Night shift -- can you just take it easy, please? - page 3

I'm a day shift nurse. I usually handle 5 patients on days on a busy cardiac tele unit. On any given day shift, there are usually ten different tasks on 5 different patients, many more demanding... Read More

  1. by   assidere
    I've rotated 4-5 times between days and nights due to staffing issues, so I am very familiar with both sides of the coin. In this time, I have noticed two popular phrases "That's a DSP (day shift problem)" [spoken by night nurses about non-routine new intervention after 3AM], and "I just didn't have time. You see how busy this place is" [spoken by day nurses as an explanation about why routine interventions were'nt completed by 1900]...

    I've heard many people say (sadly enough alot of it was from instructors in school), that nurses are famous for 'eating their young.' Even though this isn't an experience vs. inexperience issue in regard to the original post, I believe the same principal hodls true. A lot of times we as nurses fall short of solid teamwork and communication, two things we're supposed to be good at...

    My favorite staff development coordinator had a phrase: "Always do your best to set the oncoming shift up for success." I wish more nurses wokred this way and I think if they did, we as a profession, and our patients, would have better outcomes...
  2. by   WillowNMe
    Hm, if it is stressing you out that much I would definitely think about moving to nights, bringing this up when a nurse does this, discuss with management or go to a different unit.

    I have worked overnights in LTC for years, but just recently switched to nights in my acute care job. I think the argument of which shift is easier, harder or busier is null and void. I'm sure we can all agree that each shift has its trade offs - and more importantly, its different for each hospital and each unit. Not to mention personal preferences. So instead of grouping all shifts together and pitting them against each other, I would suggest aiming for what is causing the issue and make your hand off better for yourself. No sense in ending the shift on a bad note.
  3. by   elthia
    Quote from SoundofMusic
    I'm a day shift nurse. I usually handle 5 patients on days on a busy cardiac tele unit. On any given day shift, there are usually ten different tasks on 5 different patients, many more demanding family members with zillions of questions and demands, interns who sit around dreaming up new stat orders to write, never enough techs or techs who want to help, endless lines of little old ladies who need to visit the bathroom 10 times a day . . . managers who seem to rove around, checking out paperwork and whether you've fufilled each and every educational requirement scheduled.

    ...If I don't get to that ONE urine test, or that ONE timed blood draw ...can you just stop rolling your eyes for once and just HELP me make up the slack? Surely you've got at least a few free minutes at night to do this ...

    I've worked nights, too. I know how it is . get busy, too ...but you DON'T, I repeat, you DO NOT have to deal with what we do on days ...diets, tests, procedures,, and many more meds to give. It's likely I am NOT going to get it all done ...not w/ 5 demanding patients, NOT with discharges and admissions way, no how. I am also NOT going to reach every doctor and solve every single problem all day long so YOU can have a "quiet" night and not have to call a doctor once in a while ....

    Sorry -- know I'm going to be flamed for this ...but I just can't stand it anymore. Nurses need to work together and stop putting down their co-workers constantly for not completing every single freaking task in one shift.

    I hate shift wars...I truly do.

    Each shift is varied and unique.

    The same doctors, NP's, and PA-C's that are polite and shake my hand during 0900 meetings and inservices are rude and yell at me when I call them at 0100 in the morning because a pain med expired.

    Or if I get busy because of a near code situation and the LVAD pt's driveline didn't get changed till 0200, and he has orders to not be disturbed between 2400-0600. But dayshift was too busy to change his dressing, yet I get faulted for disturbing his rest and not doing it earlier, however it was dirty and needed to be done and couldn't wait any longer.

    Or I come on shift and 4 out of my 6 post op patients need to walk before bedtime and night shift has less aides than dayshift, and I have 3 1/2 hours to do this and get my meds passed and get them tucked into bed,yet I can't physically walk them all at the same time and pass my meds without them being late, and I get dinged for the patients not meeting their cardiac rehab.

    Don't lump a few bad apples into the whole bushel. Not all night shift nurses are bad...not all day shift nurses are bad. Not all nurses have crappy attitudes. There are some day shifters I love to follow after, there are some that it is like following a train wreck in slow motion. The ones that will not have a single admission, no discharges, work the weekend, and you just know you will spend the entire shift playing clean up and catch up and praying that no one is near death when you come on. Then there are the golden apples that can turn over all their patients, have spotless rooms, and send all their labs off, apologize profusely because the pt only has 1 IV site and multiple IVPB's, yet all the admission assessments are done.

