Working 16hr Shifts-Weekend Double

TheCommuter, BSN, RN · Jun 7, 2007

How do you manage your breaks/rest during that 16 hour period so you do not end up sleeping on the job?

I have worked 16-hour weekend double shifts at the same nursing home/rehab center for the past 16 months. I am unable to manage my breaks since I have been transferred to a busy rehab unit very recently. Sometimes I don't get a break. I haven't fallen asleep, though. If you think about it, the average person is awake 16 to 17 hours out of the day, and sleeps for 7 to 8 hours each day.

- How do you handle the charting (monthly summaries, medicare charting, e.t.c)

I must do charting on all 15 of my patients at least twice per shift, and more as needed. I also do weekly summaries on all patients that have been newly admitted to the unit within the past week.

- How to handle the dining room

I check the trays to ensure that each patient is getting the correct diet, then I allow the aides to work the dining room while I get back to work. I am always in close proximity in the event that a patient is aspirating, though.

- Handling family members (who probably show up in great numbers during the weekend)

Since this is an upscale rehab unit, some of the family members are excessively needy and outright abusive. I explain to them that this is not a hospital, and that I'm doing the best I can. I also attempt to satisfy reasonable requests within a reasonable amount of time. Additionally, I try to explain that I cannot schedule appointments or arrange for transportation on the weekends, since many of the entities are closed.

- Staying in touch with the weekday crew

I see the weekday crew on payday inservices, of which our attendance is mandatory. Personally, I prefer to not be around the weekday clique.

- I think to work a 16 hour shift you would have to take short mini-breaks (probably 5mins) then at the end of the first 8 hours then take the major break "30 minutes". This strategy goes a long way in resting the body.

That's an excellent idea, only if it could be put to use. However, it is difficult to escape for a break when I have three admissions coming in, med passes to 15 patients, several IV ABTs to hang, a bunch of wounds to dress, etc. This is nursing home rehab, so we do not employ unit secretaries or ward clerks to do our admit paperwork. I must do my own admission paperwork, and I often stay until midnight or 12:30am getting it all done, even though my shift ended at 10pm.

pat8585 · Jun 7, 2007

Do you get paid double time or time and a half for logging all those hours in one day?

TheCommuter, BSN, RN · Jun 7, 2007

Do you get paid double time or time and a half for logging all those hours in one day?

No, I simply get paid 40 hours for working 32. It's referred to as the 'Baylor Plan.' I do this in order to have Monday through Friday off (5 days in a row). Double time does not exist where I live, and time and a half is only reserved for those who work in excess of 40 hours in one work week.

Ready2BRN · Jun 9, 2007

I was thinking about switching my schedule to work 16 hour shifts on the weekends (7a - 11p). But at the nursing home I work at, we just get paid for 32 hours, not 40. I really just want extra time to study and working those hours would give me time during the week to do so. But thats a hell of a long day though. Anybody have any suggestions on how to get through such a looongg day?

brotherbear · Jun 22, 2007

I have worked 16-hour weekend double shifts at the same nursing home/rehab center for the past 16 months. I am unable to manage my breaks since I have been transferred to a busy rehab unit very recently. Sometimes I don't get a break. I haven't fallen asleep, though. If you think about it, the average person is awake 16 to 17 hours out of the day, and sleeps for 7 to 8 hours each day.
I must do charting on all 15 of my patients at least twice per shift, and more as needed. I also do weekly summaries on all patients that have been newly admitted to the unit within the past week.
I check the trays to ensure that each patient is getting the correct diet, then I allow the aides to work the dining room while I get back to work. I am always in close proximity in the event that a patient is aspirating, though.
Since this is an upscale rehab unit, some of the family members are excessively needy and outright abusive. I explain to them that this is not a hospital, and that I'm doing the best I can. I also attempt to satisfy reasonable requests within a reasonable amount of time. Additionally, I try to explain that I cannot schedule appointments or arrange for transportation on the weekends, since many of the entities are closed.
I see the weekday crew on payday inservices, of which our attendance is mandatory. Personally, I prefer to not be around the weekday clique.
That's an excellent idea, only if it could be put to use. However, it is difficult to escape for a break when I have three admissions coming in, med passes to 15 patients, several IV ABTs to hang, a bunch of wounds to dress, etc. This is nursing home rehab, so we do not employ unit secretaries or ward clerks to do our admit paperwork. I must do my own admission paperwork, and I often stay until midnight or 12:30am getting it all done, even though my shift ended at 10pm.

