Impaired nursing not cool

sasha2lady · Nov 28, 2009

After re reading my vent I need to clarify it . When I talked to my superior I didn't come out and tell her that I think this nurse is impaired, I told her I didn't think she was quite ready to return to her duties yet because of obvious observations-glassy eyed,sluggishness,increased drowsiness and the "hiding" for over an hour. I talked to my sister inlaw who works in nurse mgmt a d asked her what to do. She sAid that if I'm charge then I could be held accountable for her lacking if something were to happen and I did nothing about it and knew or suspected her of being impaired or sleeping while on the clock. That scared me.she said I have a duty to report and then whatever mgmt decides to do is up to them. I wouldn't go to the rm she was napping in because I didn't want to see it. I wasn't the only one who heard her say that she was going to go hide either. I suggested that maybe the superior pop in unannounced on days this nurse works and just observe before taking action to see if tthey see what some of us other few have seen . I'd hate to see her get fired but you can't nap on the clock and you can't hide either.part of the reason we got extra work assigned to us is because so much wasn't getting done by the prn nurses and prt time ones. I feel like a snitch and I hate it. I'm so antidrama but what if she makes this a habit? She's already done this before and she told me herself she got fired from her other job for refusing a drug test. I think people do things more once they see they can get away with it . I think she shouldve been up there helping us or doing her charts or doing something to keep busy & awake. I offered to make coffee. This type of thing makes it so hard on the restof us. Maybe I should just talk to my superior again and tell her to hold off for a while til she sees it herself. Help!

jeweleebleu · Nov 30, 2009

First thing first...don't feel like a snitch because you're NOT! I applaud you for even making the decision to talk to your superior it must have been difficult :yeah: . Remember that we took an oath and it is our nursing duty to protect our patients I completely agree with you sister in law. My question is as charge nurse you are able to ask the nurse to go home if you see she is unable to perform her duties correct? How does that work exactly? Because I would have asked her to clock out and go home if she came to work in the state that she was in. Really... my heart goes out to this nurse and her recent lost it but, in the same respect she is obviously not in the condition to care for anyone else and she is not able to care for herelf. Being oblivious to the problem is not going to make it go away. Her careless acts are going to result in possible patient death, the loss of her license and possibly yours if you are not careful.

I think the administration needs to step in immediately and get her off of the floor and get her some help! You did the right thing! Her causing you problems would be a smudge on your radar compared to long term problems that you would be preventing. Be proud that you have the morals, values, and ethics that have convicted you to take a stand. Good Luck! Keep us posted.

tewdles, RN · Nov 30, 2009

As charge nurse you ARE responsible for the nurses practicing on your shift...you are accountable for who has what assignments, etc. If she messes up and there is a law suit you will be deposed...that is the bottom line. You are obligated to confront her about this in a private manner the next time she is working your shift. You must pull her aside and tell her of your concerns. Your obligation to the patients, the other nurses, and the employer must come before any concern you have about the tendency to "pick fights" that this RN has demonstrated. If you, as charge nurse, do not feel that she is able to safely carry out the duties of her job you must contact your supervisor and then dismiss her from the shift...just like you would if you thought she had a communicable illness. It is not your duty or responsibility to prove that she is impaired. It is your duty as charge nurse to insure that the nursing care required by those patients is delivered safely and according to the policy/procedure/standards in place.

Take the bull by the horns, talk with her next shift, make a choice. Whatever choice you make, measure it by the impact on patient care and safety...GOOD LUCK.

pagandeva2000, LPN · Nov 30, 2009

I think that you are responsible to inform the nursing supervisor of your suspicions, but I am not sure if you, as a charge nurse, has the power to send a person home...in most facilities, this is the responsibility of the nursing supervisor or DON. Definitely, you have every right to advocate for the safety of your patients and co-workers, but just be sure that you know the protocol on what is expected of you.

wearingmanyhats, RN · Dec 3, 2009

I think I would call the BON... this person is an accident looking to happen...

teeniebert, LPN · Dec 3, 2009

Next time she goes off to 'hide' have another nurse or aide look in the room with you. Write an incident report stating "at 5:30 pm on 12/4/09 Nurse X was observed by This Nurse and That Aide lying on the bed in room 123 with her eyes closed." There is probably something in her contract prohibiting sleeping on the job. The time for worrying about starting a fight or 'snitching' is long past.

tewdles, RN · Dec 5, 2009

I think that you are responsible to inform the nursing supervisor of your suspicions, but I am not sure if you, as a charge nurse, has the power to send a person home...in most facilities, this is the responsibility of the nursing supervisor or DON. Definitely, you have every right to advocate for the safety of your patients and co-workers, but just be sure that you know the protocol on what is expected of you.

I have never worked in any facility other than a hospital, so my knowledge of charge nurse responsibilities ends there. When I was charge in a PICU and when I ran the PICU the charge nurses made decisions about sending someone home...they certainly weren't going to call me and ask my opinion off shift! Outside of the normal business hours of 8-5, there was a "house supervisor" type of person who could assist in those decisions, BUT, the nurse left in "charge" of the pedi ICU was "in charge" of determining who was going to do what to whom...that included sending people home for whatever reason. The people "in charge" were given that responsibility and stipend for a reason...the choice is not made willy nilly.

systoly · Dec 6, 2009

Check your BON's website. In my state, sleeping on the job is abandonment, clearly spelled out by the BON. As a charge nurse, I've directed a staff member to clock out on several occasions. Some of the reasons were alcohol breath, family emergency and patient safety issues. If this falls within the scope of your role as a charge nurse, you might be doing someone a favor by sending them home when they are under the influence. However, before instructing a staff member to clock out, take into consideration the staffing ratio. Certainly, if a staff member is clearly risking patient safety, compliance with ratios is irrelevant for the time being, but you need to evaluate what is best for the patients' welfare at the time. You most certainly did the right thing by not ignoring this. Not only do you owe it to the patients, but to yourself as well, because tolerance, in this case, could have bad repercussions for you. If you observe anyone sleeping, or otherwise jeopardizing patient care, get a witness and a written statement from the witness. I understand you wish to remain anonymous in this matter, but unfortunately your anonymity leaves you without proof of addressing this matter. I admire your kind concern about this nurse and perhaps with some help her situation could improve, but be sure you don't enable her and remember: you can't make her get help or even realize she needs help.

L8RRN · Dec 6, 2009

Got a camera phone? Take a picture of her asleep.

pagandeva2000, LPN · Dec 6, 2009

I have never worked in any facility other than a hospital, so my knowledge of charge nurse responsibilities ends there. When I was charge in a PICU and when I ran the PICU the charge nurses made decisions about sending someone home...they certainly weren't going to call me and ask my opinion off shift! Outside of the normal business hours of 8-5, there was a "house supervisor" type of person who could assist in those decisions, BUT, the nurse left in "charge" of the pedi ICU was "in charge" of determining who was going to do what to whom...that included sending people home for whatever reason. The people "in charge" were given that responsibility and stipend for a reason...the choice is not made willy nilly.

I know that each facility works differently. I think that it is important for the nurses to know what the protocol is, what is expected of her regarding charge duties and the chain of command, especially during off hours.

sasha2lady · Dec 7, 2009

Well at my facility we can tell someone to clock out if need be....we can then call the DON and tell her. She says we can call her before or after the fact so that she can then deal with it and investigate it. I dropped a big hint to this nurse because I wrote up an aide for sleeping who was then fired after a 3 day suspension and investigation. Hopefully this will open her eyes up some and she'll know that it wont be tolerated. I just hate being drug into something so dramatic.