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?
Sure it may have been wrong but in the state we are in for good nurses, this is a bit harsh. :angryfire I feel if anything she should get some counseling on her decision to sleep, it was an accident, but fired? PLEASE. I can admit I've done it years ago and wasn't caught but we've all done something that was wrong. Oh how people forget.... :uhoh21: !!!
nodding off is one thing,because when you nod off , its only for a few seconds but if you know you are excessively tired, which we all know when we are-why would you sit down in a dark, quiet room in a comfy chair, not doing anything to attempt to stay awake/
Shouldn't there have been someone advocating for the pt's safety and requesting some meds to calm him down? the potential to pull out his trach represents a risk to his safety, therefore it would qualify for chemical restraints.
Ya gotta love these spirited debates!! :) I have been up most of the night with a sick child, and fallen asleep after she did. I didn't mean for it to happen (she had pneumonia and was having a difficult time breathing) but I'm only human. My child could have stopped breathing and I wouldn't have known it. (I know she should have been hospitalized but we were at a military hospital and they didn't have a ped unit so they sent her home). I doubt anyone would have called me an unfit mother. I can stay up all night if I'm busy, but let me sit down for 1 minute and I'm gonna be out like a light. Sleeping on the job isn't permitted at work, but this was an accident. I seriously doubt the nurse went in there with the intention of falling asleep. I also wonder if this was another nurse's patient - wouldn't that nurse have come in at some point in the 2 hours to check on him? Someone earlier mentioned that the doctor should have ordered a sitter for this patient - What if the sitter had fallen asleep???? Would anyone be in uproar then?????
Just because the patient may have needed the meds doesn't mean that the DR ordered them. How many of you have had to wake up a DR in the middle of the night for this reason? We do not always get what we want or need. And often they turn us down after they chewed us out for a bit, because you just woke his/her baby when you called. Then we try something else, like sitting and holding the hand of the patient, if that is what works.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
To All,
I do not believe that as an isolated incident in a dark room at 0500 should result in termination. As anyone who has ever worked the night shift has fought sleep while charting, taping, talking or driving. I have fallen asleep at RR crossings as I just leaned back for a min.!! Only to be rudely awakened by a blowing horn and an Irate driver. We all need to watch out for each other as help us realize that we are not perfect. A stern warning as we call LEVEL ONE....which means 90 days, no OT,no occurences, no tranfers...then POOF all gone. I do not believe that over one time sleep that the BON would revoke anyone's liscense unless it was "The Final Straw" with some horrible out come. Have pity...Have mercy!! We all can become sleep deprived. Boston
I don't think anything would happen to this nurse in the hospital where I work. No one is perfect. She was trying to do the right thing. No one was hurt. She didn't intentionally break a rule. I would imagine she has told the nurse manager that she will never again sit quietly with a patient, knowing she may accidently fall asleep, I think her own reaction was punishment enough. I worked nights for 12 years and it wasn't easy. I used to have to walk laps to stay awake. Once I wasn't feeling well and I fell asleep while using the toilet. After about 30 minutes my co-workers came looking for me. We all had a good laugh. No harm was done. Once in 12 years, I considered myself lucky. No more nights for me. My hat is off to all of you who do nights!
Oh for goodness sake, no one said they are perfect. Talk about judgemental.
Good night.
I disagree, not only a few posts ago you said that you have never made a mistake, which I don't believe, but anyway...how would you feel if your manager came up to you after you have made your first mistake and told you that you were fired.
The lone RN on our rehab unit feel asleep once out of boredom. She was drug tested, written up but not fired. I think this person deserves a chance. I've worked nights and had a few moments where I had to get up and walk around or I was going to fall asleep.
Specializes in Case Mgmt; Mat/Child, Critical Care.
:angryfire OMG, I can not believe what I am reading! There are actually nurses out there that thinks this nurse needs to be reported to the BON and lose her job ???? You have got to be kidding me??? I would like to know which one of us is without mistake, without error? Which one of us goes into work every day and performs our mind-numbing, thankless, physically exhausting job day in and day out and never, not once has made a mistake???
Cause whoever you are, I wanna shake your hand! :rotfl:
You do realize, don't you, that any mistake or error, in our profession, can have the most serious of consequences??? Life threatening consequences?
I would like to know how many respondants of the "rope her up and hang her out to dry" mentality are actually RN's that have a few yrs of experience under their belts, and have worked night shift are there?
It's easy to sit and point fingers when you're not in the hot seat, again I invite those of us without transgression to step right up.....
Specializes in Case Mgmt; Mat/Child, Critical Care.
The lone RN on our rehab unit feel asleep once out of boredom. She was drug tested, written up but not fired. I think this person deserves a chance. I've worked nights and had a few moments where I had to get up and walk around or I was going to fall asleep.
Well, I think almost every nurse that has worked nights, at one point or another, has been indescribably fatigued, and has had the urge to sleep. It is amazing how many nurses I have witnessed, over the years, snoozing at the nurses station, chart in front of them. Or how many simply take their break to get a few minutes sleep. I even worked at a hospital that on nocs we gave each other "sleep breaks" instead of lunch breaks! And mgmt was totally on board! My point is, it is not natural to work nocs, some love it and choose to being the nocturnal creatures that they are, but for most of us, it is tough. Especially if you are not a noc person!
Specializes in Case Mgmt; Mat/Child, Critical Care.
Oh, and I have to add, I really don't like the tone of what kind of "punishment" does this nurse deserve....
I mean, are we children here, in nursery school? I think not. We are professionals...I believe it would be appropriate to say
"Should this nurse receive any disciplinary action, and if so what"....or something along those lines. Does administration "punish" MD's when they've messed up or do they "punish" each other when there's been some gross misconduct performed....I don't think so.
Nurses are not children...we need to start thinking, talking and acting like adults, and professional ones at that!
If a lawyer found evidence of repeated instances of any kind of unacceptable performance on the part of a nurse that went UNADDRESSED by the hospital, that would surely support a claim of negligence against both the nurse and the hospital.
But no one is suggesting that she should be allowed to continue working without some kind of counseling/remediation/discipline, just as occurs EVERY DAY with other errors in nursing performance. If we fired every nurse the first time s/he made an error that had the potential to jeopardize patient safety, no one would be left!
Why do we allow nurses to continue to practice following med errors, errors in transcribing orders, errors involving patient identification, etc, if we want to hang this person for a first offense despite a long history of providing excellent patient care? Wouldn't it be more prudent to provide counseling and place the employee on probation as we do with so many other situations involving unacceptable performance?
Talk about judgemental.
AMARTIN1
81 Posts
Sure it may have been wrong but in the state we are in for good nurses, this is a bit harsh. :angryfire I feel if anything she should get some counseling on her decision to sleep, it was an accident, but fired? PLEASE. I can admit I've done it years ago and wasn't caught but we've all done something that was wrong. Oh how people forget.... :uhoh21: !!!