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 Utilization Review/Case Management.
Sorry, You don't have to be a "perfect" nurse to know that falling asleep in incredible dangerous, inapproriate, and unprofessional. I worked nights for many years. I never fell asleep, never. That's not being "perfect", that's being professional. This wasn't a "nodding off" situation, she was asleep for 2 hours, and had to have someone else wake her up.
I have read most of these posts, and I need to ask this question: where were the other coworkers????? If I don't see one of my coworkers for over 30 minutes or so, I usually start a quick look around or ask someone else where they are. Maybe that's the "MP" in me from the past, but what if he/she slipped/tripped/passed out? (Or worse, with an unruly pt, was injured by same?) If someone had just popped their head around a corner when they walked by.....maybe we wouldn't even be having this discussion.
and OF COURSE the issue needs to be addressed, but I believe all staff should be included in a discussion for a solution. (contacting the BON/termination is a bit much for a first offense that had no bad outcome, but some type of private discipline/write up is probably in order, with possible expungement after a time period of "good behavior")
All in all, I believe that too many people focus on one incident and forget the "Whole Picture". So please get all the details before you act. (could this be considered critical thinking?)
BTW, med/surg night nurse here. I too have never fallen asleep on the job, but I bet if I had been in a darkened room with the rhythm of a ventilator, I would have had some droopy eyes for sure.
Specializes in Med-Surg, Geriatric, Behavioral Health.
Well, we have come a long way with this thread and discussion. It has gone back and forth. Members have respected, for the most part, other members opinions...which is good. I think we have come to a point now where we can start voting on it. I just attached a poll to this thread's issue. Let's vote on it and see how our discussion has shaped the vote...one way or the other. See you (your numbers) in the polls.
If this nurse is as good as you say then I would think giving a written warning alone will suffice. She will probably be devastated by a write up alone. I'm not sure when and why nurses are so readily willing to report another nurse to the State Board of Nursing. Yes, there are legitimate reasons to report some people, some of the time. But those reasons are far more important than because someone was human (maybe she had a bad day and had no sleep) or maybe she just got relaxed and her body said, "okay, it's bedtime." It should not be ignored but at the same time I would think reporting to the State of Board of Nursing is quite harsh. And remember, you too WILL make a mistake. Would you want to be reported for making a human error? I think we as nurses need to slow down and put a little more personal touch into our decision making regarding not only our patients but our peers. P in FL
If this nurse is as good as you say then I would think giving a written warning alone will suffice. She will probably be devastated by a write up alone. I'm not sure when and why nurses are so readily willing to report another nurse to the State Board of Nursing. Yes, there are legitimate reasons to report some people, some of the time. But those reasons are far more important than because someone was human (maybe she had a bad day and had no sleep) or maybe she just got relaxed and her body said, "okay, it's bedtime." It should not be ignored but at the same time I would think reporting to the State of Board of Nursing is quite harsh. And remember, you too WILL make a mistake. Would you want to be reported for making a human error? I think we as nurses need to slow down and put a little more personal touch into our decision making regarding not only our patients but our peers. P in FL
I agree. When things happen such as this, shouldn't they look out for one another? Not saying she shouldn't be repremanded(sp), but not fired. I've seen tired nurses work with my mom in the hospital and I knew they were tired, but they were there, and I appreciated it. Empathy goes a long way. :)
Specializes in private duty, nursing home, corrections.
Don't we nurses get enough punishment just by working as nurses. Where else can you work and get so little thanks, & respect?? Nurses are expected to be perfect little people, like machines. We embrace humanity in our patients, but tolerate NON within our ranks. 99 good deeds, and jobs well done are very quickly wiped out by 1 "you messed up". We need to extend compassion and humanity to our fellow nurses. So many are already leaving the field in droves.
Specializes in MedSurg/OrthoNeuro/Rehab/Consultant.
Don't we nurses get enough punishment just by working as nurses. Where else can you work and get so little thanks, & respect?? Nurses are expected to be perfect little people, like machines. We embrace humanity in our patients, but tolerate NON within our ranks. 99 good deeds, and jobs well done are very quickly wiped out by 1 "you messed up". We need to extend compassion and humanity to our fellow nurses. So many are already leaving the field in droves.
I agree. I think we need to look at the person's motives and general work habits. If this was a one time occurance and no real harm was done, I think a verbal warning is the first intervention to be taken. If the sleeping became a habitual thing, that's entirely different.
I don't think she should loose her license or be fired. First of alll, medication should have been ordered to calm the patient down. Secomd, she should be counseled and written up, and if it happens again, fired, as long as no one was harmed! If she finds that she cannot stay awake on night shift, mayabe she should think about working 1st or 2nd shift or going into another area of nursing such as home visits, where she could work during the daytime.
Based on the records of other disciplinary offences (e.g., drug diversion, patient harmed or dead due to negligence), I would say she should receive a warning from the facility, perhaps inhouse probation. Sounds like an isolated incident. If this is repeated, then perhaps a final warning and/or action by the Board. Some facilities make a clear distinction between staff deliberately taking a nap, and accidentally falling asleep over their work. She should have ensured that someone would check on her periodically - or the charge nurse should have - but apparently she had no expectation of falling asleep. (Yes, she should have considered that as a possibility.)
New to this website, but felt compelled to register and respond to this issue..... bottom line is, or should be, what is the hospital's policy regarding any infraction? Surely, there should be clear guidance per policies so the nurse manager can respond appropriately per hospital policy and, thus, this becomes a moot point. The employee would know up front what the consequence is for an action (or inaction), the employee's supervisor would know, and etc., etc., etc. Make sense?
Firing the nurse will be too much punishment, i think suspension will be enough for her. Come to think of it , she did not do it on purpose. I'm sure 99% this nurse will never do it again, you always learn to your mistakes.
trudlebug
92 Posts
I have read most of these posts, and I need to ask this question: where were the other coworkers????? If I don't see one of my coworkers for over 30 minutes or so, I usually start a quick look around or ask someone else where they are. Maybe that's the "MP" in me from the past, but what if he/she slipped/tripped/passed out? (Or worse, with an unruly pt, was injured by same?) If someone had just popped their head around a corner when they walked by.....maybe we wouldn't even be having this discussion.
and OF COURSE the issue needs to be addressed, but I believe all staff should be included in a discussion for a solution. (contacting the BON/termination is a bit much for a first offense that had no bad outcome, but some type of private discipline/write up is probably in order, with possible expungement after a time period of "good behavior")
All in all, I believe that too many people focus on one incident and forget the "Whole Picture". So please get all the details before you act. (could this be considered critical thinking?)
BTW, med/surg night nurse here. I too have never fallen asleep on the job, but I bet if I had been in a darkened room with the rhythm of a ventilator, I would have had some droopy eyes for sure.
I'll just go back to lurking now.....:behindpc: