Shift Wars! Just need to vent...

[RxOnly]

(This turned out to be a novel! Sorry.. had a lot to say!)

I work 11pm - 7:30am four nights a week at a court-mandated substance abuse detox facility. I love working nights and I really like the job, but lately I've been getting stressed out so easily at work and I think it's because of those never-ending "shift wars". Admissions start coming in during the 3-11 shift after the courts close. 3-11 has been cut from 3 nurses to 2 due to budget constraints, so more and more admissions are rolling over onto the night shift. For the most part, the nurses that work 3-11 bust their little behinds and get as much done as they possibly can- and us night nurses greatly appreciate it!

There are 2 night nurses, so we split the work up the best we can: calling insurances (which takes forever!), completing multiple admissions, verifying their medications with the pharmacy, preparing the next day's discharges, preparing the methadone lists, charting on all of the detox clients, caring for 30 clients on the detox unit, sharing responsibility for the other 90 clients on the stepdown units in the building, doing controls, 5am med pass on the detox unit, 6am blood sugars for all diabetic clients in the building, rounding throughout the building every 2 hours, plus all of the general "housekeeping" duties like putting together more protocol sheets and filing, etc. There is plenty to do to keep us busy for eight hours.

Here's the big problem: the day nurses don't get it. They don't understand that the admissions process with clients takes up half of the shift (while we're juggling our sick clients on the unit and trying to keep up with rounds at the same time) and the paperwork duties take up the other half. They insist that night shift is easiest and that nothing should be left for them in the morning. Usually nothing is left for them, but they huff and puff if they have to make so much as a phonecall to a pharmacy that was closed overnight! We give excellent care overnight, but I still get bombarded with questions that make me second-guess myself during report. One nurse (who I'll just call "S"), is a very nice girl and a newly licensed B.S.N. who started her first job at this facility about 8 months ago. Forgive me for saying this, but she's a plain old know-it-all who DOESN'T know it all. We get along great when we just chat about life, but she talks to me like I'm a toddler when it comes to nursing and all but faints when someone's systolic creeps even slightly over 140 (Hello, they're detoxing! Good BP's are hard to come by at this place! Plus, we always address them if need be.)... When another nurse made a comment about how easy we have it on night shift, I was quick to defend myself by saying "Things have changed so much since they cut that 3rd evening nurse- lots of admissions roll over to our shift and it's extremely time consuming". "S" replied with "Well, I've worked so many Saturday nights and I know how easy they are." The thing is, she hasn't worked a night shift since they've cut the 3rd 3-11 nurse and there aren't any admissions on Saturday nights anyway! I willingly admit that weekend nocs are easy, but I work mostly weekdays- she has no experience to pull from in regards to judging how a weekday overnight runs now. Of course I couldn't think of a way to say this to her nicely, so I just told her that I'd "agree to disagree." This isn't the first time I've been made to feel like this. I guess I just want a little more respect for night shift, and I don't know how to get it. I put 200% into my job and I do what I'm supposed to do, what more can I say?

Can anyone else relate? Reading back on what I wrote, it doesn't seem like a big thing... maybe I just need to learn not to sweat the small stuff (easier said than done!). I'd love to hear your stories and learn how some of you nurses have dealt with your "shift wars" ... thanks for letting me vent!!

[RxOnly]

You aren't hijacking, believe me!!! Hearing your story makes me realize I'm NOT crazy, haha! And I COMPLETELY agree with you about the crash cart! I fill in on days at least once every 2 weeks, never had a code, and the day nurses insist they get multiple codes daily.... yet I rarely have much to restock during the nightly checks... HMMM

Same here....we hit the door running, yet they stroll in late almost every shift, go get coffee or breakfast BEFORE getting report, chat up their charge nurse about how their kids did in a play or soccer game while we're ready to go HOME....

We have to sort out scrambled charts, wake up docs to report labs that were bad at 3pm, deal with meds not given (sometimes for a good reason, like pt off floor for procedure, but some...?) which throws all the schedules off, which means we have to call the nightshift pharmacy. Talking to those folks is a horror at best. I called one night for patient with an allergy to to vicodin, codeine and morphine but had no problem taking tylenol, to tell them not to order the tussinex, and the man had the nerve to ask why? Hello, allergy to vicodin? What do you think they're reacting to? Days have inhouse pharmacy which is at least marginally better. If they have to slide a dose, they could at least call the pharmacy and get the meds straight since they went crooked on their shift. I just love waking someone up at 2 am to give them a lovenox shot that was originally 9 and 9 but slid on dayshift because the patient was "resting" -- like it will be better to wake them up at 2 am?

