Do you take vitals on babies who are sleeping? - page 3

by chariot 7,693 Views | 23 Comments

I'm a new nursing assistant in the float team. We get sent everywhere including the peds floor. I know we take vitals every 4 hours on patients in the adult floors. As for the pediatric floors like pediatric oncology, do we... Read More


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    This is really interesting to me because I haven't worked inpatient in a long time, but I worked at a large children's hospital, too. We took axillary temps on just about everyone, which took for-ev-er. Soft rectal probes as Jan mentioned are probably more accurate, and certainly safer. I feel sort of like an old codger, "what'll they think of next, paw?"
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    Quote from Jory

    This is called "consolidation of care". It is to NO BENEFIT to keep waking a sick or sleeping infant just because you didn't get there when the baby is awake. Most units have smaller assignments in peds, well-baby and the NICU, so it is VERY possible to work around the baby's schedule.
    I agree that ideally we wouldn't wake sleeping babies, but I disagree that it is very possible to work around the baby's schedule. I work with mostly patients who are less than 1 year old. I have 5 patients on most nights and the nursing assistants usually have around 12-15 patients each. Because I work with mostly babies, vital signs also includes a diaper change and sometimes a daily weight. We also always have some parents who do not stay overnight so there are babies who need to be fed. It would be impossible for the nursing assistants on my floor to accommodate 10-15 infants and their sleeping/eating schedules. Also, babies can look great one minute and go down hill really quickly the next. For this reason, vital signs are very important. Some parents will refuse a set of vitals or a blood pressure in the middle of the night. However, depending on how stable the child is, we may not allow them to refuse. Usually parents understand the importance of vital signs and will agree to middle-of-the-night vitals when explained the rationale.
    nursel56 and tryingtohaveitall like this.
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    I work on a neurosurgery floor so I do have to take their VS and neuro vitals if they're asleep. No, it's not nice to wake a sleeping baby, and I do try to work around their schedule (especially if they only have q6-8 vitals), but if they're hourly or even every 4 hours I only have so much time to play with.

    I let the family know the med and VS schedule at the beginning of the shift and encourage the family to let me know if the baby wakes up so I can cluster their care whenever possible.
    nursel56 likes this.
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    I'm sure you figured out a solution by now, however I wanted to tell you what I have always done for 5-6 years while all children are sleeping. If they don't already have their bp cuff, etc attached, I very quietly and slowly place it on their calf, lay the leg down, place the pulse ox on a toe very gently. If they start to stir, I immediately quit touching and drop to the floor so they don't see me! Then in a few minutes when they are still again I press start on nibp. It becomes like second nature to operate in stealth mode when you are a pediatric night nurse...it will come to you, I'm sure it has already!
    nursel56 and wooh like this.


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