PM care, or Post Meridiem care, refers to the standard set of nursing interventions performed in the late afternoon and evening to prepare a patient for a restful night of sleep. This routine is a formal, structured part of the daily shift workflow in healthcare settings, signaling a transition from the day’s activities to a period of rest and recovery. The goal of this focused care is to maximize patient comfort and security before the longer nighttime hours. By addressing physical needs and creating a calming environment, PM care helps support the body’s natural healing processes while minimizing nighttime interruptions.
Definition and Schedule of Evening Care
Evening care is a routine set of personal services performed for patients, also sometimes referred to as H.S. care, where “H.S.” stands for hora somni, meaning “hour of sleep”. The timing of this nursing activity is typically scheduled between 7:00 PM and 10:00 PM, often coinciding with the change of the evening shift or the final checks before the facility’s designated “lights out” time.
The purpose of PM care fundamentally differs from that of morning, or AM, care, which is designed to prepare the patient for active participation in the day. AM care focuses on bathing, grooming, and dressing for mobility, while PM care is centered on relaxation, comfort, and the psychological readiness for sleep. The central principle remains maximizing the duration of uninterrupted sleep.
Essential Tasks of PM Nursing Care
The core of PM care involves a combination of hygiene, comfort, and safety measures. Personal hygiene is a major component, starting with assisting the patient with face and hand washing to refresh them after the day. Thorough oral care is performed, which involves brushing teeth, cleaning dentures, or using mouth swabs, contributing to comfort and cleanliness before sleep. Patients are also assisted in changing from day clothes into clean nightwear or pajamas, promoting a psychological feeling of readiness for rest.
Comfort measures are implemented to ensure the physical environment supports sleep and prevents complications during immobility. This includes straightening bed linens, changing any soiled items, and repositioning the patient to alleviate pressure points. A back rub or gentle massage with lotion is often included in the routine to promote muscular relaxation and overall calming.
Safety checks are a non-negotiable part of the routine, ensuring the patient is secure for the night.
- The nurse verifies that the call light is functional and placed within the patient’s immediate reach should they require assistance overnight.
- Bed rails are adjusted according to policy and the patient’s care plan.
- The immediate room environment is tidied to eliminate clutter and reduce fall risks.
- The administration of scheduled nighttime medications, particularly pain relievers or sleep aids, is managed to ensure their effects coincide with the patient’s desired sleep time.
Clinical Rationale for Nighttime Routines
PM care routines are grounded in clinical principles that directly affect patient recovery and well-being. A primary function is promoting restorative sleep, which is fundamental for healing, mental health, and reducing the risk of conditions like delirium in hospitalized patients. The comfortable, clean state achieved through hygiene and linen changes reduces physical discomfort that could fragment sleep patterns. By consolidating care activities into the evening, the number of necessary interruptions after midnight can be significantly minimized, allowing for a longer period of rest.
Maintaining skin integrity is another major benefit, especially for patients with limited mobility who are at risk for pressure injuries. Repositioning the patient and inspecting the skin during PM care reduces prolonged pressure on vulnerable areas, helping to prevent the development of bedsores overnight. The application of lotion during back rubs not only aids relaxation but also helps to assess and maintain skin hydration and health.
The hygiene components of PM care are directly linked to infection control. Meticulous oral care, particularly for patients with compromised immunity or those on ventilators, helps to reduce the bacterial load in the mouth, thereby lowering the risk of aspiration pneumonia and other infections. The final check by the nurse provides emotional comfort and security, reducing patient anxiety and enhancing a sense of safety during the long, quiet nighttime hours.