First, congratulations on becoming a nurse. It is definately one of the most rewarding careers one can have. You will see the best humanity can offer-and (unfortunately) some of the worst.
I don't want to repeat what has already been stated in the earlier posts. This is more a comment on one of the earlier posts. If you do end up working night shift, and you might being 'the new kid on the block', you may find that you LOVE it. I have been working nights for 19 years and won't even consider working another shift.
Yes, you are there for the patient. But you also have to work with the doctors. DON'T CALL IN THE MIDDLE OF THE NIGHT FOR EVERY LITTLE THING! You will quickly get on the doc's hate list. If you ask him for anything, he will just say 'no' to spite you. There are 3 times to contact the doctor-
2. call him before the end of your shift
3. pass the information to days and hope they carry through, and/or leave a note on the front of the chart. (I prefer leaving a note, 'cuase sometimes the day nurse may not even see the doctor on his rounds.)
Your own gut feelings and experience will help. If in doubt, ask another nurse for her opinion, or your nurse manager/night shift nursing manager. If still in doubt-call. Better to be safe than sorry.
I have often times called for a vital sign that is out of whack, only to find out from the doctor, this is the patient's normal. Ask the doctor for some parameters, then so you and others will know when to call, and he is not called needlessly. They are usually good about doing this if they know this will get them some more sleep.
If a patient asks for something you don't have an order for, like a sleeping pill, you really don't have much choice but to call.
If something is out-of-whatck, try to eliinate some possibilities before calling the doctor. If your patients suddenly seems confused to you, is sun=downer's syndrome a possibility, hypoxia (most places now have non-invasive digital oxygen saturation monitors to use), if diabetic, take a fingerstick blood sugar and see if it is low. The doctory will appreciate what you can do to help eliminate the possibilities before calling.
When you DO make that call in the middle of the night, the doctor will be more cooperative (usually) in giving you what you want. And if you don't call in the middle of the night for every little thing, they will also respect your decision on making that call. I have called a doctor in the middle of the night just on gut-feelings when everything appears normal and be acted upon.
And if you find something that legally impells you to make that call but if not for your own license wouldn't make the call, I have then even told the doctor that this is a C-Y-A call.
And if for some reason night shift itself does not work for you, let your superior know. My hospital is real good about getting some one off nights as quick as they can if working night shift causes family strife, or you just CAN NOT sleep more than a few hourse a day, even after several days of seriously trying to adjust.
And remember there are 2 basic types of doctors. The ones who think they are gods and would love it for all to worship the ground they walk on. And second, those doctors who see themselves as a collaborator with nurses for the patient's health. This doctor may even ask for your opinion when you call him in the middle of the night. And don't be afraid to give it.
I realize this reply bacame much longer than I even thought it would be. But I felt compelled to comment about calling the doctor at 3 in the morning every morning for your patient. You do this and the doctor may question your judgement and may not act at a critical time when something really needs to be done.
To moderator=feel free to shorten this as much as needs to be shortened.