Do you sedate your pts to make them sleep?

[rncopper]

Last noc, I had a patient (I have taken care of him a lot in the past couple of weeks) that makes noises - grunting, funny noises - when he is awake. When he is asleep, he doesn't make the noises. Trying to clear is throat? At one time he had an NG down, HUGE bugger! , and he accidently pulled it out (we were all so glad! ). He was getting TF down it.

Well they put down a Dobhoff. He still makes the noises, but not quite as bad. Today, he was going to get a peg.

My question is: A nurse I was working with (the patient was in a room for 4 patients; 3 of them, including him, were WACKO!) "jokingly" said that I should "knock him out" so he would stop making the noises!

Now, mind you, the pt is in NO distress, 75 yo, VS stable, just makes noises! She told me how she had given him Ativan a week or so ago, and he "slept all noc! Didn't make any noises! But, of course, they DC'd the Ativan, but he does have HALDOL!"

What she was suggesting was that I give him the Haldol to make him sleep: shut him up!

The patient is alert and oriented. I nervously laughed, DIDN'T give him the Haldol, kept checking on him and making him comfortable, he slept for a couple of hours, snoozed on and off also.

My question: Do you give Ativan/Haldol/pain meds just so the patient with sleep (read that: leave me alone all night!!! ) all night?

[barefootlady, ADN, RN]

I don't routinely sedate patients for making noise or :bothering me:. I do give med for rest if asked or I may suggest a sedative if patient is overly anxious or restless. I always make the patient aware med is available or can be obtained by calling MD if they feel that one is necessary. Chemical restraints are unlawful and can lead to discipline if used wrongly.

[rncopper]

laurakc:

He was having pain in his shoulder and back. I gave him Dilaudid twice and tylenol once.

I am not sure if I posted this already, but I do not EVER sedate a patient just so I will have a "quiet" night. I talked with "Art" during the night, repositioned him when he felt uncomfortable, gave the pain med when he asked/needed it.

I guess I firmly believe that sedating a patient that is not anxious or very sleep deprived is the right thing to do. "Art" was just having a bad night!

I, unfortunately, don't know how he is sleeping now, that the dobhoff should be out. He was moved to a different floor on my days off. Hopefully, with the removal, he was able to sleep much better!

[Lindz]

I have only been out of school for a year, but I remember very well my instructors telling us that medicating a pt for our convenience is considered a restraint which absolutely needs a md order. Of course if the pt is truly upset and restless and there is an order then by all means give the med or call if one is needed.

[CoffeeRTC, BSN, RN]

Just wanted to add...sometimes just a tylenol is enough for some of the elderly to get a good nights sleep. Works like a charm with most of mine with minor complaints of aches or pain and complaints of getting only a few hrs of sleep. A snack at hs is also good old fashion "medicine" for some.