How do I effectively care for an extended-stay patient?


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Ask any nurse who works in a hospital and he or she will tell you a story about a patient who has spent weeks and sometimes months on the unit. The nurse can recall the room number, the patient’s and family members’ names and even the diagnoses.

Some of these patients become part of the unit family and steal a piece of our hearts when they go.

There’s no doubt that these special patients face many stressors during their extended stay under our care. I’d like to share some tips that may help make your patient’s experience happier and less traumatic.

1. Allow the patient to have some privacy. Keep the door closed when he is sleeping unless he’s a fall risk or likes his door open.

2. If the patient is stable and the physician allows it, do vitals when she is awake. This might mean doing them at 10:00 p.m. instead of at the 11:00 p.m. shift change.

3. Let the patient make some rules: curtain open or pulled, visitor limits (family only or open to everyone?) and allowances for favorite home-cooked meals as a break from hospital grub.

4. If possible, try to give medications at the patient’s home schedule, not the hospital’s schedule.

5. Get the patient outta that room! If the patient is stable enough, have a family member take her off the unit or outside for some fresh air. Let the patient sit in the hallway and spend time watching and interacting with the activity outside her room.

6. Find the humor: Laugh with your patient, never at him. Humor is the best medicine.

7. Offer emotional support. Always be sensitive to your patient’s emotions and needs.

8. Decorate the patient’s room. We all have patients who leave balloons, flowers and plants behind. Remove the dead flowers and leaves (and the “To/From” card) from a discharged patient’s bouquet and place it in your extended-stay patient’s room.

9. Look for clues. Once the patient has been on the unit for more than a week, nurses usually can pick up on her needs much sooner. Remember the Wong-Baker Faces Pain scale? Use it with your intuition to best care for your patient.

With luck, we may care for an extended-stay patient and never be one. Doing our best to keep the person’s stay as pleasant as possible can sometimes be difficult, but remaining positive and supportive can make both the patient’s and your life a bit more tolerable.

Candace Finch, BSN, RN, works on an orthopedic/bariatric unit at Upstate University Hospital Community Campus in Syracuse, N.Y., and has cared for multiple extended-stay patients. She thinks being a nurse is never boring and loves her job (sometimes).

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