What punishment should this nurse get?

Nurses General Nursing

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  1. Should THIS nurse be fired from her job

    • 24
      Yes, this nurse should be fired...no matter how excellent.
    • 372
      No, this nurse should NOT be fired, it happens...even to excellent nurses.

396 members have participated

Had an interesting situation that came up and thought I'd throw it out for discussion.

One of our staff RNs was found sitting in a chair and sleeping at the bedside of one of our ventilator patients at 7am. She tells me that the patient was very restless and they had been constantly watching him throughout the night shift because of the fear of him pulling his trach out. They found he would settle down when someone sat with him and held his hand (how basic can nursing care get?). So, periodically during the night different staff members sat at his bedside. The nurse in question says that at 5am she had caught up on all her charting and told her co-workers that she was going to sit down in the room with the patient. She sat down, took his hand and he immediately quieted down. She sat back and the next thing she knew someone was waking her and telling her it was 7am. She jumped up and worked on giving her 6am meds and ended up giving an oral report to the oncoming shift (we tape report).

A very serious decision has to be made here. This is a really excellent nurse and I'm afraid there will be no choice but to fire her and report her to the Board of Nursing. I understand that she did not intend to fall asleep and that she was helping the patient, but rules are rules, aren't they? How I wish this hadn't been reported. Our facility rules clearly state "no sleeping on the job". Our Human Resources Office and the Director of Nursing will make the final decision. What do you all think?

Specializes in ER/SURGICAL ICU/PACU/MEDICAL ICU.
She sat down, took his hand and he immediately quieted down. She sat back and the next thing she knew someone was waking her and telling her it was 7am. She jumped up and worked on giving her 6am meds and ended up giving an oral report to the oncoming shift (we tape report).

.....She could have always woken up and yelled at the nurse waking her, "What the heck are you doing!?! can't you see I was praying!"

Sleeping is not at all a volunteer behaviour, many people can fall with not responsability.

The best choice is this nurse not work in night shift; she can work other shifts; but I would first ask if this is just happened one time with that nurse?, if so, not problem, no body is perfect, she can work in the nights.

They just be glad she was there to calm the patient. i have been in this for 28 years and I'm tired of nitpicking from the uppers. Yes someone should have gotten her up before the time, BUT as tired as we get and overworked it should be treated as a minor problem.SHE did not do this on purpose and that is better then sleeping at the desk in full view and everyone, which happens quite often!!!!!!!!!!!!!!!!!!!!!!!!! Get over it!!!!!!!!!!!!!!!!!!

Had an interesting situation that came up and thought I'd throw it out for discussion.

I think at the very most she should be given a verbal warning only! She was doing her nursing duty by sitting with the pt so that he wouldn't pull his trach out. It's unforunate that she fell asleep ,but I bet she would have work up instantly if the pt let go of her hand to pull out his trach. Some pts get scared & confused when they have tubes in them that they don't understand, & are in unfamiliar environments. I think all the nurse who took turns giving one on one care for staying with this man during the night should be praised for being excellent nurses!:p

I'm a union steward and on the RN bargaining team. I have been trying for years to get language that allows nurses a secured and safe place to sleep on their breaks. LA County Mgt does not want to provide this. We, too, have a "no sleep" rule. However, there have been studies done that show naps of 20 minutes refreshes many people.

Rather than letting the axe fall, I would like to see Mgt look into why she fell asleep. 12 hour night shift? A hectic day before her shift? Feeling under the weather? An exhausting patient assignment? And how often does this nurse do this? Did the patient experience any adverse outcomes? And, as one of you pointed out, where were her coworkers?

We usually report to our charge nurse where we are and when we will return. Where was her supervisor?

If this is a California nurse, the BRN will look heavily on that patient's outcome. No adverse outcome, the nurse will most likely receive a warning only.

Specializes in Mostly Peds.

First of all...why are you being so hard on this nurse????

