Does any other night shifters feel like days has no idea how nights works?

[thomask]

does anyone else on night feel like days thinks we do nothing? Often when I give report I end up feeling like I've done nothing all night when I didn't even have time to eat my lunch. No I don't know what time the pt is going down to IR. IR isn't here at night. umm. No I didn't get the admission questionaire done. The pt looked pretty tired after that 10 hour surgery. UHh.. I have no idea if the docs want such and such. they don't like to be woken up unless its an emergency and i don't think such and such would be considered an emergency. and so on and so forth. I realize that these things are all important. I get that. But I just can't call a doc or a dept that isn't here whenever I want. I have to figure out if it can wait. and if they are breathing okay rhythm looks good and they aren't about to code. it can probably wait.

Nevermind the fact that i have had 3 transfers in and out, I had to call the pharmacy 3 time to get a med. i had to enter orders for all those new pts(no secretary) and check the chart and call pharmacy a fourth time because they sent the med I called about earlier to the floor the pt used to be on.( only one pharmacist on noc vs 4 on days) then I have to call that floor and ask them to send it to me. I had to call for the IV pumps.i had to draw 30 ml of blood from a pt that only wanted to give me 2. the pt down the hall won't stop pooping and thought itd be a good idea to pull out the ng tube and I am pretty sure thats not chocolate on my shoe. I had to get all your paperwork ready and make sure all my ducks were in a row before the drs come in 30 mins mins before the end of my shift and write another ten orders that I have to get done before I leave, and I will probably have to call pharmacy again becaus the nurse on the other floor where they sent the med sent it to a dept that wont open til 8. so yeah, I couldn't get to that. sorry. Oh and i did it all in the dark!

I always feel horrible when this happens. I am doing the best I can. But does anyone else feel like day shift thinks we can do everything they can at night??? these people they use all day long are not there at night. No one puts in my orders for me no one lifts pts for me and dr don't just stroll by all the time so I can ask them things.

why do I leave without feeling like I have done nothing when I haven't had time to pee in 7 hours??? I have more pts at nite too!! geez!! I guess you don;t know til you work nights

[MAISY, RN-ER, BSN, RN]

I never worked nights, and can't imagine it!

I am sorry for all of the floor nurses, those who are not in a teaching hospital, and those who don't have enough staffing. I wouldn't want your job. Especially at night.

My position in ER has physicians and pharmacy available 24/7. We also have testing staff on site-no more beepers. I have never worked any other way. So my view is limited to my immediate experience. I can say without a doubt, that our experienced ER staff has it better at night, how do I know? The group I oriented with, all started nights, when I began the 10a to 11p shift. Those that eventually changed over to days stated it was a fact. Days in ER were much harder than nights due to the crowds of people decending on us, both medical and the general public and their immediate needs. Most patients at night in our suburban er were holds, or out of there by 2a.

What's bad at night? No management. No educators for new orientees. No recourse for bad assignments. Charge nurses with favorites who do not help and let travelers, agency and new (out of the group) nurses sink. Medical residents who disappear and don't answer pages, because attendings are few and far between. I am sure there are other things too!

I have not had the opportunity to read a book, magazine, listen to music, do CE's, play games, text message, surf the net, sleep or anything else during my shift. While this privilage is not extended to all nurses, many do this at night-as reported by their co workers, and commented when you pick up their empty rooms. It seems they transfer patients to make full assignments for those unlucky, unliked few. While I know this is the perception that night nurses don't like to hear, it does happen. I truly believe it was a good thing I never worked overnight...don't think I would have dealt with that crap well! I belive I would have been management's worse nightmare! I believe in sharing the good and the bad.

Maisy;)

[EmmaG, RN]

What's bad at night? No management.

That's one of the PERKS of working nights, IMO

[MAISY, RN-ER, BSN, RN]

Pretty funny! I guess no management could be seen as a perk!

The problem with being older as a new nurse is that you have no issues with addressing management directly for problems. Recently, one of our new 22 yo new grads has been getting abused at night, given assignments that are very high acuity(while others are sitting on their butts, but are favorites), and considering leaving. Every morning she is crying and scared for her license. To me that is unacceptable! If an educator was assigned to follow their progress at night, or some management was on....perhaps she'd have the support she needed...perhaps, a couple of these charge nurses would get their butts kicked a little. What is that saying about absolute power corrupting? A couple of our PM charges definately suffer from this.

Although I am sure many agree they are a pain, in this case I believe they may actually be an asset.

