Comatose patient can't close his eyes and has no curtain for sun protection

Published

One time the charge nurse asked me to turn this patient who was comatose and could not close his eyes.

He had no curtain and the sun was glaring in. I told her, "I did not turn him because the sun is in his eyes...."

She agreed with me.

Later on in another nursing home, I found a stroke patient who could not move and who was postitioned with

the sun burning her eyes out. One charge nurse had already asked us not to leave her like this and no one could remember.

Everyone who does patient care should try facing into the sun with your eyes shut when it's glaring in the window and see how many seconds you can stay there. This is memorable and instensely painful.

The last time I found a patient stuck this way I wrote a note to the DoN and alerted everyone to it.

I said I would call DHS if I found her this way again. From then on, they always turned her back to the sun.

Even with the curtain shut, it still can hurt their eyes.

Specializes in PACU, CARDIAC ICU, TRAUMA, SICU, LTC.

Lubricate the patient's eyes with an eye ointment such as Duratears and tape them shut. If the patient cannot close his eyes, he is unable to lubricate them through the blink reflex. When it comes to eyes, there is nothing more painful than a corneal abrasion. Think of a patient undergoing surgery and receiving general anesthesia; a GOOD anesthesiologist will lubricate the eyes and either tape them shut, or patch them. I worked in a PACU for a number of years; the major causative factor of post-op corneal abrasions was lack of attention to eye care in the anesthetized patient.

lubricate the eyes throughout the day and physically close the eyes and cover with the above suggestions( mask,tapeshut) but I would think that a bedsore on a comatose pt. that can only be turned on one side or back is a greater risk. Running to report the incident and not solve the over all problem is child-like.

Specializes in ER.

Turn him upside down in the bed during daylight hours.

I'm amazed someone had to post this to figure out a solution. Think about it for a minute, and fix the problem! Patient is probably still lying there thinking "I can't wait for sundown."

When I was doing private duty taking care of an ALS patient, we would never let the sun shine in his eyes. We had the bed placed out of direct sunlight. And if he were outside in his geri chair, we had sunglasses for him. I would only cover his eyes at night, but his lids would go down with asst, I would never put a cloth or cover over open eyes. We used drops qid.

Specializes in Gerontology.

Why are there no curtains on the window? There should be blinds or curtains for both privacy and sun protection.

Specializes in retired from healthcare.
I agree it's not comfortable. Can you not tape his eyes?

I guess I'm not familiar with this.

However, as far as just having someone close their eyes, everyone caring for helpless patients should try standing in front of a window when the sun is glaring in and shut your eyes and see how many seconds you can take it. This is torture and if you have ever tried it is memorable.

Specializes in retired from healthcare.
Why not get a sleep mask? Or fold a washcloth and place it over the pt's eyes? We still need to turn the patients!

Or maybe move the bed to a part of the room where the sun won't glare in.

I would turn the bed in the room so that the patient is not facing the window.

Specializes in retired from healthcare.
Tape an eye guard to each eye and cover the top of the eye guard with gauze. either that or get two styrofoam cups, cut them to size and tape them on.

just gettin' creative...

I'm wondering if having all these things on the patient is really comfortable for them. Speaking strictly for myself, I wouldn't be able to rest with tape or styrofoam cups on my eyes.

Specializes in retired from healthcare.
The patient still needs to be turned. Turning from back to side away from the window is okay, but they still need more rotation. Why not place a wash cloth dry or moist over the patients eyes to protect them. I honestly don't see why this patient can't be turned to look out the window.

If the eyes are kept moist and healthy through eye drops and frequent eye care it shouldn't be that huge of an issue. I hang outside in the sun all the time without special eye protection. I maybe able to blink my eyes to keep them moistened, but there are other options.

Threatening to call DHS for this is a bit over the top. What this patient needs is a good careplan that addresses a good turning schedule with eye protection.

It's true, they all need to be turned.

However, no one should ever be facing directly into the sun, which I have seen happen to these patients who can't move.

Several times, I have tried getting where my patients are and facing in their direction, looking into the sun, and had it drive me insane in a matter of seconds. One lady had wooden shudders on her windows whcih nobody had even bothered to shut for her.

Specializes in retired from healthcare.
very interesting. Which direction is the window facing? the sun cannot be glaring in all the time. What about timing the turning to allow for his back or side to face the window during the sunny part of the day?

This is what they should be doing.

However, the same thing that has happened with sun lamps where some patients have been burned can also happen here. The staff gets busy and they don't get time to turn them on schedule.

Specializes in retired from healthcare.
Could you possibly put sunglasses on him?

I don't think sunglasses would be enough. Speaking strictly for myself, I sometimes need a hat with a visor

because the sun drives me insane even with sunglasses on.

+ Join the Discussion