Sleeping Nurse = No Agency?

Specialties Private Duty

Published

We have (my husband and I on separate occasions) caught one of our night nurses sleeping. The first time it happened, DH saw her on the baby monitor (I was already knocked out!) and he didn't say anything. He just got up to the hall bathroom (even though we have the en suite) and made a lot of noise so she would wake up. I guess she got the hint, because the next morning when I relieved her she told me about how she was coming down with something and may not be back that night. Being a PDN myself, I understood and respected where she was coming from, and just told her to call the agency in enough time for them to find a replacement since I had no day nursing that day and would be exhausted. She ended up calling in sick, we got a new nurse and all was well. We never reported it, and asked her back because we assumed it was an isolated incident. We watched her, and the other nurses on the monitor as indicated for the next few days, and had no real concerns. I trust most PDNs are honest and do a good job. I know I've always tried to do a good job and I never want to be one of "those" parents. I try to see it from the nurse's POV.

Weeks later, I woke up with one of my other children and happened to glance into the room and see the nurse sleeping. Not just dozed off (which I admit, I have done in the past- but not on purpose- and never comfortably) but LAID OUT on the floor (off camera) with Gem's Minnie Mouse throw blanket over her! I took care of my other child, put her back to bed, and when I walked past again, the nurse was sitting up in the chair (red eyes, groggy looking, obviously just woke up). I offered her a cup of coffee, and asked if she wanted to sit in the living room with a monitor to have better lighting. She declined, so I kindly reminded her that there is no sleeping and Gem can turn on a dime, so we needed full eyes on at all times. I don't think I was nasty about it, and I told her I wouldn't report her because I understand sometimes it's hard to stay awake.

Third incident, two night ago (3 days later), on my birthday. I came in from my celebration and went straight to bed. I had been the night nurse the night prior and my family had my birthday full from morning to night. I was EXHAUSTED! Because I fell asleep around 9, I was awake again by 2. I got up to get a drink, looked at the monitor, and didn't see the nurse. When I went downstairs, the nurse was on the couch with the other video monitor, lights low, TV off, curled up on the chaise lounge. At this point, I woke her up and sent her home. I did the rest of the shift and called the agency Monday morning. They said they would take care of it, apologized profusely, and arranged to send more nurses out later this week to interview.

Well, yesterday I get a call from them telling me they would no longer be able to staff my case! We are foster parents. These children aren't mine legally, and I HAVE to have nursing coverage 60% of the week as part of my placement contract. I have 6 kids total. They are not going to allow a medically fragile child to stay in a home with limited nursing coverage! When I asked the nursing director for an explanation re: canceling our contract, she simply said because I overreacted with the nurse and it would be difficult to find nurses who are NEVER going to doze off on night shift. I advised her there had been other incidents, and it was NOT dozing off in the traditional sense. It was sleeping. She told me that being a nurse myself, I was already a harder case to staff because nurses don't want to work in homes with other nurses, and this was proof that I heldthe staff to a higher standard than most parents would. Whatever. I moved over to PSA full time, and some of the best nurses I've had are from there. I just wanted two agencies to try to keep my case fully staffed, which didn't work as planned, anyway.

OK, fellow nurses. Please help me improve. Did I overreact?

Specializes in Pediatrics.
OP, i know you mean well by trying to cover for or excuse the sleeping

my question to you, if something happens to the pt. while the nurse is sleeping and you know this is going on

aren't you (going to feel) responsible?

to everyone who thinks it's ok to nap, sleep, rest: are you going to be ok with the fact this happened on your shift

of course it's hard to stay awake, but i'd rather sit on a thumbtack than having to explain why i don't know when the

pt stopped breathing

Ultimately, because she was my foster daughter I was responsible for her safety whether we had nursing coverage or not, which is why when we caught her sleeping the initial time we became more vigilant with our spot checks the following nights. I do believe in first chances, and even second chances in some instances, and therefore I felt compelled to allow her to come back. As I've very honestly said, I've dozed off on night shift before. Not laid out, but I recall my eyes getting heavy, reminding myself I needed to walk and opening my eyes 6 minutes later and I knew I had dozed off. For SIX WHOLE MINUTES! Unacceptable!!!! It happened and I am not proud. I went into that shift well rested, I drank coffee before and during the first half, I had busy work, I was in a well-lit area, everything... and it happened. So, I can't, in good conscience, hold someone to a higher standard than I hold myself knowing I've made mistakes. I had a second chance. I re-evaluated how I worked at night to ensure that I never dozed off again. I learned from my mistake, and thank God, no one was ever harmed. I wanted to offer that same chance to her to become a better person, a more proficient nurse, and/or learn that nights does not really work for her. Meanwhile, we were hyper vigilant in the following nights to ensure our child's safety. Does that make sense? We misjudged her. Plain and simple, and I am thankful nothing bad happened. And yes, I would've felt responsible if something happened on her shift, but I would've felt responsible should anything had happened on anyone's shift.

