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?
First of all; why didn't anybody come looking for her sooner. That was 2 hours that she was in there, surely someone would have missed her before then.
Oh my god just listen to yourselves. I hope you all never make a mistake and are on trial for it. If like You say it was a one off and an accident then can we not just give her benefit of the doubt an put it down to experience. I am sure she is beating herself up about this and will probably be punishment enough.
What responsiblity will the hospital have if the next time she falls asleep harm comes to one of her pts? What if the next time, someone dies? The hospital would surely be at fault for letting someone like this continue to care for pts.
Oh my god just listen to yourselves. I hope you all never make a mistake and are on trial for it. If like You say it was a one off and an accident then can we not just give her benefit of the doubt an put it down to experience. I am sure she is beating herself up about this and will probably be punishment enough.
Is it punishment enough? What if the next time she fell asleep, it was while watching your critically ill child or spouse? What if you found out that she had done it before, and just because nothing happend to the pt the first time, they let it slide? I worked nights for years, and I never fell asleep. Mistakes are one thing, but sleeping is always unacceptable, not to mention incredibly unprofessional.
Oh my god just listen to yourselves. I hope you all never make a mistake and are on trial for it. If like You say it was a one off and an accident then can we not just give her benefit of the doubt an put it down to experience. I am sure she is beating herself up about this and will probably be punishment enough.
I'm listening (reading) loud and clear.
I would expect that if i'm charged with neglect, or any other "mistake", that i should get the appropriate punishment if proven that i did it.
IF my family member dies as a result of neglect, i will not see is as "an experience."
I have 17 years of experience I manage a ward and have responsibility for 25 members of staff and I have never known a patient to loose their life because a nurse nodded off. I agree that it is not acceptable for a nurse to fall asleep on duty correct me if I am wrong but if a ventilated patient arrested would the alarm not sound on the machine. If this was brought to me to deal with I would not recommend this nurse be disciplined unless there were other problems with her practice.
Yikes! Does that mean ANY error that could have been dangerous calls for a dismissal. Your reasoning could apply to almost any type error.:uhoh21:
It could, depending on the situation(s)! In this particular situation, my facility would see this as neglect (we've had it happen before), and i agree with it.
Let the one who has never made a mistake throw the first stone.
Gosh, there is making a mistake, and there is sleeping on the job!
If you are not able to stay awake during your shift, then you should not be working! Your responsibility is to be a safe practioner to your pts. If the night is too hard to work, then speak up to your boss and get traded to days. Gees, imagine being the agitated pt: Imagine looking over and seeing your nurse asleep!! And, BTW, this wasn't a little nap-this was a 2 hour nap! Someone had to wake her up! Totally and completely unacceptable...
boopchick
158 Posts
Excellent point.