Good tips here. Why don't you like mingling with the weekday clique? Is that not where most of the power concentrates around? Anyway, you got a good grasp on running a 16 hour shift (can articulate it too :-)

On the mini-breaks, they (health & wellness magazines) say it refreshes you and keeps your body from more alert. However a lot of nurses can go on adrenaline. Some even going 20 hours straight.

crissrn27, RN · Jun 22, 2007

I was the weekend nurse supervisor at a LTC for about a year and did 2 16 hour shifts. I hated it. I felt like I was in a fog on the 3-11 part of Sunday.....such a bad feeling. I do know some folks handle it great. A lot of the CNAs I worked with there did 5-6 16 hour shifts a week and were fine. Don't know how they did that.

I always took a break around 5 pm and wash up, my face, feet, etc.....kind of refreshed me for the night. I never ate a heavy meal, that would put me out like a light. I finally stopped doing the weekend shifts when I began pregnant with my dd, it was just impossible for me after that.

txspadequeenRN, BSN, RN · Jun 22, 2007

i spent 5 years as a weekend ltc supervisor working 6a-10p . however, i never saw those hours sometimes i was there well in to the night , working 18-20 hours a day. now i work as a floor nurse 6a-10p work 32 get paid for 40. i have been doing these hours a long time and i am very organized with my time. as far as breaks i take one when i want usually every 2 hours or so for 10 min. plus working 16 hours you should get 1 hour for lunch/dinner, then you can split that up. my facility has 6 halls and one locked unit. i work on the locked unit and the medicare unit ,last weekend i think i had 14 patients (3 medicare, the rest behavior) but have the capacity to have 28 residents. i chart on everyone i need to twice daily once for 6-2 then again for 2-10. we have a schedule for the monthly summaries and i just go with the schedule. i also have my own set of skin assessments to do. i always do my treatments between 8-9a after dining room and morning med pass and then if they need to be repeated i do them between 2p-3p of course this depends on the shower schedule. i do them early because ..one you never know whats gonna happen during your shift and two i need those measurements so i can chart them....there is no way in h$ll that i would work m-f , i want to go in do my 2 days and get out. i don't communicate with the week day shift besides on the 24 hour report. in other places i worked the weekend nurse would call the monday nurse and visa versa. that seemed to work out really well...

dorselm · Jun 26, 2007

I am a CNA at a LTC facility on the skilled floor and I do doubles on the weekend. I work from 7am to 11: 30 pm. I'm not going to lie, it is very hard on my back. My feet are a little used to it but if I got my weight down, I think my feet would appreciate it alot better. We get 2 15 mins and a 1/2 hr for each shift. There is sooooo much to do on the 7-3:30 shift that I don't take my 1st 15 min but I do take my 1/2 hr break and my other 15 min before my 1st shift is over. Then I have some down time when the 2nd shift comes on so I can rest for a few minutes and go to the charge and change my shoes for the next shift. I find that changing my shoes gives my feet a rest and gives them new cushions for the next shift. The 3-11:30 is not as fast paced as the 1st shift so I can take all of my breaks and I use them to stretch and to sit back and clear my mind. By the end of the night, I can barely stand up straight and I pray the whole way home that I as well as my co-workers can get home safely.

dorselm · Jun 26, 2007

oops...charge=car

dede1956 · Oct 15, 2008

Having done 16hrs as both staff nurse and supervisor on weekends and during the week in the acute care setting, I am here to tell you that you are no longer as alert and effective at the end of your shift. I know I have worked with those of you that have done that. The research shows that after 8-10hrs nurses are no longer as quick or effecient and that is when the majority of the worst mistakes are made. I'll stick with my 12hr shifts and pick up extra 4-12hrs when I can, as my other committments allow...I also teach nursing students. :up: