Night shift and body mechanics

[weirdscience]

Night shifters...do you practice proper body mechanics? If so, how do you minimize disruptions to your sleeping/nauseated/hurting pts?

It feels like our rooms are set up like an obstacle course...IV pole plugged in around the corner at the bathroom outlet, with the actual pole at bedside and tubing stretching to the bed, and behind all that is the button to turn off the call light/bed alarm. I do the limbo multiple times a night to avoid tubing/cords. Not to mention hunching over pts to draw labs at 4 am. Everyone says "raise the bed" but I feel like a jerk doing so when most of them are getting the only 2-3 hours of decent sleep they can get in the hospital.

I need tips from those of you who've been doing this for years. I'm in my early 30's, been a med/surg nurse for 6 months, and I'm sore and achy!

[K+MgSO4, BSN]

When you start your shift clear the area around the bed for yourself.

Yes raise the bed you have only one back there will be thousands of patients. Most of your beds are electronic are they not? How is raising the whole bed going to disturb the patients any more than waking then to do bloods?

[HouTx, BSN, MSN, EdD]

Back in the day (yep, I'm old), we provided "PM Care" to all patients. My area of practice has always been critical care, so in addition to the usual comfort measures, we also cleared and tidied the area around the bed so we could safely negotiate after the lights were down. It was a standardized routine. We also applied reflective tape to floor level obstacles (at the suggestion of our risk management dept.) to minimize tripping - makes them easier to see with just a penlight for illumination.

We need to be pro-active to encourage patients' uninterrupted sleep as well as protect our own safety. Nurses are creative people, I am sure you and your colleagues can come up with a similar process to achieve both goals. Turning it into a PI process will garner support from the powers-that-be.

[weirdscience]

I do always rearrange the room during assessment time, before they're asleep. I think part of the problem is just poor design of our rooms. There's really no other place to plug in poles and it leaves the nurses with very little room to maneuver, especially if there's a cot with a family member in it on the other side of the bed.

Yeah, I can start raising the beds. I do think it disrupts them...they are electric, but still noisy and clunky to operate. I guess it's a necessary evil.

[~PedsRN~, BSN, RN]

The rooms really are designed like crap. Who decided the code buttons and call buttons and all that jazz should be behind the bed? Nothing like going in to turn off the call light at 3am, and trying to do some sort of cirque du soleil act around the IV pole, monitors, and the fifteen recliners people have shoved in there.

[nrsang97, BSN, RN]

I agree how is raising the bed any more disturbing to the pt sleep than going in for a lab draw. I do tons of them as rapid response. I turn on the light and raise the bed. Like the first response says there will be thousands of patients and you only have one back.

I would straighten up the room when I came on shift when I worked in the ICU 7p-7a and when I worked the floors as a med surg nurse.

[lyndy]

Yes, many nights I have experienced exactly what your concerned about... so much so that I brought up my concerns to the "safety committee" maintenance went through the rooms and bundled up cords and we worked together to create a safer environment.

[brownbook]

Worked nights 17 years. I really understand hating to disturb the patient's sleep. What is more healthful than a good nights sleep. However I finally realized I had to harden my heart. If the patient is sick enough to need to be in a hospital then they (unfortunately) need to be woken during the night for a variety of valid reasons.

Don't let "hate to disturb a sleeping patient" stop you from any night shift care, from head to toe assessments to IV's site checks to wound checks etc. Unfortunately you often have to turn on the lights to really check. Sure a flashlight can often do the trick, but if you are unsure or your gut says something just doesn't look/feel right turn on the light and do what you need to do.