Rounding on patients at night - page 3

by proud nurse 5,791 Views | 29 Comments

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


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    Although the CNA's make rounds, I make my own rounds hourly. This way I know for certain what condition my residents are in. And if someone is sleeping comfortably, I'm not waking them up to inquire about pain. Rest is the best medicine, and I administer pain meds at bedtime and when they ring, or when they're up to the toilet.
    loriangel14 and Fiona59 like this.
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    I had a patient who I thought was sleeping all night and doing great, until I went in around 0630 before shift change and he started yelling at me, telling me I didn't do my job and he was in pain all night. I checked on him multiple times and his eyes were closed. Maybe I missed the times he was awake and in pain? I learned my lesson from that one. If I had told him the plan for the night and stated when I will wake him and how I want him to sleep and please use the call light, we could have avoided the horrible yelling and things he said to me.

    It's better to wake them up and have them complain that they didn't sleep all night versus complain that you neglected them.

    Glad I don't work nights anymore!
    proud nurse likes this.
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    Quote from getmethisnownurse
    I had a patient who I thought was sleeping all night and doing great, until I went in around 0630 before shift change and he started yelling at me, telling me I didn't do my job and he was in pain all night. I checked on him multiple times and his eyes were closed. Maybe I missed the times he was awake and in pain? I learned my lesson from that one. If I had told him the plan for the night and stated when I will wake him and how I want him to sleep and please use the call light, we could have avoided the horrible yelling and things he said to me.

    It's better to wake them up and have them complain that they didn't sleep all night versus complain that you neglected them.

    Glad I don't work nights anymore!
    To avoid that I would usually ask my pts at the beginning of the night if they wanted me to wake them up when they were due for pain meds, or if they were sleeping to let them sleep. Did you ask the pt if he was in pain why he didn't use his call light? We are not mind readers and if he didn't tell you he was in pain and wanted meds there is no way for you to know. I've had pts pull stunts like this, yell up and down how they can't sleep, need meds, etc and when I pull the meds and go in there they are sound asleep. They wake up later mad they didn't get their meds, well you were asleep, not gonna wake you up to give you your sleep meds!
    loriangel14 likes this.
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    I worked nights for 15 yrs in a hospital. I got good at going in rooms and not waking up patients.
    I always said that I could see quite well in the dark and must be part bat!! ahem.... ok...so I am "batty", but that's beside the point! I did have to laugh when a confused pt complained that "people were looking at her all night" and "my family thinks i am crazy because i said that"!!!! I explained to pt and family, that she was telling the truth, that people were coming into check her off and on all night!!!!!
    loriangel14, nightnurse28, joanna73, and 2 others like this.
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    sleep is beneficial to healing. Don't wake me up to ask me about pain. I will let you know.
    loriangel14, Libitina, and joanna73 like this.
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    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?
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    Quote from Vespertinas
    Ha ha ha ha. That's awesome!
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    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.
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    Ty for the info. They are no longer doing v/s.
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    Quote from rdsxfnrn
    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!
    loriangel14 likes this.


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