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.

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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?

I'm glad to see opinions have moderated toward the end of this thread. I couldn't believe the punitive attitudes I was reading at the beginning. Hopefully the CA BON will take a reasonable approach.

Our nursing board does not get involved in hospital policies. The board's actions are based on standards of care. All nurses involved with this case would be interviewed and the accused nurse would be given a chance to respond in writing. Her nursing background would be looked at, including any prior complaints to the board, prior facility discipline, and all employer evaluations. Aggravating and mitigating factors are considered (eg. nurse showed remorse and has taken steps to avoid this behavior in the future). Patient harm is considered.

In this case, it would not be unreasonable to give a long, hard look at the nurse who was assigned the patient. After all, it was his/her responsibility to monitor the patient. Did no one look in on the patient for 2 hours assuming someone was with him???

The purpose of board discipline is to be remedial, not punitive. My guess is that this would not rise to the level of discipline, or, at the very most, a reprimand. Unless the sleep was caused by impairment, it is hard to say this was a deliberate act. I feel the 7 day suspension by the hospital is harsh and I agree with those who say it is a systems issue. If we continue to punish, we will only perpetuate failure to report and cover-ups. That is much more dangerous.

I am very disappointed to see so many old-fashioned, conservative attitudes on this site. Nurses must be held to the highest standards but that doesn't mean they deserve the death penalty when they make a mistake!

If the guy busing tables at the coffee shop fell asleep I wouldn't care, I wouldn't even wake him up. If the guy at the all night gas station fell asleep I'd wake him up just long enough to get my gas. If the charter boat skipper taking me and a boat load of other passengers out to the fishing grounds fell asleep at the wheel in the middle of the night with no other person on watch and I discoverd him I'd wake him up and stay with him, keep him engaged in conversation to keep him awake,possibly get him some coffee. Now theres a situation that could put many lives in peril and it happens a-lot. There is alot of stigma that surrounds "falling asleep while on watch" fact beingthat she isn't pumping gas or busing tables for a profession and she better wake up and smell the coffee before she does something this neglectful again.

There is alot of stigma that surrounds "falling asleep while on watch"

Sounds more like W & his cronies... :beercuphe:barf01:

22_1_26v.gif Yes, who has worked night shift that has not dozed or slept, let us hear from you. Yes it is a serious matter, a fireable offence, reportable to the BON. Who of us have slipped when charting at night and the pen either made hen scratches or unintelligable words.

Was this an acute unit, sub acute or ICU. Where were the other staff members, respiratory for example if the patient was on a vent.

What was going on in this nurses personal life. What happened to us that we don't take care of us,{our fellow nurses}, so we can take care of our patients. Yes there is a science to nursing, but it is also an art. The art of caring for another using knowledge, science, technology, ingenuity, common sense, patience and mothering to care for people at some of the toughest and worse times of their lives.

Yes the punishment should fit the indescretion, but it will probably never be as bad as what this excellent nurse already feels. By the way, did anyone else sitting with this patient close their eyes and hit lala land for a few minutes.:)

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a verba; reprimand would be appropriate, but where was the rest of her colleagues when this happened? Don't you people check on each other? What kind of teamwork is this? she was performing one of the basic tenets of nursing care and you want to hang her? What ever happened to helping your coworkers?

I work at a magnet hospital and two years ago one of my co-workers was on her BREAK and found asleep. She was fired. I do not believe she was reported to the BON though. Our hospital policy specifically states that you cannot sleep at any time (lunch or breaks) during your hours of work.

Specializes in ER, Cardiology, and GYN long ago.

OK, guess I'll weigh in on this....

I've worked nights for almost 13 years and I've NEVER fallen asleep but I've had to get UP and get a java or walk around many, many times. I really don't know how I feel about this issue... I would be absolutely livid if I found my father or husband (both dear to my heart) attended? to by a sleeping nurse but on the other hand, I've worked long enough to know that sh...t happens.

I guess in summary, if I were a family member, I'd want something done to discipline the nurse BUT if I were the nurse, I'd want a break for being a human "BEAN" .

