Waking Up Patients?

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Hello!

I'm a nursing student from Ohio in his fourth semester of an ADN program getting ready to graduate this August, so reading some of the knowledge and advice on this forum has been extremely helpful :)

I had a quick question I've been wondering about for the past month or so. I have clinical starting at 6:45 in the morning, and we are required to take vital signs and do a head-to-toe physical assessment almost as soon as we go on the unit. The problem is, its very early in the morning, and we are on a palliative oncology unit, so these people really need their rest. I hate having to be that nurse that disturbs the patient so early in the morning, while many of them are still sleeping, even though I do my best to work efficiently so that they are able to rest for a little bit longer after I leave.

I know that sometimes you just have to do what you have to do as a nurse to assess the patient, because their immediate physical needs come first regardless of the time of day, but does anybody have any tips or ideas for going about this task in a way that is best for the patient? Thank you :)

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I would follow the plan for that patient on that unit, consult the patient's nurse. Hospital above school, always.

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I usually try to wake them up gently by softly calling name, or touching a foot, then I explain I'm sorry to have to bother you but I have to do vitals, I'll be as quick as I can while I'm in there I ask if theres anything they need or anything I can do for them

I personally have no problem waking patients up for vitals or pain meds, when I worked nights, although many nurses wouldn't, after switching to days and having many patients complain of 10/10 pain at 0700 because they werent given or offered pain meds at night because the nurse didn't want to bother them. If a patient is really really bothered by being woken up, I'll see if we can get an order to change the time of their vital signs. jmho

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Specializes in SICU, trauma, neuro.

On a *palliative* unit, I would never wake a pt up -- unless it is for a comfort care intervention, e.g. scheduled pain meds. Consult the bedside nurse about the care plan, and enlist her help if your instructor is insisting you MUST do assessment right away.

If *I* were your instructor I would give you points for your *patient* centered plan and critical thinking. (By critical thinking I mean the recognition that you WON'T practice the same way with a palliative pt as you would a fresh open heart pt. -- because your GOALS are not the same.)

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If any of the patients are already awake, I start with that person. The odds of having every patient asleep is slim; it is hard to get any rest in the hospital.

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Specializes in Critical Care.

It doesn't really matter if your program wants you to do vitals and head to toe assessment as part of each clinical rotation, if it's not part of the patient's plan of care to wake them for these assessments since they are palliative focused, then you don't do that, so before you do anything, come to a clear understanding with the patient's nurse about what we are and aren't doing with the patient.

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Specializes in Emergency, Telemetry, Transplant.

If I were a nurse on this type of unit, and a student went in and woke up "my" patient just so that he/she could "practice" assessment skills, I would have a talk with said student, as an educational conversation. I realize that the students are only doing what their instructor wants them to do, therefore I would also speak to the instructor. If the instructor is not receptive, I'm taking this one up the chain of command within my facility. I would be going to my manger and telling him/her that the instructor on the unit has the students waking up our palliative patients. If that goes nowhere, I am going above the manager. On this type of unit in particular, the pt getting rest (for strength, comfort, etc.) takes priority over anyone--student, staff, etc.--doing a head to toe.

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Thank you everyone for the replies! I'm glad that I'm not alone in thinking that the patients rest is a priority, especially on this type of unit. Unfortunately, I have gotten in trouble for trying to do things like go through the chart or look up meds first to give the patient more time to rest. I have been talking to the nurses for both of my patients first thing in the morning and asking them when the best time to assess the patient would be, that has been very helpful.

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Specializes in CMSRN.

During my clinicals, the night before clinicals the instructor/student would introduce

themselves and ask permission to do an assessment in the am. We would go over a plan and make sure

the patient was ok with it. Some were ok with first thing in the morning and others would set up a timeframe

with us so there were no surprises. It worked well.

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