Specializes in LTC, Memory loss, PDN.

it makes a lot of sense

i apologize if i sound or am too judgemental, but i know of a case where the night nurse fell

asleep and the patient expired

i have no way of knowing if the outcome would have been any different if the nurse had been awake

but i do know the nurse is no longer practicing

as far as i know (this is just hear say) no charges were filed by the family

Specializes in Med-Surg, LTC, Psych, Addictions..

Three strikes you're out!

You did the right thing.

Don't feel guilty.

I recently had to write up a CNA at the LTC facility where I work because I caught her sleeping.

I also do PDN--overnight--and because I am all-too-human, (and terrified of falling asleep) I get the extra large coffee at the drivethrough on my way in to work. I bring my ipad to play with during downtime and keep me alert. And if I feel my head nod, or my hands start to droop on the keyboard, I get up and go through a jumping-jacks and stretching routine (if the mom's watching me through the baby monitor, she probably thinks I'm completely nuts! But I haven't fallen asleep.

(if the mom's watching me through the baby monitor she probably thinks I'm completely nuts! But I haven't fallen asleep.[/quote']

That's hilarious!

I do get up and stretch when I feel sleep coming on. I'd probably wake the family up if I did jumping jacks! They are literally right around the corner with the door open (I am in the living room). And they have hard wood floors which would be a little noisy!

I was a private duty nurse for over 25 years. I made sure I got an adequate amount of sleep during the day so I could be awake and alert on the night shift. For the last 8 years we have had pdn's for my son who has a c/4 SCI. You had the right to fire any nurse caught sleeping while on duty. They are being paid to stay awake and monitor their patient so mom can sleep. Check with state boards, if you file a complaint they will investigate. I have found that many night nurses fill out their assessment including signing off on their meds before they have even entered the patients room. We had several who just made up vital signs and documented them on the nursing sheet. When reported the agency just sends them on another case, they only care about collecting the money , not the quality of care provided. Many of the nurses work several jobs and then take a night shift case expecting to sleep. I think the quality of care has gone to the dogs. Any agency that thinks it is acceptable for a nurse to sleep while on duty should also be reported. One agency actually said they fall asleep on night shift because they are bored. So not true ,they fall asleep because they are tired from not getting enough sleep during the day. Here's my question. An agency sends out the charge nurse to open a new home care case. The nurse while at the patient's home goes into the living room , gets up on the sofa and falls asleep. Two hours later the agency calls stating the charge nurse failed to show up on the next case she was to open , you reply, Oh she went in and fell asleep on the couch. Do you think she would still have a job at that agency ?? I think not ! And yes as a licensed nurse myself I do hold the nurse to a higher standard because I am aware of the danger that they are placing the patient they are being paid to care for in a bad situation. It's called neglect. We all went to nursing school and were given a code of ethics to follow. Get enough sleep, stay awake and alert, do not compromise your patient's care , you would be held liable if something happens.

I would love to have you as my son's nurse.

Sometimes you need a camera, you may not like what you see though. Meds being tossed into the trash and not flushed down the g tube. Suction machine turned on and the nurse just stands there a few minutes to make the parents think they are suctioning the patient. Rough treatment. Gzz

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Thanks for posting, pdnnurse. I value hearing this experience since usually we aren't able to meet and discuss as in most other specialties.

We've had a few nurses who also have kids in need of skilled nurses. You've got perspective on both!

It is also neglect.

The agency I work for tells us it is a reportable offence - they will report to BON and Child Protective Services. We are told this when hired, reminded during our yearly review/skill check off and reminded frequently with their monthly "newsletter" they send out to the families with all the flowsheets, MARS etc.

Sometimes you need a camera, you may not like what you see though. Meds being tossed into the trash and not flushed down the g tube. Suction machine turned on and the nurse just stands there a few minutes to make the parents think they are suctioning the patient. Rough treatment. Gzz

I have heard stories like this....I don't understand why someone would just go thru the motions of the required treatments.

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