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 ICUs, Tele, etc..

Wow I check my email and behold so much from this particular thread. Getting back on the OP she didn't fully state if this was the patient of that particular nurse. She just said ''our'' and different staff members were sitting the whole night. Can you imagine if you were nice enough to help out because you did everything that you needed to do for your patients, then you help out another co worker by sitting then this happens? Anyways that was just IMHO. I think someone should make a poll about this to see who's really for or against.

Specializes in Cardiac.
WOW!!!! It amazes me how many perfect nurses we have here.

How many of you have had to sit with a patient on night shift, with the lights low.....I don't care who you are, you start to nod off. Been there done that...Humans are not nocturnal creatures, I have seen studies that show that 8 hours of sleep in the day are equal to about 4 of real sleep. I worked night shift for years and you always feel like a zombie. It isn't natural for us to be up then. I don't know one night nurse who hasn;t caught him/herself nodding off from time to time, especially on a quiet night. But when it hits the fan, they are right on top of things. Unless you have been in that kind of a situation, don't judge her. I am sure she feels terrible about it. No harm was done.

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. Missing meds, report, and God know's what else. Everybody tries to say that I am being judgemental, perfect, high and mighty, and of course, someone mentioned that people who aren't nurses don't know how to appropriately opine on this situation. Sorry. :uhoh3: Working nights in a hospital, whether it be as a tech or as a nurse doesn't make you any more or less special to share an opinion with somebody. If I were to fall asleep in clinicals, you bet I'd get kicked out. If I fell asleep at work (as a lowly tech), I'd get fired-on the spot. Why should a nurse who is entrusted to care for the life on someone get to sleep for 2 hours??? No way. This is ridiculous. YOU CAN'T SLEEP ON THE JOB! Never. If you take a break and sleep then, fine. But she was watching another pt and nobody was watching hers! As I said before, critical thinkink skills are not present when you are asleep. A nurse who makes a med error can be remediated. People who fall asleep at work....how do you prevent this from happening again? If she can't protect her pts then she shouldn't work there. This isn't a utopian vision-this is how it should be. AGAIN, I ask, how would you feel if the pt was your family member?? How would you react then? You would say, "That's OK, everybody makes mistakes". No you wouldn't. You would be furious. Why is it not OK when it's your family member, but OK when it's a stranger pt???? Where are the pt advocates?????

Specializes in Cardiac.

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?

.

So only RN's can have an opinion that is valid on this subject? That is silly. That is because the only people advocating for the pts here are a tech and a LPN. Nice-I like how people dont want to hang her out to dry, but if you're not a RN yet, then it's ok to discriminate. Sorry, like I said before, I worked nights for years. I never fell asleep. Never.

Looking over some of these responses it would appear that this subject has been completely blown up and out of control. This nurse made a mistake. She will now probably be suspended a few days, given a ear beating or both. This nurse may have a very good reason for being so exhausted. Would be nice to hear her side of the story. Who really knows what happened, but if we can believe how it transpired by the original post, no harm was done! She will probably be drinking coffee every two darn hours from now on to prevent this in the future. This was a "excellent nurse" with no history of being inadequate. I sometimes think the same people on here all the time is not good. Having 10,000 posts does not make you a expert. It really is the same old thing, nurses are very hard on each other. Just what if this nurse has been ill, or a family memeber ill, or financial problems or just is having a difficult time working against the clock. So what, she nodded off one time,now she has to be rung out to dry? Yes, it could have been my son or daughter on that vent, and if anything happened the alarms would sound and she would be there to check pt and vent in ONE SECOND! Lets just think a little outside the box first before we hang the girl! PS, I work steady daylight, but I would like to take this opportunity to THANK each and every one of you out there who work nights in any facility taking care of our sick...God Bless you, you are giving up alot to work that shift!

Specializes in OB.

Chiming in late here: To go back to the OP's question - If this is an otherwise exemplary nurse, I'd consider written counseling and a switch to day shift for some set period of time as appropriate action.

