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

[wannab06]

What if you take you break off the floor? Example inside your car and take a little nap?

[wannab06]

I say same thing. What ever I do on my break is my business. 30mins, 15mins and even 10mins of shut eyes can help a whole lot. Setting the alarm is key though. I forgot to do it while out in car one night and over slept.

[Palliative Care, DNP]

Unfortunately, I witnessed several RNs sleeping on night shift. One was brazen enough to go in empty rooms. Believe it or not, only write ups no firings.

[HeartRN13]

Precisely why I don't do nights. I can't do them lol

[mimi90]

great article! as a new grad--most of us expect to get night shifts starting out our career. getting a handle on those all-nighters is one of the biggest hurdles (or so i've heard)

[Esme12, ASN, BSN, RN]

What if you take you break off the floor? Example inside your car and take a little nap?

This depends on your facility and their requirements. Many facilities do not want you leaving the facility especially at night. As a supervisor I didn't mind if on their break nurses found a spot to close their eyes as long as we knew where they were and they could be awakened if needed.

I would HATE to have something happen, like a fire, and I couldn't find a staff member....or a staff member would be assaulted in their car at 3am in the parking lot.

[Ruby Vee, BSN]

What if you take you break off the floor? Example inside your car and take a little nap?

I've worked in a lot of hospitals, and not one had a parking lot I'd consider safe to nap in at 3AM, to say nothing of getting to and from the car on a 15 (or 30) minute break!

[Just_Kidney, ADN, BSN, RN]

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.

Wow, that's terrible! I think night nurses should have on-call rooms just like the docs do where they can power nap. It would probably reduce medical errors and insurance premiums would probably go down if nurses weren't so sleep deprived. But then again, most of the nurses I know barely have time to pee, let alone nap.

[outsidethebox]

I work nights on a surgical unit, and many of the patients' family members spend the night. Well, one spouse did not sleep (she worked night shift as a nurse), and noticed that the staff was not in the room in about 4 hours. She turned on the call light to request pain medication for her spouse. The staff answered by intercom and she was told the nurse would be in. About half an hour later, she walked to the nearest nurses' station. She found the lights off, and the nurse sitting there was bundled up with a blanket and pillow. She awakened this nurse to inquire where the nurse for her spouse was, and the nurse called the other nurse. As the phone rang, she heard the phone and walked toward it. The nurse walked out of an empty room with her eyes reddened and creases in her face (like she had been lying in one position). Luckily, her husband was not injured, and was fine. However, this family is more than a little upset about what she witnessed, first as a family member, second as a nurse. This is why we don't sleep on the job. Those who do should be fired immediately to prevent situations like this. If you cannot work sleep into your schedule, do not work night shift. This story shows how we look, but what if the patient had died, fell, or been harmed while the nurse slept? Isn't this the reason we have 24 hour staff in hospitals?

[Adele_Michal7, ASN, 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!

WHAT!!!!!!!!!

[Adele_Michal7, ASN, RN]

This doesn't have to do with sleeping but I have known of several co workers that have taken drugs. Both from dispensing machines and from patients. Really? Who does that?!?!?

Omg. I am shocked

[smf0903]

We had a student fall asleep in a patient's room during clinicals. Pulled up a chair and was snoozing away It wasn't even the clinical instructor who came upon the student, it was the nurse manager of the floor. That went over like the proverbial poop in the punchbowl...