Overdoing VS!!

P_RN, ADN, RN · Jul 9, 2003

Unless post op or blood etc. q4 for 1st 48 h of admission then q 8. But no one stays over 48h it seems anymore.

Jenni · Jul 9, 2003

I thnk we offten overdo v/s. i work on a mdiecal unit. Often our patients have been there for months (placement probems). So I use common sense. I will not wake a stable patient to do v/s. Esecially if they are having problbems sleeping. . docs, in the hosptal I work at , don't order v/s. It's a nursing decision. And, my pc is soo messed up, im having trouble typing this.lol

allnurses Guide · Jul 9, 2003

Q4H here . . . and I start at 2:45 a.m. so my first assessment and VS are at 4 a.m. The truth is, if I have a stable patient who has been with us a few days, I won't wake them up. I always tell the docs in the morning and have never had a complaint.

So, on my shift we do vitals at 4 a.m., 8 a.m., 12 p.m. . . . . .

I always thought it was strange to wake people up at 4 a.m. and do vitals and then make them get OOB to stand on a scale.

Hospitals are not very conducive to sleep.

steph

TreceRN · Jul 9, 2003

I think the important component that gets missed in all of this is the patient. We tend to do things because it's our "practice" that it becomes a meaningless task. Our telemetry unit standard is q4 hours times 24 hours, then qshift and PRN. In an effort to improve efficiency and patient satisfaction, our night shift has started doing our vitals when the pt wakes up, either 'cause we have to wake them up for meds of lab draw, or 'cause they need to pee or whatever. We "gang up" on them and the nurse does her assessment, etc while the CNA gets vitals and maybe an AM weight (yes, two AM is still "AM"). Prior to this, the CNA's routine was to start at "room one" and get all the vitals, then the nurses would randomly show up to give meds, etc, with no concept of any team work. Sometimes pts would be woke up 4-5 times during the night. A lot of staff really struggled with this, because "this isn't the way we do things" and "if I wait until 1 AM instead of getting my vitals at 2400, that's five hours between vitals instead of four". We forget that in order to promote healing and wellness, people need to sleep! As long as the pt is stable, what's the harm of letting the pt get some rest?

ainz · Jul 9, 2003

These days, if they are "stable," they probably shouldn't be in the hospital. I think to satisfy the people paying the hospital bill, that is Medicare, Medicaid, insurance companies, etc., the UR nurses need good documentation to justify the patient's stay in the hospital. They often ask about VS and if they are only Qshift it is difficult to paint a picture of the patient's condition from the documentation. And really, if they are sick enough to be in the hospital they probably should have VS at least Q4h.

purplemania, BSN, RN · Jul 9, 2003

As a former pedi nurse I can tell you that, except for blood pressure, you can get VS without waking the patient. Even temps. Thanks to Emla cream I have done am labs without waking the child. We do VS in pedi q 4 hr unless ordered otherwise by MD, or per surgery protocol, etc.