The worst.

[soyoureanurse]

So, the other night we walk onto our unit to get report. One of the nurses wasn't there yet and she's usually about a half hour early. We are supposed to start report at 7. We waited and at 715 split her team up and we all took an extra patient. 4 nurses with 7 patients a piece on a tele floor.

I start getting report on my patients. One pt with a recent stroke that failed the MBS that had a new NG tube. Dayshift got the order to start tube feed at noon but did nothing with it, could I please start it. Ok. Next patient with a PEG and tube feed running in restraints and on continuous BiPap. One patient that was an ICU transfer--just had a central line removed, it was bleeding through the pressure dressing, and there's no peripheral site. Next patient had a thrombectomy of her dialysis fistula. Was told everything was good and that she had +bruit/thrill. Come to find out when I do my assessment 30 minutes later that there was NO bruit/thrill and her dressings were saturated with blood. And there were also no post-op orders. They were "lost." One elderly patient with a family that needs a lot of attention.

Talk about patient safety concerns! I felt like I was the only one concerned at that point, dayshift had a full staff and I know they get busy but this was overkill.

[AJJKRN]

These are the woes of night shift that day shift won't ever understand. We sit around all night eating Bon Bon's while all the Pt's and family members sleep remember?

[brownbook]

That sounds like some of my nightmares....and I've been away from floor nursing for 15 years! So sorry. What in the heck happened to the no show nurse?

[soyoureanurse]

Apparently, she had called off earlier in the day but the message wasn't relayed to the floor. Stressful for her, too, since she kept getting phone calls and messages asking where she was at!

[soyoureanurse]

Ugh I know!! I wish everyone started out on nights!

[FurBabyMom, MSN, RN]

That's rough!

When I worked the floor, we had a night like that. 28 patients, 3 RNs, 1 LPN, 1 CNA (monitor trained who was our monitor tech - we remote monitored for two other floors). It was a rough night. It was made worse by the fact that our facility was completely slammed due to taking transfers from another hospital that lost power and their generators (we'd had a bad storm that night). I think we ended up with 30 patients that night? It was an unusual set of circumstances to begin with...

These stories are why I don't miss floor nursing. I'm good with my one patient at a time.

[nynursey_]

​While I don't want to condone turning this into a night shift versus day shift post, I can say that I sympathize with those of you who hold it together on nights (for a point of reference, I work primarily day shift, with an odd 3p-11:30p thrown in for good measure). You're expected to be able to perform the same type of nursing assessments, procedures, and monitoring without 1/2 of the support (less depending on whether or not you work in an urban hospital with more than 1 on-call physician). Often times, the nurse acting as charge (or shift coordinator) has less experience than the least experienced shift on a day nurse and very little clinical support resources, if any. Many hospitals do not have evening/night ANMs (in fact, my organization is doing away with ANMs altogether) and thus the novice charge nurses are left trying to navigate patient care, bed assignments, and nurse assignments with little to no support, in addition to attempting to clarify orders once the ordering physicians have left for the day. It's a tough road to walk.

We feel the squeeze on day shift, too. Believe me. One is not necessarily better than the other but each has unique struggles. I think across the board it's important to remember to be contentious to the oncoming shift's specific needs. It goes a long way towards making a difference and mending the us versus them mentality!