Top 10 Reasons We Get Fired: Sleeping on duty

[madwife2002]

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

[kungpoopanda]

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.

Most reasonable people are not asking to nap outside of break times, but for workplaces to make napping on break a fireable offence is unduly harsh. It is similar to saying an employee can't eat or go to the bathroom on a break.

Certainly doctors and nurses can be compared when it comes to napping or even outright sleeping overnihgt. At many places I have worked, the night doctors would come to work for the night shift having worked all day and then had CHOSEN to cover the night shift at very high hourly rates. They would do a round to sort out immediate concerns then settle down in the doctors' room (in a bed) for the rest of the night, unless disturbed by the nursing staff. A lot of nurses woud feel bad about waking the docs, unitl I pointed out they were being paid $75 an hour to sleep as their second job.

[smartnurse1982]

i got fired while working a 12 hr shift in a psych facility in NC for nodding off. I had been working for 3 days straight.

I was writing some notes at the desk and i just blacked out for 1 minute( i checked the clock).

The owner had camera's everywhere except rooms,so i guess that is how he found out.

I was the only nurse there;everyone else were med aides.

[1fastRN]

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.

....an occupied patient's bed!? WITH a patient???

[Nurse acewa]

Very true.

[Ruby Vee, BSN]

Very true.

WHAT is very true? If we don't know what you're agreeing with, you cannot really be part of the conversation. Right next to the "reply" button is a "quote" button -- if you use it, we'll know who you're agreeing with.

[toomuchbaloney]

Years ago I managed a critical care unit.

If staff were tired I allowed them to "nap" on their lunch break. I began the practice when I worked a night shift with a very pregnant RN who was struggling with the "drowsies". That girl could put her head back and be asleep in less than 10 seconds. If you let her be she was completely rejuvenated in about 20 minutes.

I believed it was safer.

One of the house supervisors was really really irritated by this practice and tried over and over again to generate problems for me, for the shift supervisors following my leadership, and for the hourly nursing staff.

I had the support of the Medical Director and the CNO so she was blowing smoke up her own skirt.

[NurseDirtyBird]

....an occupied patient's bed!? WITH a patient???

It was an assisted living facility, so most of the residents had their own full size or larger beds in their rooms. This room belonged to a married couple, so they had a queen size in their room. She'd go in there, sit on the bed between the patients, apparently to "watch TV," and fall asleep. The worst part of this is, one of the couple had CHF and weeping edema of BLE. The aide was in bed with THAT. So gross!

[BSNbeauty, BSN, RN]

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.

Agree. However, I know people that have gone out of their way to report 'nodding' off , in fact one time I was fired from an overnight sitting job for literally closing my eyes for 30 seconds. The air was so dry in patients room and I happen to close them for some temporary relief. Well a nurse came in and sent me home on the spot. No blankets, recliner, pillows.... nothing.

Since then, If I had to close my eyes I'd just wait till I go on break.

[Jory, MSN, APRN, CNM]

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.

They may have 24 hours shifts, but they still get to sleep. At what point is it decided that they don't? At 10 hours? 12 hours? 14 hours?

Truck drivers...if you log more than 10 hours of driving without rest, they can ding your CDL license. In fact, 8 hours of rest is REQUIRED between long stretches. Why? Because it's dangerous.

However, it's considered safe for nurses.

I'm not sure what the employment outlook is where you work, but if you are not willing to put in 12 hours around here, you only have about a 10% chance of landing a job. The 12 hours shifts were also designed to force the older, nearing retirement workers, into early retirement, because they tend to make the most money. You used to see tons of older nurses working in hospitals...now, I rarely see one. That isn't by accident.

When you are young, you think you can work forever, it isn't until you are older that you realize that these shifts are grueling and I work with more than one older nurse that has had to cut back to part-time because their bodies simply cannot take the long shifts anymore.

We need to keep every experienced nurse we have WORKING.

[kalevra, BSN, RN]

Our director authorized us to sleep at night, so long as we were doing it in the break-room while clocked out for lunch and properly relieved by charge.

He said cause we werent on the company time, he didnt care what we did.

[Ruby Vee, BSN]

The 12 hours shifts were also designed to force the older, nearing retirement workers, into early retirement, because they tend to make the most money. You used to see tons of older nurses working in hospitals...now, I rarely see one. That isn't by accident.

When you are young, you think you can work forever, it isn't until you are older that you realize that these shifts are grueling and I work with more than one older nurse that has had to cut back to part-time because their bodies simply cannot take the long shifts anymore.

We need to keep every experienced nurse we have WORKING.

Experienced bedside working nurse here: 12 hour shifts are not just for the young. Us old'uns like it too.

[HikingEDRN, BSN, RN]

It was an assisted living facility, so most of the residents had their own full size or larger beds in their rooms. This room belonged to a married couple, so they had a queen size in their room. She'd go in there, sit on the bed between the patients, apparently to "watch TV," and fall asleep. The worst part of this is, one of the couple had CHF and weeping edema of BLE. The aide was in bed with THAT. So gross!

Oh gross! Why did she pick that bed???? JK, I know she shouldn't have picked anyone's bed

I have heard of hospitals in my area that allow and encourage naps on unpaid breaks. I currently work days. I have never napped on any of the night shifts I have worked but I have never worked nights long term. I would think a power nap on an unpaid break would be very beneficial as others have mentioned (and safer for patients).