How Many Times During the Night Do You Wake Your Patients?

[abundantjoy07]

Do you tend to wake them every few hours? Or do you just pop in and turn on the bathroom light just to take a peek at them?

Of course, there are some that wake up all the time, but the sleepers and the ones that really do need their rest make me wonder what's the most appropriate thing to do.

[psalm, RN]

Depends on what their diagnosis is and their condition. IVs get checked every 2 hours, and that includes looking at the IV site, not just checking the IV machine. Nothing like thinking the site is fine, then 2 hours later see an awake, wet patient!

Pts. getting blood or plasma will be monitored frequently per protocol. Dementia pts. same thing.

Meds come when they come. Some meds have been started in the ER and are continued every 24 hours. So the pt. may have an IVPB at any hour on night shift.

24 hour urines...check frequently. Even pts. who promise to use the call light after they "go" tend to forget or don't want the interruption of a nurse or aide coming to turn light on, and empty hat or urinal into the container in the ice...then we have to restart the 24 hour deal if the urinal has been there full for "a long time".

Blood sugars that are ordered every 2 hours, or every 4 hours, or sometimes every hour have to be checked by the schedule. The doc has a reason for it and should have explained it to you...

I tell my dear patients that I will come in as little as possible, but it depends on the meds ordered, the blood sugars ordered, the treatments and/or dressing changes, and/or their roommates being checked on or any of the above. I tell them they will get their meds, their labs and xrays, other tests may be STAT per doctor. They may not get much rest in the hospital, but I will be as quiet as possible on my IV rounds and will use a small flashlight to check site, etc.

It's a difficult balancing act and I wish the physicians AND the hospital would emphasize that the hospital is not the place to get rest, it is the place for tests, treatment, monitoring after treatment, and rehab that cannot be done at home or at a clinic. If we wanted to make it more restful, we would reconsider the visitor policies and the marketing of amenities that would be better utilized at a 5 star hotel.

[ScrubMan0416]

I work on a small 12 bed Inpatient Rehabilitation Unit and on admission the MD will write "Do not desturb patient between the hours of 2200-0630." Of course we have 'wiggle room' in that if the pt is a diabetic and is sweating, we can do a blood sugar, or if the pt is on a turn q2 schedule it is changed to turn q4 at noc, etc. But since we have a three hour tharapy per pt rule per day, we try and let them sleep as much as possible.

[nerdtonurse?, BSN, RN]

One thing I do is if the pt is admitted to the floor at 0300, for example, a lot of the q24 drugs will be scheduled -- guess when? 0300. I call pharmacy and asked, "Hey, can I get this rescheduled to a time when the pt might actually be awake?" Nothing like waking up a demented Alzheimer's pts who kicks, scratches and bites, just to give her a lovenox. That goes over really well.

[nerdtonurse?, BSN, RN]

One thing I do is if the pt is admitted to the floor at 0300, for example, a lot of the q24 drugs will be scheduled -- guess when? 0300. I call pharmacy and asked, "Hey, can I get this rescheduled to a time when the pt might actually be awake?" Nothing like waking up a demented Alzheimer's pts who kicks, scratches and bites, just to give her a lovenox. That goes over really well.

[locolorenzo22, BSN, RN]

I tend to only wake patients if I need to give meds, or turn, or check them for something. I usually wait until aides need to wake a patient up for vitals, then make a check. I do stick my head in to make sure they're breathing, and give pain meds if they need em....but I try hard not to wake anyone up.