I worked on-call triage from Sunday night into Monday morning - a job I don't do often because I really like a good night's sleep. I was filling in for a nurse who had her baby a couple weeks early, but I believe her with a newborn and myself with the telephone got the same amount of sleep: almost none.
Some of the calls that came in really surprised me. I was roused from a light doze at 12:00am to inform me that the caller's father was going to need a refill of his medication in the morning. I can't figure out why that call couldn't have waited until normal business hours. Another call in the middle of the night was to inform me that a patient was constipated. I can't imagine the patient wanted an enema in the middle of the night and we certainly don't send nurses out in the middle of the night to do them. Other calls came in that were urgent and needed my attention.
As much as hospice nurses want and need to be there for our patients in times of crisis, we don't want to be woken up in the middle of the night for non-urgent matters. Remember, we are better nurses when we are well rested and healthy. I think it's important for hospice staff to educate patients and caregivers about what constitutes an after-hours emergency and what issues can wait until the next day. I am creating some guidelines that will be posted on this site very soon to help patients and caregivers, but in the meantime I'll leave you with this advice:
If the hospice patient is in pain or suffering in any other way, has any emergency that you would normally call 911 for, or if you have urgent caregiving questions that can't wait until morning call the hospice nurse for advice. If you need medication refills, are dealing with constipation, or if you have general questions about caregiving, wait until daylight hours to call the hospice nurse.
Common End-of-Life Symptoms: This list can help you recognize and manage some of the most common end-of-life symptoms.