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? 

[SmilingBluEyes]

Way back when I worked NOC I had patients turn on their call light and then apologize for interrupting my nap. I politely told them we do not nap on night shift. They were not being mean, they really thought we slept unless something was going on.

I agree w/taking it up the chain. It's really all you can and should do.

Personally, I found it harder and harder to stay awake nights so when a day shift opportunity opened up I took it. The older I got, the harder it got to stay awake. I was not a good day sleeper. I woke up at 1pm no matter what was going on, usually I had to pee even though I went before laying down. It just did not work for me.  And it's hard on a lot of us.  I drank a LOT of coffee on those shifts. And trying to be "normal" when not working, like attending sporting events for kids and socializing was killing me. Sleep was very much in short supply for me. I feel for the nurse who has to work nights.

NOC is for that rare person who loves being up at those hours, I have discovered. Too bad most positions available in hospitals seem to be for night shift, only.  It's ROUGH. Especially if you have kids to care for during the day, which I did.  I was always short on sleep and patience.

[TheMoonisMyLantern, LPN, RN]

I don't know of a single night shifter that hasn't struggled with drowsiness during a shift at some point. But to just blatantly throw caution to the wind and go hide and sleep... it really boggles my mind that a nurse can do that with a clean conscious.

[Gratefulbutnotstupid, ASN, LPN, RN]

She is scary. As the charge nurse on the shift are you expected to correct staff?  Such as sitting down with her and writing up what happened and how it was decided to deal with it by both of you and then signed and dated by you both.  The written word has much power.  If that does not work, an email to any superiors you spoke to gently reminding them of the situation and if they want you to do anything else.  Make sure the email is encrypted.  Sound helpful and as a team member.  Then let that part go.  If nothing happens, then stay on her to do her job.  Go in and get her as much as you have to and document everything. 

[Allgood2016, LPN, LVN]

If "higher ups" don't/won't do anything; contact your nursing board a d turn her in.

Ask to be kept anonymous.   Keep notes on when & where she is found sleeping; if possible keep copies of write ups; and, when you notified the "higher ups".

[Robmoo, ADN, BSN, RN]

What is you facility policy and why has your manager not taken action?  Our policy is coaching, verbal counseling, written counseling, final counseling and then dismissal.  This process is usually done at the manager level.

If your manager is refusing to take action then write him/her up yourself.  You need to protect yourself in this situation.  When something goes down if management can prove that you knew about the situation and did not follow the process, they will throw you under the bus.  Make sure that you write him/her up and document every instance of reporting the situation to your superiors.  If your manager refuses to take action then report each incident to the house supervisor accompanied by an official write up on your part.  

Unless this person if a buddy of your manager or you work at a union hospital I don't know why this person isn't gone already.  I've heard that it is difficult to get rid off bad nurses in unionized hospitals, but there still has to be a process.  To protect yourself and the patients, you have to follow the process.

[Lunah, MSN, RN]

I am flashing back to old slumber party tricks... putting her hand in warm water, or filling a palm with shaving cream and tickling her nose, or just writing "I love LSD" on her forehead. 

Seriously, this is AWFUL. And shocking that no one seems to be doing anything. I hope some of the suggested actions in this thread bear fruit. 

[marshahousen]

Wow, I have a private duty 12hr over night case that I take a nap on. The family is aware and they don’t say anything. I know it is grounds for immediate termination but now that I am told it is considered patient abandonment I will stop immediately. I really do see why they say nurses eat their young. You nurses are merciless on each other. When you know better you do better. 

[londonflo]

marshahousen said:

Supervisors, if they are smart instead of trying to play "gotcha" they should cover their nurses caseload so they can get a catnap on graveyard shifts. Yes, I do believe nurses eat their young, this too is a known fact. Instead of offering solutions to help your fellow nurses stay awake, there is an automatic negativity placed on napping on a long shift.

marshahousen said:

when I worked day shifts and I had the option to combine lunch and breaks, I jump at the opportunity to get a catnap in my car.

Okay, So before you go off to sleep,  you have given report to the nurse covering you. The patient codes..Who is available to wake you up in your car so that you can provide additional pertinent details (medications, reported symptoms)  prior to the code? 

marshahousen said:

Instead of offering solutions to help your fellow nurses stay awake, there is an automatic negativity placed on napping on a long shift. 

You betcha! I have worked nights and I NEVER saw anyone napping.

marshahousen said:

. Yes, I do believe nurses eat their young, this too is a known fact.

What do you want those older nurses working with you and "who eat their young" to do for you? Provide a pillow, warm beverage and tuck you in? Buy an airline ticket for a service like this. I .gotta say that with most RNs who work on the floor only being there for 9 months or less, there really is no evidence that currently 'nurses eat their young" 

 Nurses have a professional duty to arrive at work awake,  continue to stay awake and  be ready to handle the job the entire shift.. 

marshahousen said:

I think it wise to combine breaks and dinner time together to allow staff to have a catnap which has been proven to keep you alert and attentive mentally. Supervisors, if they are smart instead of trying to play "gotcha" they should cover their nurses caseload so they can get a catnap on graveyard shifts

You posted here with the belief that it is okay to nap during your shift and your supervisor should cover for you. When posters (including me) said that was unprofessional you jumped on us for 'eating our young'. We responded with what IS NORMAL. Have you been evaluated for sleep apnea or narcolepsy? Please do investigate this. It is not normal to need to take a nap during a day or night shift if you get adequate sleep. If your home life does not permit an adequate nights sleep, look at that.  Please practice self-care, you will find yourself, your homelife and your family in a better place. 

[JKL33]

8 hours ago, marshahousen said:

To aggravate you more, when I worked day shifts and I had the option to combine lunch and breaks, I jump at the opportunity to get a catnap in my car. You should try it, maybe it will help to not be so prickly and self righteous. 

The OP of this old thread specifically noted that the nurse is NOT just "napping" on break, but is sleeping for hours during the shift and not caring for the patients.

Tons of us have worked nights at one point in time or another. While managing life's other responsibilities. It is not easy, that is true. But it isn't particularly self-righteous to believe that the described behavior is a serious dereliction of duty. We should have compassion for each other, absolutely. However, this nurse's personal reasons, whatever they may be, for not performing ANY aspect of his/her duty for hours at a time, are of utterly zero significance to the patients whose care and monitoring is not happening.

You're probably not aggravating people the way you think you are; it's just that you're wrong. You're simply not even talking about the situation posed in the OP. You can nap in your car all you want while you're on break and someone else is being paid to care for the patients. But if one can't perform even a single aspect of the job for an extended length of time during the shift (outside of break time), the supervisor needs to be notified. That is a bare minimum ethical expectation. I'm sorry if you perceived some kind of NETY harm in the past but you're way off base here.

[Gratefulbutnotstupid, ASN, LPN, RN]

I worked nights for a few years.  It was the only way to get your foot in the door.  It was hard working nights!  I could never get into a rhythm of awake and sleep.  I’d fall asleep as soon as I got home.  Sleeping was not tolerated.  If you left your unit, you alerted another nurse and gave a brief report of what was going on to continue continuity of care.

As far as nurses eating the young nurses.  Some do it all the time.  They are just cutting their own throat because that nurse will not be new forever and some never forget the way they are treated.  I go with, we all started somewhere.

[mmc51264, BSN, MSN, RN]

How is this not grounds for immediate dismissal?? Once is a mistake, an ongoing issue is mismanagement by the facility. wow

[MelEpiRN]

What about the medical director of the ICU? They usually have enough pull to get management to listen to them.