Top 10 Reasons We Get Fired: Sleeping on duty

Sleeping on duty is number 3 in my series of 'Top ten reasons we get fired' Internet searches on this topic show it is a world wide problem, and not limited to the US. Research is showing that allowing Night shift workers to have naps on their breaks can help to prevent errors which occur. Yet we continue to be very intolerant of co-workers who nod off or sleep when at work. Nurses General Nursing Article

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Top 10 Reasons We Get Fired: Sleeping on duty

Sleeping while on duty is the number 3 in my top ten of reasons nurses get fired.

In 1910, we slept for an average of 9 hours; by 2002, the average dropped to 6.9 hours per night. Early studies indicate that those Individuals who work nights and rotating shifts rarely obtain optimal amounts of sleep; they may have 1-4 hours less sleep.

This could all add up to a sleep deprived night worker, which could cause a night nurse to nod off while on duty! Or even fall asleep while driving home.

Complications of sleep deprivation

Sleep deprivation can have serious consequences for both the nurse and their patient's safety.

Impaired decision-making, slower reflexes and motor skills, and heightened stress levels are all potential side effects of too little sleep.

Health issues such are diabetes and heart disease could be more prevalent, depression and mood alteration issues are well documented for night shift workers.

Patients could suffer serious consequences from sleep-deprived nurses for example medication errors, slower responses to critical incidents, and even death.

Consequences of sleeping while on duty

For some nurses no matter how much sleep they get during the day, they are unable to stop themselves from 'nodding off' during their night shift.

This causes many co-workers to feel angry and upset, they feel the need to report the napping co-worker to management. In some health care facilities even nodding off on your break time can be considered grounds for termination, the expectation is you should be alert and available to be called upon at any time.

Some will argue that nodding off on your unpaid break should be allowed, unfortunately this argument maybe something your management team will not tolerate.

Suspension, termination and being reported to the Board of Nursing, may occur if you sleep on duty. In some occasions where sleeping or nodding off have caused harm to patients, nurses may end up in court.

Tips to help you stay awake

Caffeine is probably the number one crutch night workers use to stay away. Coffee, diet coke and the 5-hour energy drinks: Be careful you don't become addicted to too much caffeine, try and use it moderately and sensibly.

Get up stretch, walk briskly around, sprint 100 yards if you can which will refresh you immediately.

Drink plenty of water.

Don't remain seated when you feel that overwhelming tiredness, find yourself physical work to do. Computer charting can increase the desire to close your eyes

Eat healthy food; reduce the carbs and high sugar food, which can make you feel sleepy. Try to have small frequent meals if possible rather than one large heavy meal.

Talk to your co-workers, have interesting lively debates.

Sit in an area which is brightly lit.

Try to get as much sleep in the day as possible, use black out curtains and eye masks to reduce the light in the room.

Turn off your phone during the day

If you struggle on night duty, you may need to find a day job.

Current research for night duty nurses

Newer studies support 20 min napping on your break could prevent some of these errors and revitalize the night nurse.

Hospitals around the world are starting supporting this research, although it may be years if ever before U.S. hospitals will set up sleep rooms for nurses!

"Several studies support positive outcomes for on-duty napping for health professionals," noted a 2011 study in Critical Care Nurse, the journal of the American Association of Critical-Care Nurses.

Further suggested Reading

Patient Safety and Quality: An Evidence-Based Handbook for Nurses.

Chapter 40. The Effects of Fatigue and Sleepiness on Nurse Performance and Patient Safety Ann E. Rogers

Sleep Rooms can Benefit Nurses on the Night Shift

RN with 26 years of experience many of those years spent in dialysis. I have worked in acute care, home, ICHD as a CN, FA, and currently a director.

61 Articles   4,777 Posts

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1fastRN

196 Posts

Specializes in Emergency Nursing.

Who has time to sleep at work!? I'm too busy to even think about taking a nap!

I do really wish there was a quiet area designated for nurses to nap during breaks though. I think by giving RNs 45 minutes to lay down and recharge would be great in terms of productivity and safety. I know I feel recharged after a 20 minute nap... 45 minutes would be a sweet spot to actually be able to fall asleep, shake off the grogginess and return to the floor. I don't see this happening.

With all the research showing the benefit of a quick nap I really wish hospitals would take this into consideration. After 10 hours I start to feel sluggish and I'm not functioning 100%. Maybe one day in a perfect world we'll be able to nap, have something to eat, and be able to empty our poor bladders!

Chisca, RN

745 Posts

Specializes in Dialysis.