Maisy;)

[cardiacRN2006, ADN, RN]

Nevermind the fact that i have had 3 transfers in and out, I had to call the pharmacy 3 time to get a med. i had to enter orders for all those new pts(no secretary) and check the chart and call pharmacy a fourth time because they sent the med I called about earlier to the floor the pt used to be on.( only one pharmacist on noc vs 4 on days) then I have to call that floor and ask them to send it to me. I had to call for the IV pumps.i had to draw 30 ml of blood from a pt that only wanted to give me 2. the pt down the hall won't stop pooping and thought itd be a good idea to pull out the ng tube and I am pretty sure thats not chocolate on my shoe. I had to get all your paperwork ready and make sure all my ducks were in a row before the drs come in 30 mins mins before the end of my shift and write another ten orders that I have to get done before I leave, and I will probably have to call pharmacy again becaus the nurse on the other floor where they sent the med sent it to a dept that wont open til 8. so yeah, I couldn't get to that. sorry.

This all happens on day shift too. Add to that many pt transfers, many calls from pharmacy, lab, social work, family, etc, etc.

Both shifts are hard. Each has it's own pros and cons. If your day shift thinks you do don't anything, then it isnt' a shift issue, it's a respect issue.

Just keep doing what you're doing, and don't let the next shift bother you...

[EmmaG, RN]

The problem with being older as a new nurse is that you have no issues with addressing management directly for problems. Recently, one of our new 22 yo new grads has been getting abused at night, given assignments that are very high acuity(while others are sitting on their butts, but are favorites), and considering leaving. Every morning she is crying and scared for her license. To me that is unacceptable! If an educator was assigned to follow their progress at night, or some management was on....perhaps she'd have the support she needed...perhaps, a couple of these charge nurses would get their butts kicked a little. What is that saying about absolute power corrupting? A couple of our PM charges definately suffer from this.

Although I am sure many agree they are a pain, in this case I believe they may actually be an asset.

Maisy;)

Even the smallest hospitals I've worked have had clinical on-call. In a case like that, where an assignment is truly too much or even dangerous, you work your way up the ladder. If the charge nurse won't address it, you go to the supervisor, if they refuse then you go to the clinical resource on call. Hell, call the unit manager at home if need be. But there's no reason to allow that to happen simply because the suits are not in the building.

[MAISY, RN-ER, BSN, RN]

Good point. I'll pass that along to our newbie. No one should ever be abused the way this young woman has been abused. No patient's safety should be disregarded, the way it has been by giving a new, inexperienced nurse multiple high acuity assignments. Especially with other nurses having none!

Maisy;)

[clemmm78, RN]

BUT, the one thing that really sent me over the edge was when a day/pm nurse had the balls to tell me - "You just have no idea how busy it is on day shift - maybe you should work a few so you have a clue":angryfire

Oh how I remember that well. The last place I worked had someone who couldn't keep her comments to herself. One time, when I made a comment about it being constant all night (I didn't say busy, I said constant, which is a big difference), she threw her pen across the table and said "M.... you have no idea what it's like to be busy. You should come and work days and know what it's like." She did that a few times.

Funny thing? I did go work days for a while. Drove me nuts. Why? I am not exaggerating. The day staff would come on and if no-one was in dire straits, they would sit at the station and talk, decide who was going to take which patients, talk, talk some more and then finally start rounding. I remember asking who my patients would be "oh, we'll decide in a bit," when I found out, I wanted to go check "Oh no, we'll all go around together shortly." Drove me insane. Absolutely insane.

And, this wasn't just me saying it. Others who worked evenings and nights who had to come on to days sometimes said the same thing.

I'm pretty lucky I think. Most of our dayshifters worked nights on our unit before going to days.

Problem is, many of them have very short term memories.

[Tweety, BSN, RN]

Boy do I know exactly what you're saying. I worked nights for 13 years, all on med-surg and it was busy busy busy. Sometimes in the wee hours of the AM there was time for get my act together, but I usually ate while charting on my 8 to 10 patients, checking charts, etc. etc.

On the other hand, I often heard nights complaining about days "I can't believe they didn't hang that blood", "this patient didn't get bathed today", "the admission data base wasn't done", on and on and on.

Mutual respect runs both ways.

I've been on day shift the last 3 years and am still working my butt off, with a whole new set of issues and priorities. I've always been a great person to give report to both day and night because it's a 24 hour business and I pick up and go from wherever I have to pick up and go (with reason, I hate laziness).

I personally don't have a short memory, I remember how rough night shift is, physically and mentally.