Having worked both shifts, night shift does work harder for less credit. Like tothepoint said, people like to pass away at night, particularly around sunrise for some reason; they also like to go bad during the night. But dayshift acts like they're the only group to ever have to crack the crash cart...which we check, inspect and restock each night, as well as all the rooms, give the baths, take out the trash, reorder supplies, do the dressing changes that always seem to get "missed" change the aged out IV lines and hanging meds, do the TLC dressing changes and cap changes....I swear, I've never seen a day shift nurse's initials on a changed triple lumen dressing... Last time I worked days, I had all my meds given, both vent patients bathed, dressings changed, respiratory cultures sent, rooms perfect, fresh IV lines and bottles by 0930, while they're all wandering complaining how far behind they were! I asked if they needed help, and caught up 2 other patients (and I had the sickest, not the easiest by a long shot). They all looked at me like "how are you doing this?" Well, because I worked, not socialized...?

Didn't mean to hijack, but I feel your pain...believe me!

[RxOnly]

Oh I also hate late morning relief nurses. By the time the ned of my shift rolls around at 8am my bowels go into revolt and I need to be home soon lol.

I think there is no excuse to be late coming in the morning. You got to have a nice nights rest. I am always early for day shift because I know at the end of a night shift your body starts to shut down and you start to feel sick.

I work rotating shifts so I experience it all.

Couldn't agree more! Our relief is supposed to be in at 7am and it's a rare day when they arrive before 7:30!

[Pepper The Cat, BSN, RN]

Exact oppisite where I work. Night shift comes in 15, 20 minutes late, yet leaves at 7:30 AM on the dot. They don't re-start interstial IVs, just leave a note asking day shift to "reassess need". They don't answer call bells after 7:00 - just tell the pt to "wait for the day shift". (I have heard then say this!). They don't collect specimans. They won't call an MD for pain meds - just let the pt suffer all night and leave a note to have day shift ask MD to "reassess pain meds". God help the pt who rings every 4 hours for pain meds - they are labelled "med seekers" and left to wait for pain meds.

They take at least 2 hour nap breaks - days are lucky to get 20 minutes for lunch.

I could go on but I've said enough.

I don't think its the shift to blame - its the nurses.

[KarmaComesAround]

I understand completely where you are coming from. Seems like where I work it is day shift vs night shift, techs vs techs, nurses vs techs...the list could go on. It gets so old hearing the bickering, complaining, and tattling. It amazes me the people that will write up another person or send a note or talk to the manager for something so simple that they could just address it with the individual.

I work both shifts, so I see both sides. Both day and night shifts are busy for different reasons and tasks. I agree that we should walk in someone else's shoes, as the quote says...

Best of luck. Maybe you should talk with the higher-ups about needing an extra nurse on weekday nights. But I know sometimes that goes in one ear and out the other...budgets=boo! Worth a shot though.

[wooh, BSN, RN]

They should also be required to repeat this for any trouble they instigate with their moaning and complaining.

Sounds great. Until an ingenious nightshifter that's on the waiting list for dayshift figures out the more they complain, the more they get to work days!

[mama_d, BSN, RN]

Jeez, I need a nap just after reading OP!

It used to not be so bad where I'm at, until days lost 95% of their strong experienced nurses. Now we've got a bunch of newbies being trained by the...lets say...less diligent nurses who are lacking in (or are too lazy to use) critical thinking skills. The really sad thing is that a handful of the newbies seem to have a lot of potential but have been trained and ingrained in the floor culture by inferior nurses. And by floor culture I mean the attitude that is prevalent now that the night shift can do whatever days wants to dump on us even though we have less staff and less backup.

Our night shift is awesome in general, we only have a couple of weak links. I just wish mgmt would have the newbies train on nights with competent nurses instead of on days with incompetent ones.

[Indy, LPN, LVN]

Heh. We don't have much in the way of shift wars, at my current job both shifts are too busy trying not to drown. We're generally nice to the oncoming shift, whatever it is, because we want them to show up the next time!

I do hear a lot of "it's hectic" from days. I mean, a lot. It's ok, families are there, I know it's difficult when everybody's awake. So I did a 16 a while back. I took my load that I had from the night before and tried to remember that it's a whole new shift so stuff resets. I straightened my rooms, bathed two patients, cleaned up poop, did 9 am meds... and turned around and it was 0845. This along with having to track down my coffee cup because someone didn't want the bigwigs to see my coffee, and hiding in the break room for 15 to eat something like breakfast.