California nurses are allowed to nap on their breaks although I don't know if this is by law or just a provision of contract negotiated by the California Nurses Association. Another reason to belong to a union. As a dialysis nurse we are frequently subjected to shifts lasting up to 18 hours and longer yet I have known coworkers who have been fired because they nodded off. Inform management that you feel unsafe to continue and it is refusal to accept assignment. Remind me again when slavery was outlawed?

Ruby Vee, BSN

47 Articles; 14,026 Posts

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

There's an enormous difference between "nodding off at work" and dragging two blankets, a pillow and a recliner into a dark corner and settling in for a nap. I don't know anyone who goes out of their way to "report" someone for nodding off at work, but the intentional napping is another story.

Specializes in Med/surg, Quality & Risk.

I used to take a blanket into the conference room and use it as a pillow and nap for my lunch on night shift. Falling asleep by accident wasn't really possible though - too much to do. The times that I would sit down and chart and feel like sleeping, I'd get up and get some ice water and do something else.

NurseDirtyBird

425 Posts

I caught an aide sleeping IN A PATIENT'S BED once. Who does that? Apparently, she'd been disappearing for hours at a time, and we finally found out where she was going. So many things wrong with it! Infection control, violating privacy, and it kind of seems like abuse.

Mully

3 Articles; 272 Posts

Specializes in SICU.

A lot of us take naps on our break and let me tell you, it is SO refreshing. I honestly feel so much better for the rest of my shift. People say, "I'd never wake up" if they took a nap, and I thought that at first too, until I tried it. I'm a big time nap proponent (on breaks only of course).

Specializes in NICU, ICU, PICU, Academia.

There is a HUGE difference between 'sleeping on duty' and taking a power nap during one's unpaid break time.

I recently completed a research study looking at institutional practices related to night workers, and in 50% of the facilities I surveyed, napping during unpaid break time is a firing offence. This make ZERO sense when one considers the overwhelming evidence of the benefits of short naps during overnight shift work.

I am happy to say that the hospital system I work for takes seriously the evidence I've presented and is taking steps to 'de-criminalize' this type of restorative napping.

Mully

3 Articles; 272 Posts

Specializes in SICU.
There is a HUGE difference between 'sleeping on duty' and taking a power nap during one's unpaid break time.

I recently completed a research study looking at institutional practices related to night workers, and in 50% of the facilities I surveyed, napping during unpaid break time is a firing offence. This make ZERO sense when one considers the overwhelming evidence of the benefits of short naps during overnight shift work.

I am happy to say that the hospital system I work for takes seriously the evidence I've presented and is taking steps to 'de-criminalize' this type of restorative napping.

I didn't know that there were any facilities with these types of policies! And guess what? I guarantee you that somewhere in that same hospital there is a doctor sleeping on his or her paid time (in house call time) and is expected to immediately wake up and start writing orders at a moment's notice. The hospital can't have it both ways. Either it's safe or it's not. This is just another example of nursing getting pawned around.

I agree completely. Somehow it's acceptable for physicians to sleep during their shift but not nurses. I have made a couple of med errors and a report came out in the unit a few months ago where over 80% of the medication errors were made in the last 3-4 hours of the shift.

I know that many, especially younger, nurses like the 12 hours shifts, but the bottom line it isn't safe to work that many hours, especially for night shift people.

I would come home from work, have to wait for my children to get up, take them to school, it would be 8:30 or 8:45 before I would get to bed and then I would have to get back up at 2:45 to go and pick them up and then it would be 3:30 before I got home, by the time you waited through school traffic. I would fix a quick dinner and then get myself ready..by the time I went to work I had no less than 6 hours of sleep and most days had more like 4.

That my friends..isn't safe by any stretch of the imagination.

ThePrincessBride, MSN, RN, NP

1 Article; 2,594 Posts

Specializes in Med-Surg, NICU.

One of the nurses I work with has been known to go into an empty patient room, turn on the tv and sit in a chair with the back facing the door, pretending to watch tv when in actuality, she is sleeping.

This is going to be an unpopular opinion, but I don't think napping should be allowed outside of an unpaid break (with someone covering your patient of course). You accepted the job knowing that you were going to have to work nights. It isn't "slavery" but a policy and safety concern.

Also, one can't compare doctors to nurses as doctors are usually on-call and work FAR longer than twelve hours oftentimes having to do twenty-four shifts.

rhondaa83

173 Posts

On my 12 hour work day, I do not get paid for 30 minutes, so you can bet I will take a refresher nap... It does the world of good.

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