Sleeping on the job

I am a new RN grad nurse in a residential psych facility. I've been there around 3 months and I really like my boss and the other nurses I work with! The problem is is that I often work with an older LPN who is physically in somewhat poor health. If possible she doesn't like to get up much and walk and will sometimes drive her car across the street to give meds. I usually volunteer to do a lot of things that involve walking or taking things to patients. The LPNs where I work give meds and the RNs are responsible for writing critical incident reports and we share everything else. Okay so on occasion I have felt like I had to step in such as when a pt sprained his knee and she wanted him to come the nurses station to get his pain meds because she wouldn't walk to his unit to give them to him - he had a sprained knee and I didn't feel like he should have to walk to us. So the other day she went across the street to get the meds for the younger residents. The meds are kept on the kids unit but during the day they are given in the main hospital because the kids are usually in the main building for lunch and school during the day. So she goes over at quarter to twelve-ish. Around 12:10 another unit comes to the clinic for meds, and she is not there. I tell them that she should be back any minute now and I run to the bathroom, get some stuff, etc. and come back to the station. I then recieve a radio call from the unit requesting meds - they've been waiting 20 minutes! So, I go across the street to see if I can help and I peek in the nurses station door and I swear she is sitting over there sleeping! Either that or she is very intently staring at the wall. I asked one of the counselors how long she had been there and he says 1/2 to 1 hour.

The thing is not that she was sleeping or that she had trouble moving around but one of the kids that didn't get meds on time was a diabetic. She's fallen asleep in the station with me before but I was there to wake her up and we weren't really doing anything - I was doing some new admits but she was pretty much just watching me do them. My boss has already complained to me about how this PRN nurse doesn't pull her fair share of the load and it's been told to me that I need to give more of the work to her. Thing is I don't mind because I like to keep busy and unless I'm sinking I don't ask for help. I really like this lady, as a person, not so much as a nurse, and I know she really needs this job. I feel conflicted about whether I should mention it to my boss or not. I don't want to tell on her and potentially get her fired but I feel like as a nurse she really shouldn't be sleeping on the job, esp. when it is affecting the patients. Can someone tell me if I am being irresponsible if I don't turn her in or if there is a way I could do anonymously? I know she is applying for another full time position but missed the interview because she couldn't make it due to personal problems. That is a red flag to me but I don't know about the interviewer or her take on it. I just don't want to be in this position.
Your license mandates that you report this nurse. If you don't report it her actions are on you.

Think of the diabetic patient without any access to his meds while the nurse is sleeping or staring at the wall. - Then report her. Call you BON to see if you have to give your name to report her.

You sound like a very nice and very caring nurse and person. While I can understand why you feel sad about reporting her you need to do it as patients are suffering. It's now a problem. Let your supervisor know.

Quote from Batman25You sound like a very nice and very caring nurse and person. While I can understand why you feel sad about reporting her you need to do it as patients are suffering. It's now a problem. Let your supervisor know.

think of it this way.............how guilty will you feel when she does some serious injury or doesn't do something and injures one of the patients?Give her a heads up and tell her the next time you fall asleep, I have no choice but to report you, or the next time you..........I have to advocate for our patients and I will have to report you.If she doesn't heed the warning too bad for her, but your patients and your license comes first.

If you feel badly about reporting her, then have a no holds barred talk with her and tell her it is her last chance with you before you do report her. Then you will have given her the benefit of one chance. Keep a log of incidents to use in any write-ups.

Where I work it's a pretty close-knit community, to say the least. I started working as an aide, and now am a nurse. At any given time, there's an aide who will not speak to me. I have made the decision to FIRST be a nurse, which means foremost being an advocate for the residents. I cannot believe the difficulty and stress involved with supervising. It's so much easier to overlook and get along with aides (or in your case LPNs). Please don't though, as it makes the job of nurses who DO require high standards that much more difficult. Good luck.

Op, I can sympathize with your not wanting to cause this nurse to be fired.. or should I say not called in again?... but if you want to help her you simply have to assert yourself! Some excuse may possibly be found for a nurse who nods off on night duty, especially if she's just come off days, but in the middle of the day, when critical meds have to be given? Sorry, but there is no excuse for that.You have two options open to you; either you report this nurse and thereby get rid of an unsatisfactory worker, or put on your big girl's shoes-which you are supposed to be wearing!-and rake her down! And tell her that either she pulls up her socks or you're taking her to the NSM!Frankly, I wouldn't have given her half the leeway which you have. I'd have spoken to her once, and once only. Second time she would have been out... no mercy. She is putting patients at severe risk, and if you blink at her faults, you are equally guilty.

I think you put your license at risk by not reporting her. RNs are mandatory reporters. When I was a CNA I had to report someone. I didn't like being in that position but I had to think of the patients. btw The person was able to figure out I was the one who made the report. - She was angry at me and later she tried to harass me but I had a responsibility to the patients to do the right thing.

Okay, I get it. I'll descretely talk to my boss. Thanks for clarifying my responsibilities. I won't feel so bad about it knowing it's an obligation and not so much of a choice.

Yes, the it can be a danger to some patients. You can't be there to cover for her all the time anyway. This is why sleeping on the job is an ethical issue. I have had caregivers who have fallen asleep in front of me, and the thing is, if that individual is doing it in my home, then I know she would do it in someone else's home also. This is why every one of them have been reported.

Patient safety comes first, NO MATTER WHAT.