Question

[dialysisnurseLC]

My pt has pancreatic ca and hospice is jn for pain and anxiety. Beginning of shift my pt was oriented... Slowed speech but oriented. He was in pain about 9pm so I medicated. ThHe went to bed at 10 and i have him ativan cuz he was restless and has not woken up since... I'm feeling like maybe I should wake him up to medicate... He hasn't moaned or anything in his sleep just snoring. -fairly new hospice nurse

[pfeliks]

What symptom would you be waking up a sleeping patient to treat?

[tyvin, BSN, RN]

If his pain is constant then I would probably consider it if the time to medicate again is near. It all depends on the situation. You don't want the pain to wake him up. Care plan this in the future. Discuss it with the team and the patient and consider his wishes on what to do in the situation.

As you know it takes more med to take the pain down then if it's being controlled. If he's not on an extended release then consider that as well if the pain is constant. It's always nice to have a sq or IM prn on the books too. Bless you.

What is jn?

[leslie :-D]

i would have absolutely no problem waking up a pt to give their pain med.

would much rather stay ahead of it then try to treat pain when it is full blown.

leslie

[tewdles, RN]

I would have no problem waking him for his maintenance dose of a long acting....

probably not for a prn but I would be watching for evidence of disturbed sleep which might indicate discomfort and awaken him for the prn then.

[dialysisnurseLC]

Thanks everyone.. Pt did not wake up at all and was reluctant to admit pain when he was awake. What do y'all do if u r working continuous care and pt is sleep and family is sleep and not actively dying?

[lovinlife11]

If the patient slept I would wonder why in the world he needed a continuous care nurse for? Sounds like he was stable, in the hospice realm anyway.

[tyvin, BSN, RN]

Thanks everyone.. Pt did not wake up at all and was reluctant to admit pain when he was awake. What do y'all do if u r working continuous care and pt is sleep and family is sleep and not actively dying?

Just sit there: many hospice patients who are like yours and ones who are actively passing sleep. I don't know if I would call it sleep. The body and mind know what's best and sometimes they sleep. Bring a book if they allow it, but keep an eye on the patient. I know your new and the news is they don't all do the wave and jump out of bed...everyone's different.

[NC29mom, ASN, LPN, RN]

I agree, continuous care doesn't sound appropriate. ..