FYI- my facility has a "fire on the spot" policy for sleeping OTJ.

Not that this is an excuse for her... and since I am not a nurse yet....

She was sitting there holding a patients hand. Watching him. She wasn't running around administering injections, meds, or charting. She wasn't doing anything.

Had she been doing "work" those 2 hrs instead of watching the pt, she probably wouldn't have fell asleep.

Isn't there meds to calm the guy down? Or switch shifts of watching him every 30min so that other nurses can do their jobs and still keep him calm. If i was on that staff, that would have been a suggestion of mine.

Not that this is excusable, but look @ the circumstances as well, and take them into consideration.

I think she should get fired, because she did jeopardize the well-being of patients, whether it be the trach guy, or any of her other patients that may have needed her.

What if there had been an emergency down the hall and they needed her? The wouldn't have been able to find her, and if they did she may not get where she needs to be on time.

I think firing is a.o.k. just because of the liability issue that it would put on the hospital. Not reporting it to the board. She can still find a job in the future.

OR... Demote her and stick her on the desk.. :-p j/k

One mistake shouldn't be able to ruin her career forever.

-Mal

This is where nurses who have years of experience have insight into how this could happen, and why it's important to look at the big picture.

Of course they could have found the nurse...it was known where she was and what she was doing. It's not like she sneaked off somewhere to catch a couple "zzzs."

Some of these posts make me afraid, very afraid, of the new nurses about to start. Some of them seem very short on compassion and common sense.

This was a systems failure, start to finish. Unfortunately, one person is being made to bear the brunt of it, instead of the facility looking at all of the circumstances that lead to the incident. Because of their short-sightedness, it's bound to happen again.

We're humans, not automatons. There's been a lot of self-righteous posturing in some of these posts; may those people never find themselves in a position of needing mercy. (On second thought, that may be exactly what they need to come down a few pegs.)

Specializes in Med/Surg, Progressive Tele.

This is a good question, most nurses, want to make others look bad to make themselves look better. I see it happen all the time.

Tony:uhoh21:

I agree. What happened to taking care of our own? Sure she really messed up and I'm sure she knows she did, but to fire her over seems very extreme for a first time offense.

The nurse in the instance case did not intend to fall asleep on the job and I certainly think that she knew that she was not supposed to be sleeping.

Why should she be fired if she is otherwise an excellent nurse? From my perspective of 35 years in the healthcare field, there is no reason to suspend or fire this nurse unless there was serious harm done to a patient as a result of her inadvertent action.

All I think that should happen is that she be given a written warning so that she will know how serious this was and so that she will NEVER fall asleep again.

If the nurse is fired or suspended she will be reported to the state board of nursing and depending on the state she will undergo stress for months or even years before the matter is resolved.

Also, if she is smart she will hire a nurse attorney who is experienced in Board of Nursing matters to represent her and help her to protect her nursing license and that cost money.

Why be so punishing in your actions as to cause such a nurse to be reported to the board of nursing and discourage other potential nurses from continuing their pursuit of a nursing career.

Nursing really does eat its young and this type of behavior needs to stop and be replaced with affirming positive metoring so that nursing care will be increasingly better and nurses will have greater job satisfaction.

Excelent, "we ' re just humans", you look pretty nice :

This is where nurses who have years of experience have insight into how this could happen, and why it's important to look at the big picture.

Of course they could have found the nurse...it was known where she was and what she was doing. It's not like she sneaked off somewhere to catch a couple "zzzs."

Some of these posts make me afraid, very afraid, of the new nurses about to start. Some of them seem very short on compassion and common sense.

This was a systems failure, start to finish. Unfortunately, one person is being made to bear the brunt of it, instead of the facility looking at all of the circumstances that lead to the incident. Because of their short-sightedness, it's bound to happen again.

We're humans, not automatons. There's been a lot of self-righteous posturing in some of these posts; may those people never find themselves in a position of needing mercy. (On second thought, that may be exactly what they need to come down a few pegs.)

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