I have had vent patients before, and beleive me if something were to happen, she would have jumped up...quicker, more than likely, than if she had been down the hall. If she did not have a hx of doing falling asleep with patients, why are you being so hard on her????? We have too many nurses that don't do their jobs (those are the ones you need to be tough on).....and just are not good nurses...so like the bible says...let those without sin!!!! Need I say more???? Don't run off a good nurse, they are too valuable!!!!

Specializes in Mostly Peds.

Oh...one more thing...I am sure glad I don't work for holier than thou you the boss...who is sooooo eager to fire and throw to the board like live alligators!!!!! Shame on you!!!!!

This nurse would probably never make that mistake again. That is one good reason to keep her.

We need to take care of each other.

Absolutly true, I would almost bet my life that this nurse will never be in this situation again, usually the hard lessons imprint deepest in our memory.

It is a scary thought that any of us should ever be in such a dreadful circumstance that a mistake is made that is completely out of character in a flawless work history and reputation, but it happens.

She should, and probably will get a verbal reprimand unless there are other issues with her. You work nights long enough and it happens. I'm sure there are some people who have never know or have forgotten the difficulties of working the night shift and living a life. It's not an uncommon occurence for a nurse to run like mad and then when things wind down to be overcome in the wee hours of the morning. I've seen it happen to the best of nurses in the best of facilities. Yes it is an unfortunate thing but what is the difference in an adverse outcome occuring then or while she was on break,or with another patient? When a patient decides to pull the tube it often comes quick and frequently can happen with an awake nurse in the room. If she is the excellent nurse as described she'll be beating herself up about and a good manager will realize and account for that, if she's not a good nurse the manager will utilize the situation as grounds to start the dismissal process. In the end you can only be the best nurse you can be, good karma will reward you, even if moving from such a pissy, eat their young environment may not seem like a positive reward at the time

While rules are rules, there is always some kind of flexibility since there is no such thing as ABSOLUTE.

Before one considers the control measure( solution) ; I will not say punishment, it's too punitive, whoever is to lay it down has to consider several factors that led to the deficiency. Remember the mitigating as well as aggravating factors? One must ask the questions:

1. What is the REAL deficiency ( call it mistake if you will)?

2. What could be the CAUSE/s?

3. What are its EFFECTS?

4. What could be the probable SOLUTIONS/INTERVENTIONS?

5. Is there a progressive discipline system in placed on how to deal with

such situations (i.e. considering frequency of offense, performance

appraisal,etc) .

A good manager does not immediately fire a nurse for sleeping while on duty.She has to go back to the above mentioned querries. a PROACTIVE, not a REACTIVE perspective has to be utilized.A CORRECTIVE ACTION must be implemented but does not have to be ABSOLUTELY PUNITIVE.

Had an interesting situation that came up and thought I'd throw it out for discussion.

One of our staff RNs was found sitting in a chair and sleeping at the bedside of one of our ventilator patients at 7am. She tells me that the patient was very restless and they had been constantly watching him throughout the night shift because of the fear of him pulling his trach out. They found he would settle down when someone sat with him and held his hand (how basic can nursing care get?). So, periodically during the night different staff members sat at his bedside. The nurse in question says that at 5am she had caught up on all her charting and told her co-workers that she was going to sit down in the room with the patient. She sat down, took his hand and he immediately quieted down. She sat back and the next thing she knew someone was waking her and telling her it was 7am. She jumped up and worked on giving her 6am meds and ended up giving an oral report to the oncoming shift (we tape report).

A very serious decision has to be made here. This is a really excellent nurse and I'm afraid there will be no choice but to fire her and report her to the Board of Nursing. I understand that she did not intend to fall asleep and that she was helping the patient, but rules are rules, aren't they? How I wish this hadn't been reported. Our facility rules clearly state "no sleeping on the job". Our Human Resources Office and the Director of Nursing will make the final decision. What do you all think?

This is a very horrible event that a nurse sleeps during night shift surprisingly with venty patients

By law person shouldbe punished but i think that she has given a chance

not termination

:devil: :imbar ;) :idea:

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