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Providing Evening Care (PM Care) to Patients

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By Gil Wayne BSN, R.N.

Evening care for patients is a way to refresh and prepare them for sleep. This practice not only promotes relaxation but also enhances overall patient comfort and well-being. How can effective evening care routines contribute to better patient sleep and recovery? What are the essential steps in providing comprehensive evening care? Explore the techniques and benefits of evening care to improve patient outcomes and ensure a peaceful night.

Table of Contents

What is Evening or PM Care?

Evening care, also known as PM care or bedtime care, in nursing, refers to the routine practices performed to prepare patients for a restful night’s sleep. This care typically includes a series of activities aimed at promoting comfort, relaxation, and hygiene before the patient goes to bed. Evening care should be tailored to each patient’s individual needs and preferences. Nurses should communicate clearly with patients about the care procedures, encouraging their participation and feedback

Purpose of Evening Care to Patients

The following are the primary purposes and benefits of providing evening or PM care to patients:

1. To Refresh the Patient and Prepare for Sleep.

One of the primary objectives of evening care is to help patients feel clean and refreshed before going to bed. This includes activities such as washing the face, brushing teeth, and changing into clean nightwear. These actions not only promote physical cleanliness but also contribute to a psychological sense of readiness for rest, making it easier for patients to fall asleep and stay asleep through the night.

2. To Promote Muscular Relaxation.

Evening care often includes measures to promote muscular relaxation. This can involve light massage, gentle stretching, or positioning adjustments to alleviate muscle tension accumulated during the day. By helping to relax the muscles, these activities can reduce discomfort and promote deeper, more restful sleep, which is crucial for recovery and overall health.

3. To Prevent Bedsores.

Another critical purpose of evening care is the prevention of pressure ulcers or bedsores, particularly in patients who are bedridden or have limited mobility. During evening care, nurses inspect the skin for early signs of pressure sores, apply protective lotions, and reposition the patient to relieve pressure on vulnerable areas. These steps are vital in maintaining skin integrity and preventing the development of painful and potentially serious pressure ulcers.

4. To Promote Oral Hygiene and Prevent Infections.

Providing thorough oral care during the evening helps maintain oral hygiene and prevent infections. This includes brushing teeth, cleaning dentures, and ensuring the mouth is clean. Good oral hygiene is especially important for patients at risk of aspiration pneumonia or other oral-related infections, contributing to their overall health and well-being.

5. To Enhance Psychological Comfort.

Evening care routines also play a significant role in enhancing the psychological comfort of patients. The process allows for nurse-patient interactions that provide emotional support and reassurance. Such interactions can reduce anxiety, provide a sense of security, and foster a therapeutic relationship, thereby improving the patient’s mental health and overall experience in the healthcare setting.

6. To Ensure a Safe and Comfortable Environment.

Creating a safe and comfortable environment is another essential purpose of evening care. This involves adjusting the lighting, reducing noise, and ensuring the room temperature is conducive to sleep. Additionally, making sure that essential items are within easy reach of the patient promotes a sense of independence and security, contributing to their overall comfort and ease.

Components of Evening Care

Key components of evening or PM care may include:

1. Personal Hygiene. Assisting patients with washing their faces, brushing their teeth, and performing any other necessary grooming tasks to ensure they feel clean and comfortable.

2. Skin Care. Applying lotion to dry skin areas and inspecting the skin for any signs of irritation or pressure ulcers, especially in bedridden patients.

3. Oral Care. Providing thorough oral hygiene to prevent infections and ensure oral comfort, particularly for patients who might have difficulty performing these tasks themselves.

4. Comfort Measures. Adjusting pillows and bedding, ensuring the patient is in a comfortable position, and addressing any pain or discomfort by administering prescribed medications or offering other pain relief measures.

5. Environmental Adjustments. Creating a restful environment by dimming lights, reducing noise, and ensuring the room temperature is comfortable. This may also include setting up any personal items the patient needs within easy reach.

