Stroke patients- enough overnight care?

[Jellyb39]

I'm finding myself really worried about a family member in hospital following a stroke. They are very snotty and have been coughing up bile, sneezed and had snot down their mouth. I cleaned them up but what about when this happens overnight, I don't think they are capable if using their call button! Getting themselves into uncomfortable positions too. In a side room by themselves due an infection so there isn't even anyone who can raise an alarm for them if needed.* *Any words of wisdom? I don't want to be THAT person.

It’s fine and necessary to be that person

Don't the night nurses round the patients?

You need to be that person. My experience of care in hospital is that there isn't much care going on at all.

Be that person. I was for mil and the staff hated me but it was for her. She got much better care after.

So what do I tell them? I want him checking every 20 mins to half hour? I don't wanna piss them off and them not bother! Keep calling up?

Raise it as a concern - can go for the angle of you’ve been doing it through the day so they may not be aware.

Visiting time over soon I'm tempted to sit and see how long it takes someone to come in...meds we're due an hour ago and noone has been to give them

Don't expext 3 calls an hour during the night.
It's not intensive care unit.

So what is reasonable given they could be choking in an awkward position?!

Ask how often they check overnight and take it from there. Is the nightshift on duty yet?

Proper positioning in bed is crucial and regular supervision is essential but don't expect 1:1 and that's 3 visits per hour.
If it's a need the patient should be in a specialized ward with a high standard of night nurses.

Decent care would be considered to be cleaned, changed and repositioned every 4 hours overnight, and face should be cleaned then if a patient is drooling etc. Extra if they’ve opened their bowels as no one should be lying in that for any length of time. Side rails up so they don’t fall out of bed obviously. Realistically that is a decent standard of care.

If they are in danger of choking as they can’t manage their secretions or are vomiting then that’s a different story and yes you need to raise that and they should act accordingly.

A Dr came in to take blood at 7pm and left the side rail down, in the side they are leaning too!! I've put it up but seriously concerned to leave!

You need to report the side rail and someone will speak to the doctor that is a serious safety issue.

With regards to my earlier post - there will be obs rounds and meds rounds as well so they will be seen more frequently than that (and have their face cleaned if necessary) but probably not repositioned.

Reported the rail but think I'll be putting something in writing this evening. Night time care person gave me no faith whatsoever. Breaking my heart leaving because don't know what state they will be in overnight without anyone actually checking in.

The night nurses aren't checking patients on their ward during the night?

Yes but at a bare minimum and they just don't seem like they have any connection whatsoever with a patient. Feels like they're just ticking their boxes not actually reviewing everything.

The night nurses should observe the patients and help with necessary needs but the night shifts are not rated for anything else than minimum care unless it is a highly specialized unit with a nigh number of nurses.

Then don't leave - insist on staying to do the care as I can guarantee they won't have sufficient staff to sufficiently monitor your relative. When my DD was alive we were in the same position. She was not able to call for assistance, coughed and vomited regularly and also had seizures. No way I would ever have left her unsupervised on any ward (apart from Intensive care). One of us always stayed with her day and night.

This is outing so have name changed but I once went to visit a friend who was in the last stages of his life. He was in filthy pyjamas, hadn’t been washed or teeth cleaned and his bed linen was filthy. I went home and called the ward sister and gave her a piece of mind. When I visited the next day he was washed with clean pyjamas, he smelt clean and his sheets had been changed. He died a day or two later but at least he died with some sort of dignity. Be that person.

When so was in hospital they were forever waking me up to do obs and what not so I’m sure they will be checked on. Have a chat though to find out the plan to ease your mind