“Strike two. You’re out!” I thought I would have to say to one of our favorite nurses whom I caught sleeping on duty. She had been with us for almost a half-dozen years. In baseball, you get three strikes. Sentries caught sleeping in wartime did not get a second snooze. Should a nurse found sleeping on duty get a second chance?
We have around-the-clock nursing for my wife, Tina Su Cooper, now quadriplegic and ventilator-dependent due to multiple sclerosis (MS). Almost hourly during the day and every few hours at night, Tina gets the scheduled feedings, medications, and treatments that have kept her alive far past the few months of life expectancy they gave her when she was released from the Critical Care Unit. It was home or the hospice after a one-hundred day battle with pneumonia and systemic infections during the spring of 2004. Our lightest nursing shift is the overnight shift, from 10 P.M. to 8 A.M., but it is the one that has cost several nurses their jobs here, as falling asleep on the shift is terminal. They used to shoot sentries who fell asleep on duty. We don’t shoot sleeping nurses, but we do fire them. They are our lifeguards, our sentries, as well as our skilled medical professionals.
“Drowsy” started her shift at 10 P.M. She gave Tina a change of disposable diaper, a local washing, along with a feeding and some medications. She took Tina’s vital signs. She entered the information into our records, “charting” them, in jargon of the profession. Tina was not ready to sleep, so the lights were turned down, some soothing music chosen, and Drowsy sat down in the soft chair by Tina’s bed. This is the chair that got one of my first overnight nurses fired, when I found her asleep in it, five years before. Two or three other overnight nurses were also fired for sleeping on duty. “Hard, but fair” might be my motto, especially for these situations.
That night I noted that Drowsy was in with Tina at 11:55 P.M., not the usual pattern. I looked in. Tina was awake, saying something to Drowsy, who had propped her own head on something comfortable and was asleep in the chair. I spoke Drowsy’s name loudly twice to no avail. I shook her by one of her legs, and she awoke abruptly, acknowledging that she had been asleep.
That night I lay awake contemplating the firing of Drowsy, balancing the importance of not having nurses fall asleep against possible unfairness to one of our best veterans, along with the inconvenience of replacing her.
My old rule on such infractions was “one strike [sleeping] and you’re out.” New York State allows either employer or employee to terminate employment “at will,” for any reason. For a somewhat different case of my having fired a nurse, however, an Administrative Law Judge in New York ruled that a written prior warning was needed and, usually, a second infraction, too, if I wanted to prevent a veteran, full-time employee from collecting unemployment benefits, part of which are paid by the employer. They can be fired, but it may cost you, if you do not follow these extra rules.
To make sure I had “documentation” in case I needed it, I told Drowsy the next morning that, reluctantly, I needed for her to write a letter acknowledging both the infraction and that the next one would cause termination. I gave her the alternative that I would write the letter, and she would sign it as “read and understood.” She preferred to write the letter herself, and I have kept it in her file. The letter was due from her at the start of her shift the next evening.
Drowsy wrote the letter, a detailed explanation of how it happened, chock full of mitigating elements, but ending with an admission she was asleep, an apology, and an acknowledgment that a second such incident would be grounds for dismissal. Fair enough.
Strike one. Two years have passed without strike two, to my relief and hers.