midafternoon (after a little more sleep and some straight sugar water) I'm feeling really guilty. Like I should have just sucked it up and soldiered on.
I'm gonna call the BS card here.

Stop feeling guilty. Ya did the right thing.

Feeling woozy and bumping into stuff? I wouldn't leave the bed except to go to the bathroom. I wouldn't trust myself to drive over to the hospital. I couldn't bring myself to face my preceptor - I'd probably appear inebirated! :imbar

Last but not least - better to call in sick than administer wrong drug, dose or to the wrong patient!

If you're anything at all like my brother - your relief is temporary. I advise you to sleep well tonight - or you'll simply crash during evening/night time.

Believe you me!

Stop beating up on yourself - next to no one is going to appreciate you "soldiering" on... but they will call you out if you make mistakes because you were tired.

Part of good nursing judgement is knowing when not to do something because it is potentially unsafe - for you or the patient. Critical Care is no joke - you need to be alert and charged up everyday.

You're almost done with school. Don't do something silly near the end and leave with regrets/bad memories. :)

EDIT --

PS: Sorry your family's acting the way they are right now. Mine complaiuned that I wasn't keeping in touch, that I wasn't doing this or that, I wasn't participating enough - I just sent an email telling them that:

"I'm sorry. But I'm going through full time school. Nursing school is hard enough. I'm working two jobs to keep my head above the water. I live with idiots for room mates. I'm lucky if I get 4 straight hours of sleep a night. I understand your consternation. Please understand my predicament. I simply don't have the time nor the energy to deal with family issues right now.

I'm sorry, but that's the way things are."

My parents understood after a very terse and firm phone call from me to quit bothering me at odd hours of the day (or whenever they felt convenient). I felt rotten to be "harsh" to them - but it was either that or continue losing sleep and time over issues which IMHO could have waited.

It was my peace or their time.

My peace won out in the end and in hindsight, I don't regret it one bit. After all, I'm still sane aren't I?

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

And never forget, you have to take care of yourself in order to be able to take care of others.

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Specializes in NICU.

Thanks, you guys. Actually, now that I'm up, I was thinking I'd go to Bed Bath and get some stuff I need. But after due consideration...no. I don't think I'm even up to that, at this point, so clearly taking care of the kids is out. I just felt bad, like if I wasn't contagious in some way I should go in, no matter how crappy I feel.

Did I mention I'm both Irish and Jewish? Double guilt time!!!

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Specializes in Case Management.

Oh my God! half Jewish-half Irish!!!!!

No wonder you are going through family "stuff"!!!!LOL

what a combination!

You need to reverse the situation and call your family bright and early in the morning when you get up! then they will realize what "time difference" means and maybe they will not call you so late!:lol2: :lol2: :lol2: :lol2:

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Specializes in NICU.

Well, I don't feel guilty anymore. After an entire day in bed (most of it sleeping) I just tried to go to the store for milk. I made it three blocks, got dizzy, and took my pulse - 130. So I came back. I probably would have dropped a kid or something.

In all seriousness, when am I going to get used to this? I'm not even on nights!

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

When was the last time you had a thorough physical?

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Specializes in NICU.
When was the last time you had a thorough physical?

Next Friday, luckily. They're playing a merry dance with my meds these days. Avoiding side effect A leads to side effect B kind of thing...

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Specializes in Pediatrics.

Did I mention I'm both Irish and Jewish? Double guilt time!!!

oh gosh... me too!!! i know what you mean!!! I'm sorry you had such a rough time today... it sounds like you shouldn't have been there i agree.

i hope you feel better soon, and find something you can keep down too. and take care- i second what marie said about "you can't take care of others without taking care of yourself".

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Specializes in TELE, ICU.

Try aloe vera juice for the acid reflux, it's a natural anti-immflam. If you feel uncomfortable about it,do some quick research about it on the net. It worked wonders for me!

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Well, I don't feel guilty anymore. After an entire day in bed (most of it sleeping) I just tried to go to the store for milk. I made it three blocks, got dizzy, and took my pulse - 130. So I came back. I probably would have dropped a kid or something.

I got so messed up on my meds (namely, Effexor) awhile back that between that and my natural tendency for mild tachycardia I ended up in the doctor's office with a resting heart rate of 160. Bought myself a night in the hospital on tele with that one. I've never been so tired in my life. However, after two doses of atenolol, we dropped my heart rate by 100 beats/min - I had SO much energy, I was ready to paint the house or something -- they actually had to give me a dose of Halcion so I could sleep. Three years later, I'm still on atenolol. (And, off the Effexor, but on two other anti-depressants - it's sad when you and most of your coworkers are on some kind of anti-depressant or another so that you can function.) But, I'm rambling.

Unfortunately, the hospital where I work (as with many hospitals, I have found, through reading on this website) does NOT promote care of one's self. The only good excuse for being absent is for a funeral and it had better be your own. They don't consider exhaustion a reason to stay home. And, it's frustrating as ****, because you're dog tired, dragging yourself through your shift and a nurse manager asks you what's wrong and why didn't you just stay home, then, and you're like why didn't I think of that?!? Maybe because the supervisors at the hospital give you a hard time when you try to call off. :banghead:

And now I have to go to bed because once again, I am beat after working all day (busy day, not enough nurses...but THAT'S a whole other thread...can 'ya tell I'm frustrated with my job today?)

Thanks for reading. :mad:

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