Attention all night shift nurses, techs, cnas, and pcts...

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Specializes in Med/Surg, Float Pool, MICU, CTICU.

Do you feel like your differentials make up for the lack of staffing at night? I love working nights and the crew of people I work with, but I absolutely hate how short staffed we are when compared to day shift! I am a cna on a BUSY med/surg floor where our census ranges anywhere between 30-38 patients. Day shift can have anywhere from 6-7 nurses, including the charge nurse taking patients, and 3-4 aides on the floor with sitters available. Then when it comes to nights we may have only 4-5 nurses, and 2 aides on the floor and maybe a sitter if the need is that great. On nights I can start out with 14 pts and can count on ER in brining me 2 or more patients to add to my census. Management doesn't take into account the type of care needed for each patients. They think everybody will be asleep needing less care. WRONG! There are times when I've had 15 pts, 6 of which were total cares requiring two people to help change and turn and can often be heavy wetters needing a bed change. Lets not forget the other patients who are 1x assist to the commode every other hour and you just wish they had an order for a catheter because their output is about 100mL each time. Then we have combative patients determine to pull their tele, iv, shiley, picc, catheter, and any other tubing in site in no restriants because the family is staying in the room. Our confused patients trying to hop out of bed, so of course bed alarms are going off. To complete the night, multiple trips to the snack room for low BS, answering call lights, and assisting with RR transporting pts to the unit. Granted not everything happens all in one shift, but it comes pretty darn close.

To answer my own question, I say no! They don't pay us enough for all the work we do at night. Not that I am soley about the money, it's just we work entirely way to hard the way we are staff and the pay just doesnt reflect our work. Budget cuts are also hurting us and 70% of our reimbursement will come from good scores from random patient surveys and ours scores are not great, which equals little reimbursements. I just wish they would put 3 aides on the floor at night because it makes a huge difference and relieves some of the stress of the night with all the new night admissions. I love doing what I do and will be starting nursing school this month, but I can't help but feel like I am being spread so thin! Maybe it's just the med/surg enviroment I'm not a fan of. I like staying busy, but this is just ridiculous. During our monthly meetings, the staffing issues has been discussed, but still remains the same. If management could grant 3 wishes, better staffing, new vital machines, and better pay are all I need to be happy camper :)

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Since I have never received a differential for working night shift, there is no way it could make up for short staffing on night shift. Night shift jobs, with no night shift differential, are almost impossible to get, at least in my area.

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I've worked all shifts and prefer nights... That said-

Days has rounding docs, labs coming back, more orders to process, families awake and hunting them down, baths, 2 meals, visitors all over the place, patients going for tests, scheduled surgeries, more med passes, more q day orders to take care of (treatments), accuchecks, more supervisors hanging around, administration, and more acuity with the person being awake.

I know patients don't all sleep. But it is a different pace. Days seemed to be more organized chaos- nights was usually more routine.

My view on shift differentials- if it's not enough, work somewhere else, or a different shift :D

JMHO.

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Same goes for CNAs- worked all 3 shifts as a CNA- nights got paid more to be awake at those hours :D The work was steady and continuous- that's why it's called work and not "visiting" :D

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Try one CNA for 30 beds on nights......Alzheimers.... spent most of the night being beat up :)

If this is bugging you now, what do you expect as a nurse ? (honest question- I'm really interested :) )

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Specializes in Cardiovascular, ER.

I think it's worth it as long as you can maintain a healthy lifestyle while on nights. Once you can no longer do that (like me) then it becomes no longer worth it.

Night short staffing is just one of those things in a lot of places. No amount of differential can make up for that in my eyes.

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Specializes in hospice, HH, LTC, ER,OR.

I worked nights for 8 months and the shift diff is not worth the headache or the sleep deprivation. The sun-downers that are up all night, the complainers, the ones that just want to look at you because you are so cute when a crises somewhere else is going on. The under staffing, and this is what did it for me I was left one night by myself at work the only nurses on the floor with 75 patients. I called the unit manager, DON, administrator, no one answered. When it was time for me to get off, the unit manager called and asked me what was I doing all night. ***! day shift from now on!

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Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

You think ur job is hard now? Wait until u become a RN and anyone and everyone is running up to you with problems when ur in the middle of trying to do meds/narcs, wound cleaning, trying to counsel suicidal and/or depressed patients, in the middle of a suspected MI/CVA or arguing with doctors/NUMs who just don't listen to what ur telling them, and the Dr is refusing to give a palliative care patient narcotics. And it's 10 times worse when ur ENs/carers/PCAs don't do what you tell them, then stand and have the audacity to argue about it, and the BSLs/BGLs etc aren't done and u find out later they haven't done numerous other jobs too, and don't communicate stuff to u (even when u have asked them to). EVERYTHING is put b4 the RN, ENs and carers can't seem to think for themselves for some weird reason. So u spend most of the shift running from one end of the ward/unit/facility to another trying to double-check everything, on top of caring for ur own patients.

All I can say is, get used to it, cos when u get to nursing school and if u end up being in charge, it will be many more times hectic but with a different set of responsibilities.

And if u don't like ur job can you quit or go thru an agency instead? I'd be looking to work in another facility myself.

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Specializes in Peds Medical Floor.

I've worked every shift and I can honestly say they are each difficult in their own way.

I do get sick of hearing "It must be nice to work when everyone's asleep." I love it when day shift nurses/aides work and are shocked by the number of CB's that go off and people who get up and wander at night.

And it sucks having only 2 CNAs for 43 residents, especially if someone is off or calls in sick and no one tries to find a replacement. Grrrr!

