Night shift and assessment

43 minutes ago, MyAimIsTrue said:

When you start your shift at 11 pm and finish getting report at 11:30, do you then have to wake up your patient to do your head-to-toe? I mean, of course you do have to. But it feels so wrong to wake someone just so you can feel their pulses and look at their skin. Any tips for this?

I cluster care when I can. If they're up for medication, the bathroom, vital signs, etc. I try to jump in and do everything. Other than that, I just do what I have to do. They are there because they need nursing care/assessment.

I have seen a few cases where patients were left alone to sleep and experienced very bad outcomes, including death.

Right after report I always went to the patient's room to check my safety equipment and look at the monitor with their vitals, plus make sure they were actually breathing! I admit I tried to walk with some heavy feet and maybe "accidentally" bump the bed a little, then apologize for waking them up! And mention oh btw while I'm here I'll just get everything done so I can let you sleep, and do my temp, assessment, any meds I could give, ask about bathroom, pain, etc. I also took the opportunity to explain what had to be done that night, what time, and promise to try to disturb them as little as possible. I found people were more understanding than if I just woke them up a bunch of times without warning. 

As Sour Lemon mentioned, I also tried to cluster the care. When lab went in between 0400 and 0430 I would take my 4am vitals and check on the patient. Night shift was tough for me due to the sleep schedule, but I did find myself having interesting conversations with the patients at 3 am!

When I did acute care and would come in at 11pm I would wake folks up for assessments, however usually that was when VS were due or often they had midnight meds so I would have woken them up anyway.

I wad criticized a few times for waking people up to assess them by my co workers. I always figured if the patient declined the doctor wouldn't want to hear about how I didn't assess them because they were sleeping, just my opinion.