The night was fine. I was on the psych/behavior unit. I had not been there since last month. The residents don't call for anything, and that is the problem. You must constantly monitor them because they will attempt to get out of bed or have some other difficulty and the resident and the roommate will never activate the call bell to request help. The aides are upset because the Director of Nursing made a new rule that the floor must be toured every hour. They told me this as if I would say, "Forget that. Just sit there and sleep." I did say, "Forget the hour rule. The floor should be toured every fifteen minutes." As you can imagine, they rarely toured the floor. I have read several studies that conclude that frequent touring of the floor reduces falls and increases customer satisfaction. I have prevented falls myself with tours by finding residents getting out of bed.
One resident screamed and yelled about back pain. I believe her. She has severe osteoarthritis. She calmed down when I took her vitals are positioned her better in the bed.
There was a new resident, described as "alert and oriented x 3." She was much sharper than the average resident, but with early dementia, which resulted in repeated requests for a sleeping pill. I can't page a doctor in the middle of the night for a non-emergent matter, and contrary to popular thought, the inability to fall asleep quickly is not an emergency.
I changed the times of administration for meds on two residents. The day nurses had a fit. I was not going to do anything, but then I decided to go ahead and make the changes because I am correct, I have more authority than they do because of my education and license, and they can just deal with it. I'm tired of their bullying. Rarely do I work on any floor without making changes that others have overlooked. I'm now going to make appropriate changes on this floor as well.