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Do you feel like your differentials make up for the lack of staffing at night? I love working nights and the crew of people I work with, but I absolutely hate how short staffed we are when compared to day shift! I am a cna on a BUSY med/surg floor where our census ranges anywhere between 30-38 patients. Day shift can have anywhere from 6-7 nurses, including the charge nurse taking patients, and 3-4 aides on the floor with sitters available. Then when it comes to nights we may have only 4-5 nurses, and 2 aides on the floor and maybe a sitter if the need is that great. That is GREAT night staffing

On nights I can start out with 14 pts and can count on ER in brining me 2 or more patients to add to my census. Management doesn't take into account the type of care needed for each patients. Do you think they are clueless? Have you talked to them- CNA to upper management ? Do they seek your advice, with their years of experience... I would hope they value your input- but management has a LOT going on that people on the floor have no clue about- and don't always need to know, to have something else to complain about :)

They think everybody will be asleep needing less care. NO- they know what goes on- night shift workers do go on to BE management as well as day folks :)

WRONG! There are times when I've had 15 pts, 6 of which were total cares requiring two people to help change and turn and can often be heavy wetters needing a bed change. Lets not forget the other patients who are 1x assist to the commode every other hour and you just wish they had an order for a catheter because their output is about 100mL each time -and that catheter would put THEM at risk for infection and sepsis for YOUR convenience :)

. Then we have combative patients determine to pull their tele, iv, shiley, picc, catheter, and any other tubing in site in no restriants because the family is staying in the room. So no DAY shift patients do this stuff ???

Our confused patients trying to hop out of bed, so of course bed alarms are going off. They do this 24/7

To complete the night, multiple trips to the snack room for low BS, answering call lights, and assisting with RR transporting pts to the unit. Granted not everything happens all in one shift, but it comes pretty darn close. Try working more day shifts !!

To answer my own question, I say no! They don't pay us enough for all the work we do at night. But, days, with much more scheduled stuff going on (and other things in my previous post) are getting what THEY deserve???

Not that I am soley about the money, it's just we work entirely way to hard the way we are staff and the pay just doesnt reflect our work. ON ANY shift :D

Budget cuts are also hurting us and 70% of our reimbursement will come from good scores from random patient surveys and ours scores are not great (then focus on improving scores and not how unappreciated you feel :) More money won't make your scores improve- YOU will :)

, which equals little reimbursements. I just wish they would put 3 aides on the floor at night because it makes a huge difference and relieves some of the stress of the night with all the new night admissions. (and you get the only admissions that would benefit from more staff???)

I love doing what I do and will be starting nursing school this month (if you're this bugged now, you might want to rethink one of two things- nursing school, or hard work... more responsibility as a nurse means more work- not some easier day/night simply because there are more nurses than aides...)

, but I can't help but feel like I am being spread so thin (yes- again, that's why it's called work, not visiting :))

! Maybe it's just the med/surg enviroment I'm not a fan of (NO- this is nursing :))

. I like staying busy, but this is just ridiculous. Welcome to healthcare

During our monthly meetings, the staffing issues has been discussed, but still remains the same. (always has been, and with healthcare being what it is, it's not going to change any time soon- You are a piece of the business- a replaceable piece of the way facilities run... look at how many people on this forum would love to even have a job)

If management could grant 3 wishes, better staffing, new vital machines, and better pay are all I need to be happy camper :)

Things do not create attitude- how you choose to view things is totally up to you.... would you rather be unemployed with kids to feed and a mortgage payment ??

I hope you do well in nursing- but trying to rally the troops who have been doing this for ages (or even are new and have been through this) is not going to make you happy with what you do- that is totally up to YOU :) From this post, it sounds like you have an idea about nursing that isn't realistic. Idealistic- but not realistic.... best wishes :)

And this goes for any job- healthcare or not- you can always go look for something better- if it's out there, great....but having a job at all is a big deal these days. :)

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Specializes in Emergency/Cath Lab.

I orientated to days and then chose to work nights.

While night shift gets dumped on a lot, days gets it worse I think. Having to do more admits, DC's, dealing with more family, docs, PT/OT etc etc. I am glad I dont have to deal with that

On nights we typically have one Hospitalist covering out floor and when there are fewer of you and less going on, they get to know you better and they trust you more and you know what they expect of you. That is something I really like as well.

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I worked nights for 8 months and the shift diff is not worth the headache or the sleep deprivation. The sun-downers that are up all night, the complainers, the ones that just want to look at you because you are so cute when a crises somewhere else is going on. The under staffing, and this is what did it for me I was left one night by myself at work the only nurses on the floor with 75 patients. I called the unit manager, DON, administrator, no one answered. When it was time for me to get off, the unit manager called and asked me what was I doing all night. ***! day shift from now on!

What? :eek: Do you work in a prison? Or are they lonely? :confused:

It stinks that you were left to deal with 75 patients.... employees can also call the state health department to report unsafe situations. You should not have been left like that :( If the state feels something is urgent, they can be there in a couple of hours... I hope you quit that place after that...:heartbeat

I worked in a nursing home (as the w/e supervisor) where 7 of the 8 nurses called in for the weekend....I happened to work for a big corporation, and knew who was the regional director (the nh administrator and DON were nowhere to be found- admin on a cruise- DON out of town w/nobody on call for her). I had to get staff from the other facility I"d worked at longer to come in- I had the regional guy's approval to offer double time- but that's because it was an impossible situation.... OH- and there, for 90 beds, it was common for only 2-3 CNAs to show up for 3-11.....:twocents:

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