Why is everything the day shifts responsibility?

[JenniferSews]

Maybe it's not like this at your facility but I'm curious. I work 6a-2p and it seems like everything is on my shift. I do 80% of the meds and ALL the dressing changes, treatments, etc. The evening shift will get more admissions than me but often they do some of the admission and the rest is left for day shift (usually the skin assessment that requires a complete assessment of the pts entire body with 2 nurses. There are only 2 nurses on each shift so that is hard at any shift) Is there some reason I don't understand why it's like this? Aside from the never ending med pass just the complicated dressing changes on my pt load (all sub acute patients, most post surgery of some sort or with decubiti) takes forever. Then I have weekly skin assessments, neb treatments, picc flushes, picc line dressing changes, other sterile dressing changes, the occasional peritoneal dialysis that runs into day shift, change a catheter, straight cath for a urine sample, 2x tb tests on new admits, and a dozen other little things that eat into my day. Not to mention, for the love of Pete, the charting! The other two shifts get treatments like "monitor bruising for s/sx of complications until resolved q shift." But for me there's that plus a complicated dressing change that takes 20 minutes when we're rushing. I'm getting really good at wound care, but I still changed 1 dressing 3x today because of the location of the incision and the drainage. Things like sample collection often get left for the next shift but I feel bad! I still don't pull a bunch of meds at once in labeled cups like others so I know that's holding me back but I just can't make myself do that. It has to be possible without short cuts, right? (please???)

I love the team I work with so I'm not complaining. But I'm a new nurse so I keep wondering if I'm missing some reason it needs to be like this. Eight hours is just barely enough time. I left feeling like I was leaving what may have been a declining pt to the evening shift because I just flat out didn't have time to monitor her like she probably needed. That would be the third pt in 2 weeks that may or may not be sent out that could arguably have been sent out on my shift. Do I just need more experience?

[ophirose]

Most things are left for day shift no matter where you go. I work in a hospital, and have worked on both night shift and day shift. Working the two shifts is like belonging to two different cultures. Just remember that nursing is a 24 hour per day job, and not to feel bad if you cannot finish something. Take your time, and above all else, remember patient safety.

[Student2Registered]

Totally true! I'm glad I alternate shifts for that exact reason, I don't ever want to be a night shift nurse that doesn't appreciate the workload of the day shift nurses.

[NurseLoveJoy88, ASN, RN]

I used to be day shift charge nurse and I got burnt out quickly due to everything due my shift, so i switched to evenings and have way less stress.

[lpn87]

It must just be the facility you work at because I worked night shift at a long term care facility and 3rd shift done ALL of the treatments and wound dressings but this new place i work at day shift does do most of the treatments and i think that its better that way because for one i hated waking patients up in the middle of the night just to change a dressing when someone could have easily done it during the day.....its just rude and if it were me i wouldnt want to be woke up so id say thats probably why most facilities are that way....remember you have to put the patient first and what would benefit them most :)

[NurseDevonL]

I experience the opposite, I work rotating shifts in a level III NICU so I am on both days and nights regularly.

Nights:

ALL fluid and line chages(with babies that sometimes have 8 pumps all going at once) all fluids and lines are changed q24.

Art line transducer changes

Baths (3 nights a week)

Complete bed changes

Weights

Measurements, code sheet updating

ALL labwork (unless stat daytime labs)

Parents still coming in

Same amount of meds and treatments

Days:

More admits/discharges

Rounds

More parents

Nights is STRESSFUL for me.:eek:

[Zookeeper3]

Shh, nights the best kept secret. Plus we get a $4/hr shift bonus for less meds, few docs, rare administration, few visitors and less stimulation. You on days get a normal sleep pattern and don't kringe at the yellow shinny ball in the sky:lol2:

[JoMark06]

I work night shift at my facility and a LOT happens on my shift. We do I/Os for 2 shifts (evening and night) with very little charted for the first 4 hrs of evening that I was not there, yet I'm still expected to enter an accurate I/O assessment into the computer. There are several other paperwork things only night shift does such as ITPs and chart reviews. We do all daily weights and if they are missed, day shift rarely will get them. All lab draws occur on my shift because the docs want their lab results when they round. Day shift rarely does dressing changes because the surgical team will do the morning dressing change and then the dressing will go untouched until night shift comes on. And I hear a lot the following: "You might want to call the doctor about XYZ because the pt did/said XYZ." Well, let's see....you have access to the doc all day (even if he/she is in surgery, an intern or a nurse will call back and you will get orders) by the time I get in to work, I have the on-call physician who doesn't always know the patient very well. Also, day shift has a HUGE amount of staff to assist with admissions, discharges, med passes, etc. Our NM and ANM are constantly helping out and there is always a sitter available on days to help sit with a difficult patient. On nights, we're on our own, with one nursing supervisor to cover 6 wards and if we want/need a sitter for a patient, that person comes out of staffing.

So, while day and night shift will ALWAYS disagree on who has the harder job, please take into consideration that each shift has it's difficulties and neither is entirely easy.

[CoffeeRTC, BSN, RN]

It is a bit different at my place. 3-11 gets all the admits, weekly dressing changes, daily dressing changes or any that are considered more difficult, vac dressings etc. Most of the daily IVs are also timed for 9pm. We still have the two med passes to do to. We have less CNAs too.

Days gets the two med passes, two meals and most of the discharges. They have the meetings to go to and all of the anicllary staff (housekeeping, maint, therapies, extra nurses too) They do most of the doc calls for labs and set appointments as needed.

I dunno??

[Schmoo1022]

At my facility..Of course days have the most meds and the most appointments, but we do split up skin checks and monthly summaries and TRXs. I worked 1st forever and it is easy to burn out. Especially in LTC, no matter what shift something happens on..first shift is asked what happened. State is usually in on first. Families, administrators, pharmacy, PT OT all in on first. They all take time away from the million other things you have to do.

[suanna]

How right you are. I've worked nights my entire career. Mostly I stay on nights because all I do as play games on the computer between naps. The patients all sleep quietly through the night and we have all the support staff we need. If there is a crisis the "night shift doctor" is always at my beck-and-call. On top of all that, I have so much more time with my family, (I'm sleeping- but I'm still "with them"). That is why there is such a long waiting list to get onto night shift!

[ScoopsPerson]

I work the evening shift at my hospital on a busy med/surg floor. I come in at noon and work until midnight. I do 3-4 med passes, discharges until 4pm..admissions from noon-mn. I can discharge 4 and then get 4 new admits in one shift. We do not have techs at my facility. My med passes can take 1.5 hours for 4-5 pt's as I am answering call lights, fetching water, snacks, dealing with upset family members in person or having to take phone calls, etc. I am lucky if I can do a full assessment! On new admits we have to draw all the labs, often start IV's..so I am trying to do this and pass my meds at the same time. Evening shift is responsible for totaling all the I/O's for 24 hours. Rectifying all the missed meds for 24 hours and clearing out all the PRN's for 24 hours. Did I mention we have no techs? I have decided enough...I am so burnt out and have not had a lunch break in over a year. I am transferring to night shift starting next month. I do believe I will sleep better, be able to eat a healthy diet, and my quality of life will improve. I have worked nights on and off as we have no float pool either and am asked to stay to 4 am. Nights is a slower paced at my facility. Instead of 4-14 admits....they may get 1-4. Sign me up!!! ( and only 1 med pass):)