Then I turned around and confounded the secretary after getting a critical lab... by asking for the rest of my labs to be printed off. She didn't know we have to do something with that info within 30 minutes. Nor did she ever expect a nurse to demand that she quit filing her nails and do something. Then the doc arrived, IV meds were hung like christmas lights (there were a lot), and familes wandered in and were updated. Whew. At 1100 when I was ready to report off, there were people who had taken a breakfast break, and had the assistants running like they meant business, but hadn't completed AM meds yet. I was sort of ... confused. It might have had something to do with a few of 'em walking around like they didn't know the walls were supposed to be beige.

I guess my training was to always run like your butt is on fire, and hope to god nothing worse happens to make you not early getting your things done. That way when people die, code, crash, go to the bathroom 15 times, have an allergic reaction, hit the call bell endlessly, or just plain need to talk, you have time for some of those things.

[murphyle, BSN, RN]

I can't really say that we have shift "wars" in my department... minor armed conflicts perhaps? In all honesty, a lot of the "war" seems to me to boil down to individual personalities versus a defined hostility between shifts. KarmaComesAround has a very good point, too, in fingering a culture of opposition and one-upsmanship as feeding the whole "shift wars" phenomenon. We're lucky that we don't generally have a whole lot of that where I work; a little yes, we're not all angels, but as a rule it's pretty low-level compared to what I've heard from other units and other facilities.

I think pretty much anywhere you go, there will be certain day-shift staff who will leave the oncoming night shift a department in flames and a team full of excreta and expect it all to be taken care of by 0730... oh and don't forget to restock all the carts and make a fresh pot of coffee before they come back in the morning, please-and-thank-you. However, on the flipside there are also day people who will leave you a marvel of modern nursing, have everything done and the admissions all tucked in and the discharges all dressed and ready to leave, and then offer to cover resus until the night nurse gets out of report or take your ICU patients up to the unit, whichever would make your life easier. On the night side it's the same story; we have people who bust their fannies all night long and people who sit on their fannies all night long. I know which I'd rather be, and which I'd rather work with, and I hope that those around me, day or night, see it the same way.

In shift politics as in just about everything else in life, a little Golden Rule goes a long way. :)

[prinsessa]

We don't have too much problem between the shifts. It does get kind of annoying when day shift complains about have to leave late sometimes. I work 3-11 (and not by choice) so I would love to get out at 5P. You would like to have dinner with your family? So would I. When I ask them how they would like getting out at 1A I never get a response.

[southjerseymrn]

A lot of good points are made in this thread, but it seems that many of the post perpetuate the shift war problem. I"m new to nursing (9 months) but have worked in another industry for 9 years and have worked on on every shift. There is always the thought that the other shift doesn't do anything....in nursing and every shift type work. Now I work day shift on an oncology floor, and I feel like I'm being interrogated during my report from the night shift, it's sad but sometimes the most stressful part of my day is when report time comes. I think some of it is because I'm new, because I don't ever see them give the more experienced nurses a hard time, but after they give me a hard time I run the situations by my charge nurse and she says that I'm right and the particular nurse is crazy. I understand every shift has its challenges, at times meds are passed to me in the morning and other task and I just smile and say that's fine don't worry about it. ARE WE NOT A TEAM? it's a 24 hour operation, task will pass from shift to shift..right? I believe we should support each other, not attack and try to push people down. In my short time in nursing this is a major problem that I see.

[AOx1]

This whole "nothing should roll over to my shift" irritates me on both ends! Having worked both nocs and days, I can relate. Nursing is a 24-hour job, and BOTH shifts should be understanding of the other. If she keeps it up, she should be offered the chance to come in for a few night shifts to see how things really are. I did this when I managed: those who whined about other shifts were offered the chance to switch to that shift either temporarily (to see what things were like) or permanently (if they thought they could do so much better), or to shut up and stop whining if they refused that option.

Of course, there is a difference between things occasionally carrying over and having that ONE coworker who never seems to get things done while having time to shop online, read, etc. This type of thing should be addressed by management. However, this doesn't sound like the case at all in your instance. It sounds as if cutting the staffing of the shift before has caused the work to roll downhill to the next shift, and so on. In part, it sounds like a staffing issue, and also like a new grad who is clueless.

[Poi Dog]

All shifts should realize that the "woe is me" look is so not in.

The place I work at engages in shi!, oops, shift wars too.