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I've been working in home health care for a little over 3 months & I usually work during the day, but recently I thought I’d try night shifts. On my fourth night shift in a row (didn’t know this was a bad idea), I dosed off for 10 min, my client's wife came in the living room and saw me and was so upset. I apologized endlessly bc that’s all I could do. She said “this won’t happen again,” “I don’t pay you to sleep,” “I pay too much money for you to not be awake.”  She said she tried to yell my name to take her husband to the bathroom. I’m extremely worried I’m going to lose my job over this. It’s the first time something like this has ever happened. Thoughts?

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Well, you were honest and told her the truth. It’s most likely because you’re transitioning into a new schedule.

Also, you did apologize which was absolutely the correct response. I don’t know what else you could have done. Have you spoken to the agency that you work for to try to explain? Not sure if that would be helpful or not.

Do you think she will speak to the agency?

Do you want to continue working nursing nights or would you prefer to go back to days? Do you have other responsibilities during the day that you are not able to sleep? Trying to burn the candle at both ends which obviously won’t work for either you or your client.

I do understand your client being upset. I feel that you understand that as well or you wouldn’t be upset.

Tell us a little more. Did you feel like working at night would be an easier, less responsibility? You do still have to be available for when your client needs you so it’s imperative to sleep during the day.
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Not that I excuse the rude behavior, but I think in your situation, and those other caregivers are in, you're not dealing with professional bosses or managers who have experience in working with others and/or managing.   Tact is obviously not one of the wife's strong points.

I would act pre-emptively and raise the issue ASAP with your agency, so they're not caught off guard.     And ask them for any suggestions in adjusting to night-time work.   That shows that you're attempting to address the different needs of night work.

And have you considered an alternate of working in a facility with more staff to respond in the event one  person isn't available, and also where you're working with more experienced and hopefully professional supervisors?

I'm curious though, and just have a suspicion that this woman is not going to be easy to work for.    Is "yelling" her primary means of communication when she needs something?
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onlydaughter39 Dec 2019
I had 1st hand experience with a caregiver for my Dad that on numerous occassions would nod off on morning shifts. As a daughter, who has been thru years of aging parents & home care aides, you're already dealing with so much. When you hire someone to work in your family home, you just want them to do what they've been asked to do!! I get her being upset. Don't jump to the conclusion that she was "yelling" etc. It is EXTREMELY hard to find good caregivers that are the right fit. Maybe night shifts are not a good fit for YOU. Taking responsibility for your actions in someone's home is key & discussing with your agency. I think most people expect when you use an agency & pay top dollar, the helpers should already be well trained & know what their strengths & weaknesses are.
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Night shift is not for everyone. Two neighbors of mine are nurses who only work night shift because they are "night owls" and have never had an easy time waking up early. They say they don't really feel awake until noon. I've asked them how they manage to keep awake overnight and they will walk the floor, check in on their patients, drink tea, have a snack, read, chart on their patients, and basically do "busy work" to make the time pass.

I would offer this woman some help like folding laundry or organizing her pantry or tasks that are quiet but will keep you busy while you keep an ear out for her or her husband needing assistance.

Try not to worry because good CNAs are hard to find and, even if she does complain to your agency, an employee who owns their mistake and apologizes is becoming harder and harder to find.

Also remember that we are all human and we are humans taking care of other humans. Let she who is without sin cast the first stone. If she's unable to let go of this mistake, can you ask your agency for a new assignment?

Four shifts in a row sounds like a lot to me.
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It happened, you said you were sorry and you have learned. Let it go, it's over and it won't happen again. I do agree you may want to stay on day shifts, and I can imagine the fear you feel,, but you did your best. I work in a major hospital and imagine my surprise when we were told as long as you answer your calls and pagers.. you can take a nap! I am not making this up! Your client was not harmed.. so hopefully the wife will get over it. I do hear from my night shift co workers that is it better to be either day or night shift.. not to try to do both. Heck I have trouble doing 3 days shifts in a row, and I know many who take a short nap during the day.
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Tell your wife's client to find someone else or tell her to take care of her own. See how fast she will be nicer to you. If your intentions are good and you are doing your best you should feel no guilt or fear. I am sure you can find a job somewhere else. Not everyone is a caring caregiver. Care giving is probably one of the most difficult of all jobs. Your client's wife is definitely stressed and upset over her husband's condition and her situation. God Bless you and hope things works out for you. You are not the only one who has not been appreciated. Be strong and know that you are doing God's work.
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FloridaDD Dec 2019
If OP is from an agency, they will  just send her someone else.  If they won't, there are likely other agencies.  I suspect OP will not get fired, but just shifted to another client.
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Money may be an issue with her, and CNAs are not inexpensive . Maybe reconsider your available hours. If she wants you gone, she really doesn’t need a reason. I expect that the agency, however, will be much more reasonable.

I had one experience with a home health aid and she 1) treated me as an interloper and 2) listened only to my husband, who didn’t want to do ANYTHING but sit around and chew the fat with her. She was gone the next week. Apparently she didn’t know who makes the financial decisions at chez Dizzy.

I doubt very much that you will be fired by the agency for taking on more than you could physically manage. It’s not as if you tried to shirk your duties. You fell asleep. I’m sure people have done that before.
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As a former hospice provider who worked nights frequently, I understand how easy it is to fall asleep on the job. I'm not talking blankets and pillows but the kind of sleep where you nod off while you're sitting up.

Some families encouraged me to get some rest while my client was asleep and some jobs were "awake" jobs, where you're expected to stay awake.

I don't think you committed a cardinal sin but I understand where the wife was coming from. If she was yelling your name from her bedroom to take your client to the bathroom, this says two things: the wife is a caregiver for her husband and is even caregiving from her bedroom during the night. She's wound up like a top and is suffering burnout. Secondly, if this woman and/or your company gives you a second chance with this client, beware because she will be breathing down your neck and micromanaging the care of her husband.

If you do another night shift, my suggestion is you drink a large coffee and bring crossword puzzles or other brain-stimulating activities. Things to do in the wee hours when it feels like you're going to die of exhaustion.

You made a mistake and everyone makes mistakes. You've apologized, that's all you can do. And you can be assured that you're not the only caregiver who has ever fallen asleep on the job.

Hang in there, this will pass. Let us know how it all turns out.
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If you are not a "night owl", you would probably be better off sticking with a shift that fits you better.
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You are human and you overextended yourself.

I didn't pay for HomeHealthCare - but they didn't take my DH to the bathroom. I was responsible for his toilet needs.