    I worked day shift too. The greatest difference I find between night shift and day shift...on day shift you can spread your work over your shift, but it is hard to organize your day due to tests/procedures/visitors. On night shift you have to cram all your assessments and treatments into the first part of your shift because the patients get really cranky and upset if wake them up for dressing changes or treatments after midnight or before 0400. I can't walk post op patients after 2300, or before 0500, unless they request it. So if I am too busy to do it before or after those hours, it doesn't get done. If I have more than 2 patients with complex dressing changes, and I have an emergency, my whole night is screwed.
  4. by   wyogypsy
    We all can have busy shifts and not get everything done. I always try to give the person I am relieving the benefit of the doubt. After a bit of time I learn who the slackers are and am not quite so nice to them - so just make sure you aren't one of them and realize some people won't be happy whether you have everything done or not!
  5. by   canesdukegirl
    Quote from assidere

    My favorite staff development coordinator had a phrase: "Always do your best to set the oncoming shift up for success." I wish more nurses wokred this way and I think if they did, we as a profession, and our patients, would have better outcomes...

  6. by   Roy Fokker
    "My shift is more bad ass than yours!"
    "No! MY shift is more bad ass then yours!"

    I usually find that it's not a "shift problem" but more a "nurse problem".
    It doesn't matter if you're coming in at 7a or 7p - but if you're taking report from certain nurses, you know your shift just got a lot harder than it needs to be.

    What's the solution?
    Strive NOT to be "that nurse".

    Nursing is a 24 hour profession. Sometimes stuff just can't be done on time. It happens.
    And if and when it happens - just remember, it's not about you, it's not about the preceding shift, it's not about the nurse --- it's about the patient.

    Just get it done.
    To bastardize a principle: We can only make our own karma. What everyone else does is on them.

  7. by   glutton4punishment
    If youare looking for validation that nights are easier, here it is! I just switched to nights as a favor, and my gosh, sooo much more relaxing. I have to agree with neopedi we all should work together and help each other out rather than playing the "whih shift works harder card." I have been on nights for three weeks, and I told my sup that I want no part of the day shift anymore. Days are crazy, but but don't make it about day vs. Night...there are A hole nurses on both shifts...
  8. by   Poi Dog
    The nurses I work with get irritated when it is the same person(s) on a shift who passes the buck. There are a few of them whose favorite phrases are "I didn't have time to do it." "Can you follow up on this?" I know because I hear the same people say that during report.
  9. by   Illinurse2010
    I am tired of the shift wars too.. I do as much as I can on nights to set up the day shift--but put the blame where it belongs on the business nature of healthcare business that demands our perfection and unreasonable amounts of work--not each other. Its counterproductive and all it does is make us look bad as professionals.
  10. by   nerdtonurse?
    Quote from SoundofMusic
    Just to remind night shifters, think about the following very time consuming tasks we are required to do that you are not required to do, or are usually unnecessary on nights:

    1. Provide a daily report to case managers and/or attend rounds. ===Last night I had patient go bad and had to go to CT with them for an hour while they did one thing and then another. Off the floor, and giving the patient blood.
    2. Walk patients off the unit at discharge and/or when needing to be accompanied to test and RN to leave the floor to go with them. -- True, we don't walk them out. We're usually flying them out or transfering them to the big flagship hospital in the state capital, giving family members directions, calling them at home and waking them up to tell them their husband's troponins came back positive and if he doesn't fly, he dies.
    3. Arrange for diets, re-enter diet orders, take away trays, fulfill diet requests, fill pitchers, grab coffee, grab condiments ...generally play waitress for THREE meals on your shift. We don't have meals, that's true -- we just feed all the relatives that come in to sleep and get the patient to ask for sandwiches, sodas, drinks, etc.
    4. Receive calls from family members wanting updates, or just wanting to talk to a nurse -- sometimes as often as every 2 hours. Call them if requested. Connect them to doctors for updates. Generally fulfull every request they make concerning your patient. Daytime is when they do this ...nights they go home to sleep. Usually. (I realize SOME do spend the night and then they can be a pain to you -- but it's not as often). == they do this at night, too -- and it's fun when they're all calling because they aren't speaking to each other, but they all want to speak to you. Or 3 of them want to spend the night and expect you to be nurse and also run a hotel.
    5. Tests, tests, tests. Patients who return from tests ...needing frequent vitals, needing tele on, tele off, needing boots, transfers, etc, etc. -- we do all of that too, dealing with orders for SCDs, feeding pumps, etc., that weren't done on dayshift when there was someone with a key that could go get spares out of the basement.
    6. Orders non-stop. Most orders are put in on days don't like being called at night and we all know it. They do their orders early and you have to get most of not all of them done on your shift. -- Sounds like your shop's different then ours -- we had dueling docs writing and dc'ing each others orders until after midnight last night.
    7. Admissons (yes, you do them on nights), but most discharges on are done on days. Discharges come with: med reconciliation/education, getting signatures, more education, taking out IV's, helping pts get dressed and ready to leave. -- we get the ER admits who are PO'd because they haven't had anything to eat, are now NPO, and are calling family to bring them food. We DC people to other facilities or take transfers in from other facilities almost every night. And we're putting in IVs all night as the sundowners and Alzies pull them out.