Preparation of Patient and Environment

The preparation involves assembling necessary supplies and setting up the environment to create a calming and conducive atmosphere for the patient. Here are the details of the preparation process:

Assembling the Tray of Supplies

A well-prepared tray containing all necessary supplies ensures that the nurse can perform evening care efficiently without having to leave the patient’s side to fetch additional items. The tray should include:

1. Basin of Warm Water. Used for washing the patient’s face, hands, and any other areas as needed. Warm water is soothing and helps relax the patient.

2. Alcohol 70%. Used for sanitizing hands and surfaces to maintain hygiene and prevent infections.

3. Soap in Soap Dish. A mild soap for cleansing the patient’s skin, ensuring cleanliness and comfort.

4. Talcum Powder. Applied to areas prone to moisture and friction to keep the skin dry and prevent rashes and bedsores.

5. Hair Comb or Brush. To groom the patient’s hair, promoting a sense of well-being and personal care.

6. Bath Towel & Wash Cloth. For drying and washing the patient, ensuring thorough hygiene.

7. Pitcher of Warm Water. Additional warm water for rinsing or other needs during the care process.

8. Mouth Wash Tray. Includes a mouthwash solution, toothbrush, and kidney basin for oral hygiene, ensuring the patient’s mouth is clean and fresh.

9. Linen Required. Fresh bed linens and clothing to replace any soiled ones, ensuring the patient’s comfort and hygiene.

Setting Up the Environment

A well-prepared environment can significantly enhance patient comfort, promote relaxation, and contribute to a restful night’s sleep. The following considerations are essential in creating an optimal environment for evening care:

1. Lighting Adjustments

  • Soft Lighting. Ensure the room has soft, dim lighting to create a calming atmosphere. Bright lights can be harsh and stimulating, making it difficult for patients to relax and prepare for sleep.
  • Night Lights. Use night lights to provide sufficient visibility for both the patient and the caregiver, without disturbing the restful environment.

2. Noise Reduction

  • Minimize Noise. Reduce noise levels by closing doors gently, speaking in soft tones, and avoiding loud conversations or activities near the patient’s room.
  • Soundproofing. If possible, use soundproofing materials or devices to block out external noises, such as hallway chatter or equipment sounds, to create a quiet and peaceful environment.

3. Temperature Control

  • Comfortable Temperature. Maintain a comfortable room temperature that is neither too hot nor too cold. A consistent and moderate temperature helps in promoting sleep and preventing discomfort.
  • Ventilation. Ensure proper ventilation to keep the air fresh and reduce stuffiness, which can be uncomfortable and disruptive to sleep.

4. Privacy Considerations

  • Curtains and Screens. Use curtains, screens, or closed doors to provide privacy, making the patient feel secure and respected during evening care routines.
  • Personal Space. Respect the patient’s personal space by knocking before entering and explaining each step of the care process to ensure they feel involved and at ease.

5. Accessibility and Safety

  • Essential Items. Arrange essential items, such as water, tissues, call bell, and personal belongings, within the patient’s easy reach to foster a sense of independence and security.
  • Safety Checks. Ensure that the bed rails are adjusted appropriately, and the floor area is clear of any obstacles to prevent falls and ensure patient safety.

6. Comfort Measures

  • Bedding Adjustments. Ensure the patient’s bed is clean, dry, and free of wrinkles. Adjust pillows and blankets to provide optimal comfort and support.
  • Personal Preferences. Take into account the patient’s personal preferences for their sleeping environment, such as the number of pillows, type of blanket, or any specific requests that enhance their comfort.

7. Relaxing Ambiance

  • Calming Scents. Consider using calming scents, such as lavender or chamomile, through safe means like essential oil diffusers, to promote relaxation.
  • Soothing Sounds. If appropriate, play soft, soothing music or nature sounds to create a tranquil environment that aids in relaxation and sleep.

Precautions on When Not to Provide Evening Care

Providing evening care is an essential part of patient care, aimed at promoting comfort and hygiene. However, there are certain situations and conditions where evening care should be postponed or modified to ensure patient safety and well-being. Here are some key precautions to consider:

1. Severe Pain or Discomfort
If a patient is experiencing severe pain or discomfort, it may not be appropriate to proceed with evening care. Forcing care in such a situation can exacerbate the patient’s pain and distress. Instead, pain relief measures should be prioritized. Once the pain is adequately managed and the patient feels more comfortable, evening care can be resumed.

2. Unstable Medical Condition
Patients with unstable medical conditions, such as those experiencing acute heart issues, severe respiratory distress, or sudden changes in vital signs, should not undergo evening care. The focus should be on stabilizing their condition and monitoring their vitals closely. Evening care can be deferred until the patient’s condition stabilizes and they are better able to tolerate the routine.

3. Post-Surgical or Post-Procedure Status
Patients who have recently undergone surgery or an invasive procedure may need to avoid certain aspects of evening care to prevent disrupting surgical sites or causing discomfort. For example, vigorous movements or repositioning may not be advisable. Care routines should be adjusted in consultation with the surgical or procedural team to ensure patient safety and comfort.

4. Severe Skin Conditions or Injuries
If a patient has severe skin conditions, such as extensive burns, open wounds, or infections, evening care should be modified to avoid exacerbating these issues. Gentle care that avoids the affected areas should be practiced, and any specific wound care protocols should be strictly followed as per medical advice.

5. Psychological or Emotional Distress
Patients experiencing significant psychological or emotional distress, such as acute anxiety, agitation, or a psychiatric crisis, may not be receptive to evening care. In such cases, prioritizing psychological support and creating a calming environment is crucial. Evening care routines can be revisited once the patient is more settled and receptive.

6. Contagious Illnesses
For patients with contagious illnesses, precautions must be taken to prevent the spread of infection. Evening care should be conducted following strict infection control protocols, and in some cases, certain care activities may need to be minimized or postponed to protect both the patient and healthcare workers.

7. Severe Cognitive Impairment or Confusion
Patients with severe cognitive impairment or confusion, such as those with advanced dementia or delirium, may become agitated or non-compliant with evening care. In these situations, care should be approached with extreme patience and sensitivity. It may be necessary to modify or delay care activities to align with the patient’s current state and ensure their safety and comfort.

8. Recent Administration of Sedatives or Anesthetics
Patients who have recently been administered sedatives or anesthetics may not be fully alert and could be at risk of falls or other injuries during evening care. It is essential to ensure that the patient is adequately awake and oriented before proceeding with care routines.

Procedure on Providing Evening or PM Care to Patients

The procedures involved in evening care are comprehensive and must be performed with attention to detail, empathy, and efficiency. The following are the detailed procedures for providing effective evening or PM care to patients:

Establishing Rapport

The initial step in the comprehensive process of providing evening or PM care to patients involves the introduction and explanation phase. This phase is foundational, establishing a vital connection between the nurse and the patient, essential for delivering comprehensive care.

1. Introduce self to patient ensuring they know who will be assisting them.
Introducing oneself to the patient establishes a personal connection and promotes trust between the patient and the healthcare provider. This simple gesture creates a welcoming environment and promotes effective communication throughout the care process. By clearly identifying oneself, healthcare providers demonstrate professionalism and respect for the patient’s dignity, ultimately enhancing the overall patient experience.

2. Verify the patient’s identity using the facility’s protocol.
Verifying the patient’s identity using the facility’s protocol ensures accurate and safe care delivery. This step minimizes the risk of errors, such as administering medication to the wrong patient or performing procedures intended for another individual. By confirming the patient’s identity, healthcare providers uphold patient safety standards and maintain the integrity of the care process.

3. Explain to patient what evening care entails, why it is necessary, and how the patient can participate.
Explaining to the patient what evening care entails, why it is necessary, and how they can participate fosters understanding and cooperation. By providing this information, patients feel more empowered and involved in their care, leading to improved compliance and better outcomes. Clear communication builds trust between the patient and healthcare provider, enhancing the overall care experience and promoting patient satisfaction.

Hand Hygiene and Infection Control

The next step in providing evening or PM care to patients involves hand hygiene and infection control. The following procedures are vital in ensuring the safety of both patients and nurses:

4. Perform hand hygiene by washin hands thoroughly and use an appropriate hand sanitizer.
Performing hand hygiene through thorough handwashing and the use of hand sanitizer is necessary to prevent the spread of infections in healthcare settings. Clean hands reduce the risk of transmitting harmful pathogens between patients, healthcare workers, and the environment. Adhering to hand hygiene protocols is a fundamental measure in infection control, promoting patient safety.

5. Use personal protective equipment (PPE) such as gloves and any other necessary PPE based on the patient’s condition and facility protocols.
Using personal protective equipment (PPE), including gloves and other necessary gear, is essential to prevent the transmission of infections between patients and healthcare workers. By wearing PPE, nurses reduce the risk of contamination and maintain a safe environment for both themselves and their patients. Adhering to facility protocols ensures consistency and compliance with best practices in infection control, safeguarding everyone involved in patient care.

Privacy and Comfort

The following steps are integral to fostering a respectful and dignified care environment:

6. Ensure privacy of the patient by closing the curtains or doors and cover the patient appropriately to maintain their dignity and privacy throughout the process.
Ensuring patient privacy by closing curtains or doors and providing appropriate coverage maintains the patient’s dignity and promotes a sense of comfort and security. Respecting the patient’s privacy during care fosters trust and encourages open communication between the patient and healthcare provider. It also upholds ethical standards and legal requirements regarding patient confidentiality, contributing to a positive care experience.

7. Adjust the Environment. Make sure the room is at a comfortable temperature and has soft, calming lighting to create a soothing atmosphere.
Adjusting the environment by ensuring a comfortable temperature and soft, calming lighting contributes to the patient’s relaxation. A soothing atmosphere promotes restful sleep and reduces anxiety, facilitating the effectiveness of evening care. By creating a comfortable environment, healthcare providers support the patient’s physical and emotional comfort, ultimately enhancing the quality of care provided.

Preparation of Supplies

This step is vital for ensuring efficiency and readiness in delivering comprehensive care:

8. Gather Necessary Supplies. Assemble all required supplies, such as a basin of warm water, soap, towels, lotions, a hair comb, toothbrush, mouthwash solution, and clean linens.
Having everything ready minimizes disruptions and enhances efficiency.

Basic Hygiene Care

The following steps involves various essential practices that contribute to personal hygiene and health maintenance:

9. Allow patient to wash face and hands and use a warm, damp washcloth to gently clean the face and hands. If patient is unable to help himself, do it for them.
This refreshes the patient and helps remove any dirt or sweat accumulated throughout the day. Allowing the patient to wash their face and hands promotes personal hygiene and a sense of autonomy. It helps patients feel refreshed and comfortable. If the patient is unable to perform these tasks independently, providing assistance ensures their cleanliness and dignity are maintained, enhancing the quality of care provided.

10. Assist patient to brush teeth. Use mouthwash to ensure oral freshness and prevent infections.. If patient is unable to help himself, do it for them.
Assisting the patient with brushing their teeth and using mouthwash promotes oral hygiene and prevents infections. Proper oral care helps maintain the health of the mouth and reduces the risk of oral infections, which can lead to systemic complications. If the patient is unable to perform these tasks independently, providing assistance ensures their oral health is adequately maintained.

Skin Care

These steps are essential for maintaining skin integrity and preventing complications:

11. Check the patient’s skin for any signs of pressure sores, rashes, or other issues. Pay particular attention to areas prone to pressure ulcers.
Checking the patient’s skin for signs of pressure sores, rashes, or other issues is essential for preventing complications and promoting skin integrity. By conducting regular skin assessments, healthcare providers can identify potential problems early and implement appropriate interventions. Paying particular attention to areas prone to pressure ulcers helps mitigate the risk of developing these painful and debilitating wounds, ensuring the patient’s comfort.

12. Apply lotion. Use a gentle lotion to moisturize dry areas and talcum powder to areas prone to moisture and friction, helping to prevent skin breakdown.
Applying lotion and talcum powder helps maintain skin integrity by addressing specific skin needs. Lotion moisturizes dry areas, preventing skin from becoming cracked or irritated, while talcum powder absorbs excess moisture and reduces friction, particularly in areas prone to moisture-related skin breakdown. This simple intervention promotes skin health and comfort, reducing the risk of skin breakdown and related complications.

Back Care and Massage

The following steps are vital to promoting relaxation and addressing discomfort:

13. Turn patient to his side, unfasten his camisa or hospital gown and bathe her back.
Turning the patient to their side and unfastening their camisa or hospital gown facilitates access for the back. This position allows for thorough cleansing and ensures optimal hygiene maintenance, particularly in areas that are often difficult to reach.

14. Massage back with alcohol 70% or skin lotion paying particular attention to the bony prominences and other reddish spots on the back.
Massaging the back with alcohol 70% or skin lotion serves to moisturize the skin and alleviate discomfort, particularly in areas prone to dryness or irritation. Paying particular attention to bony prominences and reddish spots helps address areas of potential skin breakdown or inflammation. This intervention promotes skin health and comfort, reducing the risk of pressure ulcers.

15. If the patient is wearing a binder, remove it when giving care to the back. Inspect dressing for bleeding or discharge and changes or reinforce P.R.N. Return the binder in place.
Removing the binder during back care allows for thorough assessment and treatment of the back area. This step enables healthcare providers to inspect dressings for signs of bleeding, discharge, or other abnormalities, ensuring timely intervention if needed. Once care is completed, returning the binder to its place provides necessary support and maintains the patient’s comfort and safety.

Hair Care

This step is essential for maintaining personal hygiene:

16. Brush and comb hair. Protect back and camisa with towel.|
Brushing and combing the patient’s hair help maintain hygiene and promote a neat appearance. Protecting the back and camisa with a towel prevents any hair debris from falling onto the patient’s clothing, ensuring cleanliness and comfort.

Repositioning and Comfort

When providing evening care to patients, it is important to focus on repositioning and ensuring their comfort. The following steps are essential in promoting relaxation and preventing discomfort of patients during their nighttime routine:

17. Fasten patient’s camisa move patient to one side brush crumbs or dirt from the bed.
Fastening the patient’s camisa and gently moving them to one side facilitates bed hygiene, allowing caregivers to remove any crumbs or dirt from the bed. This ensures a clean and comfortable environment for the patient, reducing the risk of skin irritation or discomfort.

18. Reposition the Patient. Assist the patient in changing positions to enhance comfort and prevent bedsores. Ensure they are in a comfortable position for sleeping.
Repositioning the patient helps prevent the development of pressure ulcers and promotes comfort during sleep. By assisting the patient in changing positions, caregivers alleviate pressure on vulnerable areas of the body, reducing the risk of skin breakdown and discomfort.

19. Adjust Bedding. Ensure the bed is clean, smooth, and free of crumbs or wrinkles. Adjust pillows and blankets to the patient’s preference for optimal comfort.
Adjusting bedding ensures a clean, smooth, and comfortable sleeping environment for the patient. By removing crumbs or wrinkles from the bed, caregivers minimize discomfort and promote better sleep quality. Additionally, tailoring pillows and blankets to the patient’s preference enhances their comfort

20. Replace ice cap or hot water bag P.R.N.
Replacing the ice cap or hot water bag as needed ensures continued therapeutic effectiveness and patient comfort. By maintaining the appropriate temperature, caregivers support the intended therapeutic benefits, such as pain relief or inflammation reduction.


The following step outlines the essential procedures for safely and effectively giving medications, thereby enhancing the patient’s comfort and promoting better health outcomes during their nighttime routine:

21. Give bedtime medicine if any. Attend to all patient’s request.
Administering bedtime medicine ensures patients receive necessary treatments as prescribed, promoting continuity of care and potentially improving health outcomes. Attending to all patient requests fosters patient-centered care, enhancing satisfaction and trust in healthcare providers while addressing immediate needs promptly.

Final Checks

These concluding steps help address any last-minute needs and confirm that all aspects of care have been attended to. The following steps include:

21. Ensure accessibility. Make sure essential items, such as the call bell, water, and personal belongings, are within easy reach of the patient.
Ensuring accessibility of essential items, such as the call bell, water, and personal belongings, allows the patient to meet their needs promptly and independently. By placing these items within easy reach, caregivers promote patient autonomy and facilitate self-care. This proactive approach enhances the patient’s sense of control and comfort, contributing to a positive care experience.

22. Safety measures. Check that bed rails are appropriately positioned, and the floor area is clear to prevent falls and ensure safety.
Implementing safety measures, such as checking bed rail positioning and maintaining a clear floor area, reduces the risk of falls and enhances patient safety. By ensuring bed rails are correctly positioned, caregivers provide support and stability for the patient, minimizing the likelihood of accidents. Similarly, maintaining a clear floor area prevents tripping hazards and promotes a safe environment for both patients and caregivers. This proactive approach prioritizes patient safety and mitigates the risk of injuries during care delivery.

23. Provide final comfort measures. Offer any last-minute comfort measures, such as an extra blanket or a sip of water, to ensure the patient feels cared for and ready for sleep.
Providing final comfort measures ensures the patient feels cared for and prepared for sleep. By offering additional blankets or a sip of water, caregivers address any remaining comfort needs, promoting relaxation. This proactive approach fosters a supportive and nurturing care environment, enhancing the patient’s overall comfort and satisfaction before bedtime.

24. Remove all unnecessary things from the room: trays, dishes, etc. Empty wastebasket.
Removing all unnecessary items from the room, including trays, dishes, and emptying the wastebasket, creates a clean and clutter-free environment. This promotes a sense of calm and organization, reducing distractions and enhancing the patient’s comfort. Additionally, maintaining a tidy room facilitates efficient caregiving practices and ensures a safe environment for both patients and caregivers. This proactive approach contributes to a positive care experience and promotes a healing environment conducive to rest and relaxation.

25. Adjust screen or blinds and light.
Adjusting the screen or blinds and light helps create an optimal environment for rest and sleep. By controlling the amount of natural light entering the room and adjusting artificial lighting, caregivers promote a comfortable atmosphere conducive to relaxation. This proactive measure supports the patient’s circadian rhythm and facilitates a restful sleep, contributing to their overall recovery.


This approach ensure continuity of care, support communication among healthcare team members, and provide a detailed account of the care provided. The following step provides the key element of documentation during evening care.

26. Record the care provided. Document all care activities, observations, and patient feedback in the patient’s medical record. This ensures continuity of care and provides essential information for the next shift.
Recording the care provided ensures comprehensive documentation of all care activities, observations, and patient feedback. This documentation serves as a vital record of the care delivered, facilitating continuity of care between healthcare providers and ensuring that important information is readily accessible for the next shift. Additionally, accurate documentation supports communication among members of the healthcare team, promotes accountability, and assists in monitoring the patient’s progress and response to treatment.


  • Berman, A., Snyder, S. J., & Frandsen, G. (2015). Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice (10th ed.). Pearson.
Gil Wayne ignites the minds of future nurses through his work as a part-time nurse instructor, writer, and contributor for Nurseslabs, striving to inspire the next generation to reach their full potential and elevate the nursing profession.

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