Private Nurses for Patient At Night

[piggg]

We have a 85 year old patient with CHF and renal failure...patient is up all night long ringing her bell.....is it appropriate to ask the family to bring in a Private Nurse for help for the evening.

[caliotter3]

You can ask but don't expect the family to come up with one out of the blue since I doubt they can afford it.

[Orange Tree]

I doubt that would go over well. But why is she ringing all night? If she's confused or unable to sleep, maybe her doctor would consider prescribing something to help her relax/rest.

[Gluteus Maximus]

My NM would okay a sitter if required but not for an elderly lady who's biggest crime is ringing the bell.

You should look into getting a prn sedation order for her, if all her needs are met, but she keeps ringing d/t confusion.

When all else fails, we wheel their bed over by the nursing station for closer monitoring. It's not unusual to have 2-3 hallway patients overnight.

[piggg]

She is a diva however she is uncomfortable and wants to have her pillows adjusted and go to the washroom...probably because she is ill with extremely high creatine levels...

[Kooky Korky, BSN, RN]

She is a diva however she is uncomfortable and wants to have her pillows adjusted and go to the washroom...probably because she is ill with extremely high creatine levels...

Why do you say "diva"?

uncomfortable how? spinal arthritis that makes pillow adjustments necessary? cold? lonely? is she in renal failure and needing treatment?

Of course you can ask the family. It need not be a nurse, though. A sitter can fall asleep just as easily as a nurse - and for less money. Just kidding. By all means, try to get her a sitter. And get those discomfort issues treated. Need PT? heating pad? other comfort measures? maybe she has vaginitis and/or UTI.

[loriangel14, RN]

My floor puts patients like that in a geri chair and parks them near the nursing station where we can keep an eye on them ( plus it keeps them away from the bell).

[MunoRN, RN]

Why is she calling? If it's stuff like wanting to be repositioned, wanting ice chips, just lonely etc, ask the family if they can come in themselves, they don't need to hire a nurse for that.

[tyvin, BSN, RN]

I like the idea of putting them in geri-chairs and parking them by the nurses station but the bottom line is to figure out exactly why she is up all night and attempt to correct the concern.

Look into evaluation for one of the antidepressants that help with sleep that are taken at night. That way you aren't giving her sleeping pills (hypnotics) which should only be good for PRN or sedatives which could have hangover effects.

Perhaps a bundle pillow designed to have the patient sleep in a semi-upright position; there are ones that have sides for comfort (can't think of the name of them). Sounds like her pillows go flat and she gets uncomfortable.

[nursel56]

She is a diva however she is uncomfortable and wants to have her pillows adjusted and go to the washroom...probably because she is ill with extremely high creatine levels...

I don't think I'd call her a diva then! She probably actually feels like crap due to the changes in her medical status. A private duty nurse is expensive, but perhaps the family could share the cost of a sitter?