Learn from this experience - but fatigue is fatigue and as I said, you are only human. You should get a 2nd chance. But it might be time to be moved to another patient, just for your own peace of mind. Speak with your supervisor. Don't wait for this woman to report you, talk to your supervisor on your own.
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I understand your situation. I changed my hospital work schedule to nights so I work than go take care of my mother and be available during the day to take her to appointments and take care of her needs. I could not do the night shift after months my enter clock never adjusted.
Maybe you should ask your work from a new patient and start fresh.
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First off, I’m not a CNA but daughter that moved in to care for my dad. We have caregivers come in during the day, while I work. Once I get home, the caregivers leave. I go to bed when he does. I bought a nurse’s bell that he pushes when he needs toileting at night and his step-to-bed has a light that turns on if he tries to get up. The light wakes me up most of the time, and the bell nearly all of the time. But sometimes...it doesn’t. Dad yells at me when I don’t hear him right away. “I rang the bell 10 times!!” I am much harder on myself than he could ever be. I thought about having a caregiver at night so that I could sleep. When I thought about it, I never imagined that she wouldn’t get some sleep as well. Of course, hers would be more like a nap, which is what you did. I’m not sure what the expectations are in your position, but don’t be too hard on yourself. Maybe, just maybe, she will feel better about it once she has time to think about it rationally. We have a caregiver that does her bills and laundry at my dad’s house. I have caught her doing this twice. At first I was frustrated, but I got over it because there are a lot of good things that she does for my dad (which is not the easiest patient). Best wishes!
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gdaughter Dec 2019
Well, I wouldn't mind someone tending to her own bills to be awake while at your dad's house on "down" time, but doing her laundry? Nope. That's really nervy! And if she thinks that is okay, what next? Helping herself to meals and food in the pantry? Jewelry? Money?
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My heart goes out to you. I know the wages are terrible and often aides are forced to survive by taking on two jobs/two shifts. It's also hard for a body/mind to physically adjust to a change like that. I used to have a paper route where we would pick our papers up at about 4 AM...it's very disruptive to the sleep cycle you're used to.
The flip side is your client is paying you and so one feels for what it is costing they should have reliable help, and you have clearly been hired to be up and alert to stand watch so your client can sleep, i.e. the spouse. She does not want to feel on edge and wants to get her sleep to probably be the caregiver during the day and well-rested to do it. Many on this site will suggest hiring so people can at least sleep through the night without concern.
Maybe you were coming down with something, maybe exhausted yourself...it's hard to stay up sometimes especially if you aren't doing something beyond just sitting there and how much can you do. It also sounds like you are, or at least were that night very sound asleep and did not hear anyone. So my idea of a baby monitor placed close to you wouldn't necessarily help.
So I can only hope that the client who hired you was otherwise pleased and will give you a 2nd chance, or you will find another job. All we can do is learn from our mistakes and go on. You just might not be a night shift kind of person.
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What shift did you work? Evening? Graveyard? All night (6pm to 6am)? Some shifts are easier than others for a given individual. Nights isn’t something you can just “do”. You gotta learn how and which shift. Takes a while. You need to start with people that understand. Especially your boss and spouse. 

I worked nights for years. Worked days and nights. Nights and days. 8 on and 8 off round the clock. Midnight to Noon was no sweat. 10pm to 10am - terrible. 

Can you sit so that leaning forward your head is on the patients bed while you nap? Lay your head on a counter and sleep standing up - it won’t last long but will freshen you up. A friend would light a ciggy butt and put it between his fingers. When it burned his fingers he woke up. Years ago when soldiers marched everywhere they’d sleep while marching. Unloading trailers at night I’d hoist a bag on one shoulder and grab a couple winks walking to the tailgate. There's lotsa tricks. Believe me you can train yourself to sleep 10 minutes. That nap is very important. Without it you might be completely rum dum and ineffective or -dead.
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I would not beat myself up over this as when You start working night shifts your Body clock is all out of kilter, and even though You might feel exhausted in the mornings when your shift finishes it is extremely difficult to sleep sound
for 7 or 8 hours in the day time as you are going against the grain of nature. If you are on medication consider getting back on day work only as meds work far better in the day time. It is advisable to speak to your Boss, or Supervisor to explain what happened and why before the complaint is made by the Customer. Request a transfer to a different Patient as this will get that Lady off Your back and you will get a fresh start.
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Thank you all for replying ! Update ! I did not get fires and my agency was extremely impressed with me that I owned up for my mistake and contacted them before my client did ! They gave me new assignments & I never went back to my former client ! Thank you all for being so supportive and kind !
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Llamalover47 Dec 2019
Cna171777: Thank you for your update! That's great news!💞💞
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Very happy for you! I could tell that you cared. Otherwise you would not have been so concerned and posted that you apologized. Big hugs!
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Glad you owned up to your mistake. I have worked many years on and off as a RN on night shift. I found it helps to stay busy - on my feet or actively engaged in an activity - and to drink something with caffeine when the z monster is chasing me. Keep some colas on hand as a quick pick me up if coffee it not available or not to your taste. You can do this! Good luck.
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