HP Homecare talks with one of its specialist 24/7 care nurses, who for the past year, has been providing private nursing care at home for an elderly, post-operative cardiac patient in London, until he recently passed away. Registered Nurse – Bridget, shares her special memories of working with this inspirational patient…
So Bridget, could you please take us through a typical Night care shift with your client?
Handover/ Bed time routine
I routinely received a handover report from the day RN and greeted the patient for a quick chat before the shift started. He enjoyed reading, while taking his medication with supper. Then with the assistance of a carer, I would transfer him upstairs using a stair lift.
Following pressure area care, oral hygiene, routine checking for skin tears which, due to his medical condition, he was vulnerable to, personal hygiene and toileting, he would be assisted in mobilising using his Zimmer frame to his bedroom. He needed help to undress and had oxygen administered for a short period once in bed, whilst watching television.
The patient liked to have his night RN remain in his room for the shift, so this meant that I could easily anticipate his needs throughout.
We would have a chat about the day, remove his hearing aids and the oxygen cannulae and position him comfortably with legs and head elevated. He experienced peripheral oedema which meant that the skin on his legs and feet was highly prone to breakdown and he had medicated creams applied to protect his skin.
We found the perfect position of pillows for his comfort, to ensure his breathing was unhindered and to prevent pressure sores developing on his heels. He also had a saline nasal washout, as oxygen can dry the nasal passages. I applied a prescribed anti-inflammatory gel to his hands which sometimes ached due to arthritis. “Lights out” soon settled him to sleep.
9:00pm – 11:00pm
Handover/ Bed time routine
I routinely received a handover report from the day RN and greeted the patient for a quick chat before the shift started. He enjoyed reading, while taking his medication with supper. Then with the assistance of a carer, I would transfer him upstairs using a stair lift.
Following pressure area care, oral hygiene, routine checking for skin tears which, due to his medical condition, he was vulnerable to, personal hygiene and toileting, he would be assisted in mobilising using his Zimmer frame to his bedroom. He needed help to undress and had oxygen administered for a short period once in bed, whilst watching television.
The patient liked to have his night RN remain in his room for the shift, so this meant that I could easily anticipate his needs throughout.
We would have a chat about the day, remove his hearing aids and the oxygen cannulae and position him comfortably with legs and head elevated. He experienced peripheral oedema which meant that the skin on his legs and feet was highly prone to breakdown and he had medicated creams applied to protect his skin.
We found the perfect position of pillows for his comfort, to ensure his breathing was unhindered and to prevent pressure sores developing on his heels. He also had a saline nasal washout, as oxygen can dry the nasal passages. I applied a prescribed anti-inflammatory gel to his hands which sometimes ached due to arthritis. “Lights out” soon settled him to sleep.
Routine during the night
This patient often woke up hourly to pass urine so I would assist him with that and offer sips of water and minor position changes before settling again.
He also often had restless legs and muscle cramps so would be very grateful to have help relieving the pain with a gentle calf massage.
Hourly through out the night
Routine during the night
This patient often woke up hourly to pass urine so I would assist him with that and offer sips of water and minor position changes before settling again.
He also often had restless legs and muscle cramps so would be very grateful to have help relieving the pain with a gentle calf massage.
Morning routine/ Medication/ Personal Care
The patient liked to be awoken at this time every morning and would again have oxygen therapy for twenty minutes, followed by a saline washout before his carer arrived.
On rising, I gave him a nutritionally fortified drink prescribed by his GP and would assist his carer in transferring him to the bathroom for daily shower routine.
Regular personal care would follow, with refreshed dressings, morning inspection of his skin integrity and the application of body creams before dressing and going downstairs.
The patient had his morning medication with his breakfast and would sometimes need a little extra oxygen to stabilize his breathing and had routine eye drops administered.
6:45am – 7:30am
Morning routine/ Medication/ Personal Care
The patient liked to be awoken at this time every morning and would again have oxygen therapy for twenty minutes, followed by a saline washout before his carer arrived.
On rising, I gave him a nutritionally fortified drink prescribed by his GP and would assist his carer in transferring him to the bathroom for daily shower routine.
Regular personal care would follow, with refreshed dressings, morning inspection of his skin integrity and the application of body creams before dressing and going downstairs.
The patient had his morning medication with his breakfast and would sometimes need a little extra oxygen to stabilize his breathing and had routine eye drops administered.
Shift finishes / Handover to night RN
After making sure the patient received all of his medication and his breakfast I say goodbye to him and give the Day Nurse a handover.
7:30am – 8:00am
Shift finishes / Handover to night RN
After making sure the patient received all of his medication and his breakfast I say goodbye to him and give the Day Nurse a handover.
Interested on how a typical day shift of a HP Registered Nurse looks like?