    This does not include the occasional code, elopment, fall, or whatever crisis might happen on any given day. Doesn't inlude arguments, difficult patients, or having to explain and educate on each and every med given at 1000. -- no, just the 20 pills on the 2100 pass and then the endless "well, I take x, y, and z to sleep" when the doc has stated he's not reordering what's got the pt in trouble to begin with.

    Need I go on? And let me ask you this ..what happens when your tech staff is short or unwilling to helop we dayshift nurses get to add baths, filling water pitchers, and vitals/sugar checks to our lists . . . -- we bathe all the total cares on the floor, vent patients if I'm in ICU, and we're doing q2h fsbs with half the staff...

    How do you think we can get it all done??? It's not possible. It just isn't. I wish more night shift would realize this. -- and I wish more dayshifters would come work with us for a month if it's easier, rather than acting like all we do is bathe people and empty trash.

    I have known many a day shift nurse who burns out and goes to nights because they can't stand families, docs, managers, and all the rest of the people we deal with on days ...many of those nurses seem to become some of the most demanding and uncompassionate nurses towards the day shift, from my experience. -- because they're run ragged.

    Remember, please ..what is is like to work the day shift, before you criticize. -- I have, I did, and dayshift has more staff, more support, and when the idiot in a room breaks the water faucet so that water is JETTING into the ceiling, you don't have to wait the 30 minutes it takes someone to come in, while you've got staff slipping and sliding around.

    I'd LOVE to do nights if I could, but my body can't do it for some reason. And I really appreciate night shift people who do this, because I can't. But I wish they'd appreciate ME and all i do on days ...and try to take it a bit more easy on me at 1930 at change of shift.
    == and I'd work dayshift if I could afford it, but I can't. And I'd appreciate it if the folks that I hand off to realize I spent all night trying to keep the sundowners out of the floor, bathe people who rightfully don't want a bath at 0300, restock all the rooms that I came in to find holding toilet paper and a single alcohol prep, that I spent 2 hours trying to get ahold of the tube feeding for my patient and when I asked that you make sure we've got Glucerna I'm not kidding.

    I know you're venting, and so am I -- I'm just tired of doing my shift and half of someone else's every single night I work.
  11. by   carolmaccas66
    I worked in the ED/ER just recently.
    I had to take over patients who were sitters (sitting down waiting for a bed), and bed bound patients. Nearly ALL the patients who had medications written up and who had been admitted that morning (some very early), had NO medications ordered, and because we got so busy, nobody checked until we had to give 2000 meds - and found we didn't have them all. And I spent half my night with little old ladies who couldn't toilet themselves - one who had been given a mountain of stuff to help her bowels move - so she kept saying she needed the toilet, then nothing would come out. Of course I had to sit and stay with them all each time - this is what wastes a lot of time, when management won't pay for sitters to stay with lols/confused peoples and do these tasks.
    Nights can be busy but it's a different kind of busyness. I agree that days are worse - more people haggling you, everyone needs a bath, more toileting (it seems) etc to be done. These last 2 duties take up LOTS of time, IMO.
    But I suppose I just get mentally resigned to it - if something hasn't been done, we hand it over, that's what nursing is about. I mean I transferred a patient (she wasn't specifically my patient), to a ward - no prior h/over had been done, she had no cannula and no drugs sent with her. The ward nurse was less than impressed, but hey! no-one had had time to do anything for her - she hadn't even been on a bed b4 going up to the ward - or everyone had just assumed she had these things.
    Days ARE crazy, I have to admit that, and some tasks can be handed over. I don't tell anyone off, though I might mentally sigh and curse in my head. I just get on with it now, and if I don't finish my stuff, I hand all THAT over. Too bad if the oncoming RN doesn't like it - it's part of the job.
    All I can say is, get used to it.
  12. by   darkangel83
    The nursing world would be a much better place if we all respected each other a little more! This day shift/night shift divide is absolutely ridiculous...and I work both on a very regular basis!

    I, too, believe that nursing is 24 hours and that sometimes things just don't get done (this goes for ALL shifts)! All I know is that I do my very best each shift to make sure the next shift is 'set up for success' (I like that phrase!). When I come in for my shift, all I expect is that the person before has also done their very best!
    Yes, sometimes there's a train wreck to clean up (day or night)...interstitial IVs, missed orders, bypassing catheters, angry family members...or heck, maybe even somebody in cardiac arrest, but it's all part of the job description! And really, if you haven't worked the shift you are taking over from (day or night) don't know how busy it was or everything that my advice...suck it up! Because the next time it might be you leaving something for someone else!
  13. by   joanna73
    Each shift is a different busy. I work permanent nights. I'm one RN for 30 people, with one NA. I give evening meds, settle people to bed, chart, stock for days, complete care plans, check orders, sign requisitions, clean, turn and change 25 people, and wash 7 people for days.

    I'm one nurse. Oh yeah...monitor IVs, get drugs from the night cupboard, and call the doc who yells for everything.

    Yes, days are busy....but so are nights. You also have to be more resourceful on nights because there is no support staff where I work. However, I do what needs to be done. It isn't a competition.