Rounding on patients at night

[proud nurse]

I round on my patients every 2 hours. I go the opposite hours that the CNAs go, that way my patients are being checked on every hour. Some people might think it's overkill, but it's just the way I've always done it. I've always worked nocs, so mostly I'm just eyeballing them anyway. I can slip in and out like a cat.

Sometimes I will touch them lightly to check orientation or see if they need anything, check are they comfortable, eyeball a wound or dressing...etc. Plus, the last thing I want them to do is tell the next shift that the noc nurse didn't see about them all noc. And I definitely don't chart things I didn't do or assess. No matter what shift you work, when your patients are sleeping, do you just document they are sleep and comfortable? How do you rate their pain if you don't wake them to ask?

[tryingtohaveitall]

Ha ha ha ha. That's awesome!

[Meg,Rn]

If I have a pt that is non-verbal I use the FACES scale. Heart rate and BP can also be indicators of pain. Especially if they are more elevated than what is the PTs normal.

[rdsxfnrn]

Ty for the info. They are no longer doing v/s.

[joanna73, BSN, RN]

Curious as to what all of you would do in this situation IF the pt was pretty much non verbal, hospice and cmo. Would you let the patient go for 10 hrs without any (prn) pain and anti anxiety meds?

I work in geriatrics, so many of my patients become non-verbal when they are facing the last weeks of life. As with everything else in nursing, we use our judgment, and their treatment depends on their plan of care. Usually, those patients are receiving fluids and/or meds through IV, subcutaneous lines, or patches. And most people, even palliative, do not sleep for 10 solid hours. We round them as usual to check on their condition, and at some point will wake them to do mouth care and washing up. It's the needless awakenings that most people don't want. You should be able to slip in and out quietly. And, as some others mentioned, if I was the patient and you woke me up to ask about pain, I will not be pleased!