This was a serious infraction as I'm sure the nurse involved was aware. The other factor is that if this is not addressed and another staff member in the future is disciplined for sleeping, even with consequences to a pt. they would have reasonable grounds to claim discrimination and favoritism if this nurse were not sanctioned in some way.

. That is because the only people advocating for the pts here are a tech and a LPN.

That isn't true. I just don't think patients are served by firing a good nurse for one mistake that caused no harm and will likely never be repeated. I hope you can understand my feelings.

Specializes in Cardiac.
That isn't true. I just don't think patients are served by firing a good nurse for one mistake that caused no harm and will likely never be repeated. I hope you can understand my feelings.

That was in response to a PP who said something like "who are actually RN's and have experience". That's a ridiculous comment.

She will probably be drinking coffee every two darn hours from now on to prevent this in the future.

And then someone would probably start a thread about her subsequent frequent bathroom trips. ("Is this nurse just lazy or possibly a drug abuser?")

If she was just "sitting" for someone else's pt., then there was someone covering her pts. And I also wonder why she was left in the room for 2h with no one checking in on the pt.

Any error has the potential to be lethal, so really I guess it should be "one strike and you're out."

This is much different from a situation I had, where I found the aide sitting at the desk, feet propped up, head back, snoring. I crept up behind her, got the huge policy manual out, and let it drop on the floor...BANG!

It didn't even phase her; she seemed almost irritated that I'd woken her up.

And sure, people who aren't nurses yet can comment all they want, but having actual experience can provide perspective one can't possibly have without the hands-on element. Big difference between textbook world and real world.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
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.

In my job, no i've not made a mistake yet. I did not say that i never make mistakes in LIFE.:rolleyes: Come ON.

As for getting fired for my first mistake, hey if i broke the rules, and that's the consequence of it, so be it.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
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.

From post #64:

Just because i work in the OR now doesn't mean that i'm oblivious to what goes on on a med-surg floor, nor does it mean that i'm excluded from making any mistakes.

The "few posts ago" you were refering to is this:

So far, i have not, which certain does not mean that it WON'T. The opinion i am posting for this particular thread's subject, i would expect if i were the nurse in that situation.

I establish what i was replying on whether i'd made a mistake or not (the underlined portion) so do not put some other far-fetched spin on it, please.

Okay...have a question...you say she went in at 5am to sit with the patient, and at 7am somebody had to wake her up. Why do you all assume that she immediately fell asleep? Did anyone check on her and see her sleeping? She could have just nodded off at 6:59 for all we know. I am not saying it is right, but if we fire every nurse that makes a mistake, we would have no nurses.

I can't believe what I'm reading here,:angryfire I'm very glad I don't work with, or for the "1 strike your out crowd." I think she should be given a medal for sitting by the patient and holding his hand rather than tying his hands down like use to be done if a patient even went toward the tube. She took the time to comfort a patient - another nurses patient if I understood the orginal post correctly - admirable! As a excellent nurse she probably feels worse than you can ever imanige. I have make mistakes at work, and have been thankful that no harm came to my patients and the "hang em high crowd" wasn't working there. Sure she should be displined, but the nurse who's patient she was watching should share in that because she should have checked on her patient before 2 hours. BUT SHE SHOULD NOT BE FIRED. This should be handled in house with appropriate documations and then the matter should be over! If every nurse was fired for an action that harmed or could potinal harm a patient the nurse sortage would be outrageous.

Sure you can have an opinion about the situation, but until you actually work as a nurse and work nights, your opinion doesn't have a lot of weight behind it.

I have had the misfortune to work with another nurse that "never made a mistake" she was the scariest nurse I ever worked with. She made lots of mistakes just none she aknoledge. it was always someone elses fault. Not saying that that describes any of you, but I find it VERY hard to believe someone that states they have never made a mistake at work. I hope the karma gods didn't hear you!

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