Rounding on patients at night - page 2

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... Read More

  1. 25
    Libitina, Tina, RN, Enthused RN, and 22 others like this.

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  2. 0
    Love it!!
  3. 2
    I check every 1-2 hours at night and don't wake the patient unless necessary. An example would be a Q2H or Q4H neuro check.
    KelRN215 and loriangel14 like this.
  4. 3
    At the beginning of the shift, I let the patient know I'm there until 730 and that although I'll physically peek in every hour, I don't wake him or her unless necessary. I'll give a little plan, "you have a heart monitor so I'll be needing to wake you around 4 AM for vital signs then at 6 AM for your Synthroid pill, otherwise I'll peek in but let me know if you need me if you don't see me. I'll make sure you have your call bell handy."

    When I round I check to make sure the bed alarm is on (if warranted), call bell and personal items are within reach and the patient is breathing evenly. If the patient is incontinent or a turn, I will obviously check him or her every two hours or more often.
    Soon2BNurse3, joanna73, and loriangel14 like this.
  5. 1
    I come in at 11 two nights a week so I often have to wake up my patients to introduce myself and do an assessment. I work on a surgical floor, so when I patient comes from PACU we do vitals q1 X4h. Otherwise q4 (midnight and 0400). For a post-op fresh off a PCA and on PO pain meds I ask them during my assessment if they want to be woken up for the pain meds.
    Fiona59 likes this.
  6. 1
    Quote from loriangel14
    Why would you wake a sleeping patient? We do rounds on my floor qh.I slip in, check for comfortable breathing and leave. If they are sleeping we assume they are not in pain. We would never wake a patient for a PRN med.

    If I was a patient I would be furious if my nurse woke me up to "see how I was doing". LOL I don't sleep well at the best of times and I would be up for the rest of the night once I was awake.
    Assuming that because they are asleep that they are not in pain would be an incorrect assumption to make in some cases. It is absolutely possible to sleep while in pain, even severe pain.
    proud nurse likes this.
  7. 0
    That's true.
  8. 5
    I haven't read every reply, but the headline of this thread,
    reminded me of something i used to do if i had a patient i did NOT have to wake up, yet, did want to see. If i did not round with the CNA, sometimes i'd do this.

    I would take a large styrofoam cup, place it upside down, and stab a pencil or plastic knife into the base of cup (which is now at the top)
    and tape a peice of paper to the top of the pencil, which read something like, "HELLO! Please ring your bell if you wake up and see this! From- Your Night Nurse who wants to see how you are!"
    or something along those lines.

    then, i'd place this on their nighttable, where they'd be sure to see it.
    Worked everytime, and usually, the patients chuckled hugely over this, really got a kick out of it.

    That way, i DID get to see them during the night, and the patient got to choose when. (be sure you have collected all these "call me" cups at end of your shift!)
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    Do not document that a patient is asleep. I honestly am not at all paranoid about lawyers and law suits. However that is a big no no.

    Can't you just hear a lawyer asking you, "how did you know he was asleep and not in a coma?"

    Document the patient lying supine on bed, eyes closed, respiration's even and unlabored, skin warm and dry. If vitals had been taken with that assessment chart VSS.

    I am not the best at documenting and charting, there are probably better ways to word it.
  10. 1
    Re: charting, i only charted what i observed. Depending on that facilities charting rules or format,
    i might chart "Eyes closed, Resp unlabored, skin pink, w&d, no s/s of distress" or, "turning self from back to side, eyes closed, resp unlabored, skin pink w&d" or "eyes closed, snoring loudly, skin pink W&d"

    sometimes i add in resp rate, too.

    I'd chart whatever i saw when i stood there, IF i did not 'have to' wake them up.
    joanna73 likes this.

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