What else can be done about a nurse sleeping on duty??

Specializes in Critical Care.
What else can be done about a nurse sleeping on duty??

I work as a charge nurse in an ICU. I am having a problem with a nurse sleeping while on duty. I'm not talking about sleeping while on her 30 minute, unpaid break but rather, sleeping for hours at a time, every single shift. She doesn't let anyone know, she just disappears into the computer room at the back of the unit or into the family conference room and sleeps. Her patient's end up being horribly neglected all night as a result and the other nurses on the unit end up picking up her slack by having to answer her call lights or silencing her pumps. Not too long ago, one of her patient's coded and, while I have no proof of this, I strongly suspect she was sleeping just before it happened. 

I have spoken directly to her about. I wake her up every time I find her sleeping. I have went to management about it. Nothing works. It seems like management couldn't care less about the situation and, since she keeps getting away with it, the behavior continues. I have no idea what to do about it now. I just feel like eventually a patient is going to be harmed and/or will die as a result of her sleeping. What would you do in this situation? 

74 Answers

Time to thwart her schemes.

Find out where she is sleeping. When her patient needs something or another nurse has done something for her patients, flip on the lights and inform her. "Hey Carla, your patient's pressure was low, so I titrated up her norepi", "Your patient wants something for pain". "Hey Carla, help me clean this patient." Be cool, cheerful and persistent. Be very persistent in holding her to her patient responsibilities.

Encourage the other nurse who are taking up the slack to do the same. If the family conference room is her sleeping site of choice, can the door lock? My ICU family conference room is always kept locked unless in use.

Specializes in Psych (25 years), Medical (15 years).

It sounds like you've done all you can prudently do in an endeavor to remedy the situation, Kastiara. And the situation may just call for desperate measures.

A couple of caregivers at local hospitals have been reprimanded and/or terminated for sleeping on the job when caught by coworkers who videoed the situation.

The sleeping culprits never knew who submitted the evidence.

Specializes in Critical Care; Cardiac; Professional Development.

Video it then go to your manager again. Explain the safety issue, your concerns about neglect etc. If nothing happens, go to the next step above them.

Specializes in New Critical care NP, Critical care, Med-surg, LTC.

Do you have an in-house supervisor that rounds on nights? Can you point them in the direction of the sleeping coworker to have them "find" them? You have obviously done almost all that you can yourself. Our family conference room has a camera, as others have mentioned, can you provide evidence to management? So sorry that you're dealing with this, certainly could be unsafe for patients and it's unfair to coworkers. Good luck. 

Specializes in Nurse Leader specializing in Labor & Delivery.

Does your hospital have an anonymous ethics hotline? If your immediate manager isn't doing anything about it, I would consider calling the hotline and reporting it. Or, send an email to the hospital CNO.

Specializes in school nurse.

It's amazing that management would want the responsibility/liability of enabling a sleeping nurse, especially on an ICU.

Is the nurse somehow connected?

I hope you kept a personal record of your attempts to get management involved.

My last employer, during new hire orientation, stated if we were caught sleeping on duty that not only would we be terminated. but that the employer would report us to the Board.  The DPCS stated that sleeping on duty is a form of patient abandonment. While I think that view is overkill, it surely is interesting to know up front what your employer will report you to the Board for.  Send an anonymous written complaint to the Board.  If the Board acts, and it should, that will get her attention.

I am not sure about videotaping her. I doubt that is in your job description as charge nurse. I heard a story of someone who did that and the person being videotaped said she was praying and sued for violation of privacy or something akin to that. America is a highly litigious society. Be cautious with some of the unthinking advice you might be given herein. You have reported it. Let the buck stop where it should appropriately stop. 

Always call the supervisor first; Don't wait till they round in the middle of the night. Let the supervisor be the person who discovers her. A nurse who can sleep through a code? That's grounds for immediate dismissal. 

On 12/16/2020 at 8:30 AM, Kastiara said:

I have spoken directly to her about. I wake her up every time I find her sleeping. I have went to management about it. Nothing works. It seems like management couldn't care less about the situation and, since she keeps getting away with it, the behavior continues. I have no idea what to do about it now. I just feel like eventually a patient is going to be harmed and/or will die as a result of her sleeping. What would you do in this situation? 

There are a lot of things you could do/try, but I suggest you make it someone else's problem, in real time, every time it happens. You need to take care of patients, not babysit this coworker.

Instead of going to find her when her patient needs something, call the house administrator and say that no one knows where she is and her patients are not being cared for. Keep it short, avoid extra words. If they make any suggestion for what you should do about it or if they balk in any way whatsoever, inform them that you need them to come to the unit and take care of the matter. Use your serious voice and be neutral but completely direct.

I would **NOT** video this person. I wouldn't do one single thing that anyone could easily turn around on me.

Write her up.  Keep writing her up.  Go to HR about it.  There had to be a paper trail in order for anything to be done.

Years ago I was a Hospital Supervisor, also a Med/Surg Manager at one time as well. What is happening here is your manager has determined its easier to keep the nurse than address and replace the nurse. Not only is the nurse not doing their job but your manager isn't doing theirs either. Sad but true. 

Your best bet is to let The House Supervisor know. Put a bug in their ear to what's happening. House Supervisors do not work for the manager of that unit. Most work directly or in the direct chain to the DON. 

This is also a matter of Safety. Patients are in the ICU for a reason. That reason is many times one on one direct care. 

You can also consider flat out saying you will not be The Charge Nurse until this is addressed and fixed.. 

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