[registerednut1221]

As a day shift/former night shift nurse, I know that both shifts have both benefits and drawbacks. I have given an IM injection to a sundowner patient through his pajamas @ 0300 while chasing him through the freakin' parking lot because he was certian I had stole his truck and kidnapped him. I have called smart @$$ docs in the middle of the night a million times only to be raked over the coals for reporting something in the middle of the night that I would have been raked over the coals for NOT reporting, had I not reported it. I have had to admit a spanish speaking patient in the middle of the night (no translator) with my one semester of spanish. Been there, done that. BUT I have also had to put 6-7 patients back to bed after PT got them all up for each meal. I have transported patients out and back to dialysis (bed and all). I have to deal with family members in and out ALL DAY LONG that are adamant that there was absolutely NOTHING wrong with the patient and we are the reason this patient is now sick. I have to pass meal trays 3xs a day with every patient needing to use the bedpan/bsc EVERY freakin time I go into the room. I have had numerous occasions when every single one of my patients had STAT orders at the same d@^& time. All this being said, I am the nurse that is known for being the "night shift advocate" on my unit. I will keep your squirrly @$$ patient up and entertain him all day so that he MIGHT actually sleep tonight. I explain to the doc why it might be more beneficial for the patient to have klonopin 3x's a night rather than 3x's a day. I am the nurse that is there until 2100-2300 making sure that all your patients that are going out for procedures first thing in the am are all but ready to go. I am the nurse that stays over (often until 0100-0400) because 2 of your nurses called in sick and I couldn't leave you with 9-10 patients (and I'll be back @0700 to relieve you). Patients pull ot their NG tubes/peg tubes/picc lines/foleys on days too. They get out of bed and scream their freakin confused heads off all day long too. This day shifter knows full well what it is like to work on nights, but I also know that days aren't a cakewalk either. My rule is that if I have forgotten something/not had time to do it, you cover me and I'll cover you. We're all in the same boat...just keep paddling.

[TXNurse52]

As a day shift nurse, I have to give my 2 cents. I used to work nights and I know it's not easy-you have less resources and everything. However, here is my problem on my current floor.. Night shift usually has a tech, days usually don't. Night shift complains about having 4 patients (we all have 4 on days too), discharges, admissions, patients with TPN/IL, patients with a PCA, patients with NGTs, and basically any patient who is breathing. Nevermind the fact that on our floor of 24 beds, it is not uncommon to discharge and admit 13 patients a *day*, oftentimes without a tech. That's without counting all of the procedures we send them to and all of the people we work with everyday (nutrition, MDs, NPs, PT, OT, etc.). Then there are the other floors, ICU, and PACU that insist on bringing kids up at 1850 and we are expected to have everything done by 1900 for report. My absolute favorite part of the day though is when the night shift nurses come in at 1900 and complain because orders from 1845 weren't signed off. I'm sorry but they know the MDs round at 0600 everyday and they never sign off or do anything written after 0630.. So don't complain to me about it! I know night shift is busy, but don't assume that just because things didn't get done we are *lazy*. Several of the night shifters on my floor are there because they couldn't hang on days but those are the rudest ones when we can't get things done. The best I can do is say I didn't have time to get to it. Like others have said, it's a 24 hour job.

[SarasotaRN2b]

I agree with OP - you forgot the five people on bedchecks that try to crawl out of bed every 15 minutes.

Don't forget those patients with Sundowners syndrome. During the day these patients are totally coherent or they are sleeping all day because they were awake all night.

Kris

[SarasotaRN2b]

As a day shift nurse, I have to give my 2 cents. I used to work nights and I know it's not easy-you have less resources and everything. However, here is my problem on my current floor.. Night shift usually has a tech, days usually don't. Night shift complains about having 4 patients (we all have 4 on days too), discharges, admissions, patients with TPN/IL, patients with a PCA, patients with NGTs, and basically any patient who is breathing. Nevermind the fact that on our floor of 24 beds, it is not uncommon to discharge and admit 13 patients a *day*, oftentimes without a tech. That's without counting all of the procedures we send them to and all of the people we work with everyday (nutrition, MDs, NPs, PT, OT, etc.). Then there are the other floors, ICU, and PACU that insist on bringing kids up at 1850 and we are expected to have everything done by 1900 for report. My absolute favorite part of the day though is when the night shift nurses come in at 1900 and complain because orders from 1845 weren't signed off. I'm sorry but they know the MDs round at 0600 everyday and they never sign off or do anything written after 0630.. So don't complain to me about it! I know night shift is busy, but don't assume that just because things didn't get done we are *lazy*. Several of the night shifters on my floor are there because they couldn't hang on days but those are the rudest ones when we can't get things done. The best I can do is say I didn't have time to get to it. Like others have said, it's a 24 hour job.

I have to say that there is a benefit to nights of having less to deal with many of the things you've mentioned. Even if the nurses are very busy with the patients...day shift does have to deal more with families, doctors and managers/supervisors.