to sleep or not to sleep???

[trmr]

do you wake your patients on night shift to assess them, or wait until they wake up? I work on a medsurg floor, and have mixed feelings. I would rather wake them all up, but some are long termers, who live here. What do you do?

[nightmare, RN]

I will not wake any of mine up unnecessarily because most of them are elderly confused and once they're awake they get up! I only wake them if the meds they are prescribed are important ie antibiotics,warfarin etc.not vitamins,laxatives etc.

[XB9S, BSN, MSN, EdD, RN, APN]

It would depend on the patient, if they were new post op or unwell then definately yes, if they are stable and have been in a few days then I would let them sleep unless there was something important that warrented disturbing sleep.

So in answer to your question, it would depend on the patient, how stable they were and what the intervention or assessment was

[MedSurgeNewbie]

I am a big beliver in sleep is healing, if the sitution calls for it yea I will wake people, fresh post ops ect. I do use a pen light so i dont have to turn up lights and try to keep the covers up I try to hit everyone as soon as I hit the floor so its kept to a min..

[Tweety, BSN, RN]

Good advice above. I worked nights and med-surg and woke up most of the patients to do their assessment, because they were getting midnight vital signs anyway.

Occasionally if I knew the patient well and I would pass them and let them sleep, as I know sleep is healing, and sooner or later they'd wake up and I could assess them then.

I've seen many night nurses get burned by letting their patients sleep with a bleeding wound, or an infiltrated IV, or the patient was unarousable, etc.

Sleep is healing, but they aren't there on vacation either. If they are sick enough to be in the hospital, more than likely they are sick enough for you to wake and check on them.

Rarely would a patient complain about being awaken. Most liked knowing there was someone who was looking after them.

[XB9S, BSN, MSN, EdD, RN, APN]

Tweety has made an excellent point above, having just been a patient I was grateful for the hourly checks through the night. I looked like I was resting comfortably but in fact more often than not was in pain or feeling nauseous. I had my eyes closed because I was still drowsy from the GA, being disturbed gave me the opportunity to say I'm hurting, I'm sick I need a pee. I was also reassured that I was being cared for and the nurses were always around which helped more than any of the medications they gave

[Ms Kylee]

I was always told to wake them up... they're in the hospital, they're on our schedule not theirs, etc. But I still hate to do it. Last one I had one complain that I woke him up. HATE when that happens.

[katie258]

Always wake them. If they need meds or obs, If they have an IV running I dial up for two hours then they wake up anyway and I'm the one who shuts it up, and while I'm here I might as well get a set of obs, do you need some pain relief etc.

[Nurse Salt]

I have had patients become very irritated at me for waking them up during the night. However, I work on a critical care floor so it is often necessary to wake patients frequently. What I have begun doing to avoid future irritation from my patients is to tell them during my initial assessment/vital signs that I will need to wake them, for example, every 2 hours to assess them. I will also let them know I will try to keep all other disturbances to a minimum (mostly by clumping my duties). If nothing else, I find this assures the patient you have their best interest at heart and are not just being inconsiderate by disturbing them every few hours.

[ChristyMNOP]

I work nights in a stepdown unit and we have to check on them at least every 4 hours. I usually do what pp does and tell them, I will be in here around this time to check on you, plus anytime I need to give you a med or you need anything. And then I usually joke that in the hospital we don't believe in sleep, I'm at work so they gotta be at work getting better too. Most patients understand. And when I do go in I usually just take vitals and do a quickie assessment, check any wounds or whatever and try to only turn on the door light so the big bright light isn't in their eyes. I usually ask if they are feeling ok, having pain etc. Takes 5 minutes. If I have a doubt or they are really bad I have no problem turning on every light if I need to though.

[anurseuk]

When I worked on an elderly ward I would do whatever I could to keep the patients asleep at night, and to stop the patients from disturbing each other. As someone else mentioned a lot of elderly patients get confused in hospital and once they are up they ARE UP!

Now working in critical care I try to get my pt's into a regular sleep patern so if they're not sedated I will intervene during the night as little as possible and 'try' to keep noise to a minumum. There are some interesting articles I've read recently in relation to sleep deprivation in ICU's actually, will post the links if I can find them on line and if you're interested.

It's quite difficult at times in ICU to have control of the situation or the other patients situations and disturbances are inevitable a lot of the time; as with other specialities really.

[Miss Ludie]

I believe sleep may be healing, but I agree with Sharrie. People in pain often lie very still with their eyes closed in order to not make the pain any worse. I only worked nights for a few years, but I did find that most patients aren't sleeping -merely resting.

Just adding this...I appreciated knowing the nurse was checking on me.