When you make rounds when coming on to the night shift...

[Jasel, BSN, RN]

So I'm an LPN at a LTC facility. I'm PRN but lately have really been enjoying working nights. I'm wondering what is your approach when making rounds when coming on to work your shift. I usually knock on the door, enter, and if the patients are asleep (which is most of them) make sure that they're breathing, their respirations are easy/regular and I look for signs of movement (I do all of these things for each patient). But some CNAs and nurses that I come to relieve who either make rounds with me or are making their own rounds walk from room to room talking loudly, waking patients up just because they're so loud, one CNA who was coming onto the shift with me literally shook every patient's leg waking them up to make sure they were still alive. To me it seemed like complete overkill and extremely inconsiderate. I understand no one wants to come onto the unit, make rounds, and take the keys only to realize one of the residents has been dead for 2 hours but to me some of what I've seen seems extremely unnecessary. I used to predominantly work the day and evening shift and am just wondering how other night nurses go about making their rounds.

[Elladora]

First - if anyone shook my leg to make sure I wasn't dead, they might wind up getting kicked in the face.

You are doing it exactly right (in my humble opinion). I do much the same as you. I enter the room quietly, I watch for movement and listen to their breathing. Then I just as quietly leave. I carry a small flashlight in case I need to see anything and I start the aim at the client's feet. (No one wants to get woke up by a light glaring in their eyes). The only time I turn on the overhead light is if I need a closer look. Client's have a right to a good night's sleep. Being loud and/or obnoxious is unprofessional.

[ddunnrn]

I agree with both posters so far. When I worked on an inpatient psych unit a while back, I would gently knock on the door, wait a second or so for a response, and then enter. If the room was especially dark, I would shine my flashlight on the ceiling so the reflected light would gently illuminate the room. Observe for breathing and movement. One thing that really annoyed me was when one of my managers decided we should take VS at midnight on a psych unit. If somebody woke me up 2 hours after I went to bed, and probably needed a Benadryl to get to sleep, I'd want to go berserk, too!

[loriangel14, RN]

I would be upset with anyone that went around waking people up.I know how hard it is to get everyone settled and asleep,going around waking them up is ridiculous.I do it like you do,check for regular breathing and make as little noise as possible.

[AngelicDarkness]

I do the same. I can usually see the resident in the light of the room, so I chose not to take a light with me. I often open the door quietly, but open enough to get light from the halls, and watch for movement/breathing/positioning. I step out and shut the door quietly. I remember some night nurses a few years ago getting in trouble for noise/turning lights on/flashing lights in peoples eyes - I'd be annoyed. Nothing comes between me and a good sleep unless there is an emergency:)

[BrandonLPN, LPN]

If it's the middle of the night, I don't even knock. I know there's probably some sort of policy regarding that, but many of my residents are really light sleepers. I've never, ever had anyone complain that I didn't knock. When I was a newbie, however, I got plenty of bi***ing when I *did* knock (however softly) at 2am.

[Fiona59]

I work acute care and it's sneak in/sneak out approach. The minute you wake them up they become needy.