Ambien on second shift

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I work nights and a few of us have been discussing whether a change could be made so that Ambien isn't administered until midnight. Everyone is woken up between 11-12 for vitals and initial assessment, we don't have any 7-7 shift. If they got Ambien at 9-10, well, now they're not going back to sleep in many cases and they're mad. We can't administer after 3am, why not make it available only between midnight and 3? I understand they might want to go to sleep at 9pm, but while in the hospital, our priority is their health and initial assessments and vitals on night shift are necessary. Anyone have similar experiences or requirements for sleep medications?

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Specializes in Skilled nursing/LTC.

In my experience this is usually a no win situation. I work midnight shift in a rehab unit and have to wake residents up at midnight to give them scheduled sleeping medications. This usually angers the residents meaning sleeping pill or not, they are staying awake (and a lovely bonus, they are resistant to vitals being obtained). If the sleeping medication was PRN that could work but only if it wasn't requested before midnight (our PRN sleep meds just say as needed at HS). Some of my residents do take their PRN sleep meds between midnight and 1am and they sleep through the night. I guess it just depends on the mood of your patient/resident. Some you can talk to and reason with, some will curse at you for waking them up.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

True, there will always be some people that are upset, I know I like my sleep, too. (I always hated waking people up to give scheduled melatonin at my long term care facility.) I just feel like giving the Ambien, knowing that it's usually only effective for about four hours, and then waking them one to two hours later just doesn't make sense.

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This is where the lines of communication should be opened and often they're not. If a patient asks me for Ambien and it's 10p when I know at 11p vitals will be taken, I tell them they will be waken up anyway and usually they just say forget it or wait until after the vitals are done. And if there are any scheduled meds, I warn them also. Patients are usually better about being awoken if you warn them ahead of time that you will be disturbing their sleep.

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Specializes in ICU, LTACH, Internal Medicine.
I work midnight shift in a rehab unit and have to wake residents up at midnight to give them scheduled sleeping medications.

"Mr. Jones, please wake up - it is time to take your sleeping pill!"

OMG... PLEASE let me know it is not true. It is even worse than giving b-blockers to the patient on Levophed just because they are still "scheduled"!

:banghead::banghead::banghead:

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Specializes in Case manager, float pool, and more.
"Mr. Jones, please wake up - it is time to take your sleeping pill!"

OMG... PLEASE let me know it is not true. It is even worse than giving b-blockers to the patient on Levophed just because they are still "scheduled"!

:banghead::banghead::banghead:

Totally agree with KatieMI. I cannot rationalize waking patient to give a scheduled sleep med. Silliness.

For sure warning them with scheduled meds or vitals helps ensure better compliance and patient satisfaction as well.

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Specializes in Med-Surg/Neuro/Oncology floor nursing..
This is where the lines of communication should be opened and often they're not. If a patient asks me for Ambien and it's 10p when I know at 11p vitals will be taken, I tell them they will be waken up anyway and usually they just say forget it or wait until after the vitals are done. And if there are any scheduled meds, I warn them also. Patients are usually better about being awoken if you warn them ahead of time that you will be disturbing their sleep.

That's what I used to do when I worked the night shift. I work days now so unless I'm covering for someone sleeping pills are moot on my shift. But how I used to do it, If a patient requests a sleeping pill before vitals I just let them know when vitals will be taken and if they still want it I'll give it to them but most elected to wait until vitals are taken. Our docs are pretty good at scheduling sleeping pills PRN for the very reasons mentioned its quite ridiculous to wake a person up to give them an Ambien or remeron to help with sleep.

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...but in this case we're not talking about waking people up to give them scheduled sleeping pills, we're talking about the obligation to do an assessment after someone else has given them a sleeping pill...

Bring it to your "patient experience" people and discuss it from that angle, since that is priority number one.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.
...but in this case we're not talking about waking people up to give them scheduled sleeping pills, we're talking about the obligation to do an assessment after someone else has given them a sleeping pill...

Bring it to your "patient experience" people and discuss it from that angle, since that is priority number one.

Yes, rarely do people have scheduled sleeping meds on my med surg floor, they're prn only. I understand that second shift nurses don't want people annoyed because they're used to taking Ambien at 9pm and we're not giving it. Then we get people telling us not to wake them for vitals and assessment, and we can't do that for safety reasons, with a few exceptions.

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