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?
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.
Very good point! however there was mention of missed 6am meds. Like i previously posted, she if probable just sick about it.
You said it for me. I really can't understand why people are unwilling to look at the entire situation rather than just fire the nurse. If she has always been a reliable employee and no one was harmed by her mistake, I think it's incredibly harsh to fire her. It could be handled internally.
Wow, this is an amazing thread to read after a very long day including overtime and with a fried brain - but Fergus, I completely agree with you and madwife and others who say this is just too harsh, especially if the nurse has a good track record.
Falling asleep is very dangerous for the patient. But so is giving the wrong meds. Both of these are not done intentionally. I don't see how one is different from the other. Someone has mentioned, what if the family comes it and see a nurse sleeping next to their kin? Well, the family would be distraught. But I think less distraught than finding out that the nurse has given the wrong medication. Negligence is what the lawyers use to argue their case if damage is done. Giving wrong meds is negligence. Same difference. Lawyers, btw, only win the case based on damage, so that argument is unfounded.
I am really confused about why anyone would think this much worse that giving the wrong meds if indeed this is a good nurse and she inadvertently nodded off. The are some mention about concerns for the hospitals reputation. As far as I know, it's about the patient. No patient was harmed. To prevent anything like this from happening, some kind of punitive measures might probably scare this nurse silly for rest of her life. Therefore, to me, firing a excellent nurse who won't do it again is totally illogical - if not lacking in compassionate.
Wow, I can't believe the insanity I am reading. I especially can't believe the dis-equation of this offense with giving patient a wrong chemical to ingest!!
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.
In the quiet of the nursery at 3 a.m. while rocking a baby, I've been very very sleepy. It would have been easy to nod off - I didn't, but I can see how it could happen.
This nurse needs to be shown compassion, disciplined, and not fired or reported to her BON. For heaven's sake, there are worse med errors that we don't punish nurses for so that they can feel free to be truthful in reporting them - then we can see where the problem is and fix it.
Specializes in Case Mgmt; Mat/Child, Critical Care.
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.
I'm sorry but I notice that you are a nursing student.....ummm excuse me, but in no way, shape or form are you qualified as an RN to answer this question. Even if you are a tech, even working nights, in a million years there is no comparison. You just don't have the knowledge or training, yet, to make a decision about a situation you know nothing about. I am not looking to make this a nurse vs tech debate or anything like that. It's just a simple fact. Once you are an RN, and have worked long enough to "get it"....you may understand what I'm talking about. And if you don't and for any others looking to string this (exemplary) nurse up for this minor error, well, that's why, people, that we can't keep qualified people at the bedside. For those of you in nursing long enough, you know what I mean.....
Doctors close ranks around one of their own that makes a mistake, doing everything possible to shield aother doctor. We all have heard of many doctors practicing that have make horrendous mistakes time after time and this hospital transfers him out with no discipline and without telling the hospital of his track record. If when brought up before the AMA they are very slow to punish one of their own. I'm not saying this is good, In fact i think it stink when an obviously incompentent doctor is allowed to continue, but they do not go on witch hunts which lots of nurses do. That is one of the biggest differences between nurses and doctors.
You are a manager. The next time this nurse falls asleep and a pt has a sentinal event. How do you explain this to the big boss? How do you defend your actions? How will Goldberg & Osborn defend your actions? How will you feel knowing that if she does harm someone in the future that you could have prevented it?? Being a pt advocate means that you CAN'T SLEEP ON THE JOB! 2 hours!!! How long would she have slept had no one come and got her. And no one got hurt??? Who was monitoring her other pts? They all got no care. That is, again, completely unacceptable.
I am sorry but I do have to ask, are you a nurse or a nursing student?
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?????
Actually I would feel that I was glad the nurse was in the room whether she was asleep or awake. I have been in the horrible position of having my mother trached with ARDS not once, but twice, in the last year. Give me a sleeping nurse next to the bed over one who does not come in the room for hours on end! At least the nurse would be close when the vent alarmed!
Specializes in Case Mgmt; Mat/Child, Critical Care.
Okay I'm still steamed.
Doctors close ranks around one of their own that makes a mistake, doing everything possible to shield aother doctor. We all have heard of many doctors practicing that have make horrendous mistakes time after time and this hospital transfers him out with no discipline and without telling the hospital of his track record. If when brought up before the AMA they are very slow to punish one of their own. I'm not saying this is good, In fact i think it stink when an obviously incompentent doctor is allowed to continue, but they do not go on witch hunts which lots of nurses do. That is one of the biggest differences between nurses and doctors.
This is exactly where I'm coming from....do you think administrators are "punished" or MD's.....uh, no I don't think so. It's only in nursing that we see this mentality. No wonder we aren't taken seriously. :uhoh21:
menolly_33
47 Posts
As you can tell, I still make mistakes, like typing or spelling, sometimes both.:rotfl: