Day Shift vs. Night Shift

Burnt Out, ASN, RN · Jan 11, 2008

There are usually more meds on day shift and more procedures. But nursing is 24/7/365-we just have to have shifts because nurses would drop like flies across the world if we had to work 24 hrs a day, 3 days a week.

jessiern, BSN, RN · Jan 11, 2008

Well, naturally things are going to be different. Doctors do not round at night, generally (we have a few exceptions to that rule). Usually less meds are passed on a routine night, but an acutely ill patient may have just as many. Our hospital divides baths with days and night, days having the most, but nights having total cares. You don't have meal trays on night shift. Hopefully, most patients are sleeping at night :)

NICK-RN · Jan 11, 2008

I Like Working Nights For The Down Time. It Seems Like Down Time Does Not Exist In The Day Shift.

locolorenzo22, BSN, RN · Jan 11, 2008

Yep, I 2nd that...but many times that down time does not exist if you have total cares and a few post ops.....

RainDreamer, BSN, RN · Jan 11, 2008

In our unit, there are shift specific duties.

Day shift hangs the TPN/IL and does the line changes. Routine procedures are also done during the day (MRI, CT scans, surgeries, etc, etc).

Night shift does the weights, baths, MAR checks, and art line changes.

Those are the main things that I can think of off the top of my head that are specific for each shift. Day shift is busier with docs and procedures. Night shift is busier with parents visiting, weights, baths, etc.

I think it's really going to be unit specific as it's going to depend on the patient population and their needs (i.e. in our unit medications aren't heavier for day shift ..... it's usually pretty even for days and nights).

fluppypacky · Jan 11, 2008

Whether you are at night or day shift,both have a big obligation,advantages and disadvantages. Day shift will always be the toxic and stressful one because you need to deal with a lot of things,like meds,doctors,supervisors,procedures,relatives etc,but you will learned a lot from it. Nights shifts,well ofcourse you will get additional pay from it,less stressful but it's really hard to stay awake the whole night if you did not get sleep during the day especially for those who are taking care of their children. well I think it's a matter of choice and will only depends on what's best for your family. :idea:

swee2000 · Jan 11, 2008

I work at a hospital on a Med/Surg unit. Like another poster said, I don't mind picking up a night shift here-and-there because it's "typically" more relaxing and less hectic. You usually don't have: managers/administration staff/unit supervisors lurking around; JCAHO popping in on one of their random visits; doctors & PAs making rounds(only the ones that absolutely have to see patients in the middle-of-the-night); PT & OT therapists trying to see your patients; family & visitors calling you a million-and-one times(although some do spend the night in the patient's room); to do baths or change beds(unless neccessary, like in the case of an incontinent patient). Lastly, if all goes right, the patients are usually sleeping or at least resting in bed/watching tv.

Now, that doesn't mean night shift never gets crazy. Believe me, it can, does, and will...and when you least expect it!!! Alot of the geriatric patients with dementia go through a sun-downers stage in the late evening hours, sometimes extending into the night hours. So that could mean alot of confused patients, safety alerts who are at greater risk for falls, bed-checks going off constantly, etc. Also, I don't know if this happens anywhere else, but during the night(compared to Days or PM shift) is when I've seen many patients take a turn for the worse/getting transferred down to ICU. Not sure if this is r/t less staff on the unit during this shift, therefore less monitoring of patient situations, or if there is some other explanation. And for all the codes I've seen in my near 4 years at the hospital, all but maybe 3 or 4 happened on night shift. So as much as night shift "appears" laid-back, less hectic, and more "relaxing", don't let that fool you because all heck can break loose and at the snap of a finger(of course, this can happen on any shift; it's just more "chaotic" when it happens on nights).

NurseCherlove · Jan 11, 2008

I Like Working Nights For The Down Time. It Seems Like Down Time Does Not Exist In The Day Shift.

'Tis the very reason I just made the switch - sick of running to death! Liking it much better.

MelBel · Jan 11, 2008

I had oriented on day shift, and work nights now. I wouldn't work days at my job if my life depended on it. I find nights more stressful than I found days, but I also find EVERYONE else in the hospital (from other nurses, to supervisors, to ancillary staff) MUCH more friendly.

I like nights because when I need a chart, it is there for me, I don't have to steal it from the secretary, or charge nurse, or doctor, or PT, etc. I can organize my evening around my schedule (for the most part) as opposed to surgery's, PT's, MRI's, etc. I don't have to deal with management and doctors asking questions all the time. And I get to kick the annoying families out after a couple of hours (I let some nice ones stay!)

Downfalls?

-I work geriatrics, so most of our patients display some form of sundowners.

-Everyone seems to think we have nothing to do on night shift, so our staffing is MUCH less than days.

-A patient starts going bad, and it takes some time to get the appropriate orders and people to help.

-Patients deciding at 2300 that they need a sleeping pill :)

-Admissions with no secretary/charge nurse!

Thepurplenurse · Jan 11, 2008

I work permanent N/S and have done for the last 5 years. I work between community and a large paediatric teaching hospital. I alternate between PICU and acute medical receiving. Whilst in the hospital there can be no difference between shifts in the amount of work you may have to do, but I agree with the previous post that the staff are more relaxed and friendlier on nights. The main difference I find is that you have to be able to make more complex decisions yourself as there are less senior staff around and some times finding a doctor who is capable of making decisions can be problematic. Why do they always leave the juniors on the floor whilst the more experienced Dr's vanish??? Ever tried persuading a junior to wake his registrar up. LOL.

And then when the relatives go home, it's just you, your colleagues and the kids, heaven.

queenjean · Jan 11, 2008

To address the OP's questions specifically--

In our hospital, night shift is responsible for the 24 hour chart checks (to make sure every order from the previous 24 hours was entered into the computer) and the MAR reconciliation. The shifts take turns checking the crash carts and stocking supplies, although night shift frequently has more time to do this--but if we are low on something, we have to wait for day shift to arrive to order it (central supply isn't open for the floor's routine stocking on nights).

I work mother/baby. Day shift is supposed to do most of the teaching; night shift tries to get more of the other "tasks" done--the PKUs, hearing screens, etc. Days has more meds; nights has more paperwork (with the chart checks, MAR rec, and preparing charts for the next day). Night shift is supposed to figure out who will likely be discharged the upcoming day and print out the discharge orders for the physician and get all the paperwork ready so that days can jump on it and try to get them out in a timely manner.

I spend a lot of my time with breastfeeding education. Day shift has the lactation consultants to address breastfeeding issues; night shift doesn't--we have to do it ourselves. Day shift has more dismissals and the paperwork mess that goes with that.

We both have the same amount of paperwork overall, same assessments, and our tasks really do run 24/7. But the flow of the floors *are* different between days and nights, and thus each shift seems to have certain things that are best accomplished on that shift.