Day orientation... Yay! Night orientation...not so much

[Merrie82, RN]

So, I am still in orientation, but in 6 short shifts I will be off to the races on my own, or at least that's been the plan.  All along I have been doing well on days, and not so great at night. (I am currently rotating until June, and then am supposed to go straight nights). Some of the not greatness may be because me and my preceptor at night have never really clicked. She is not a very emotive person,  I have a hard time communicating with her, she gives little feedback good or bad. She's definitely a hoverer, which tends to make me nervous. I have tried to initiate conversations with her about some of this, and ask how I'm doing...no success really.

But a lot of the not greatness is definitely just me. For whatever reason, I cannot seem to transfer my successful day routine to nights. 4 patients during the day, sure! At night? I'm all over the place, have no time for anything,  and end up being that nurse that has to stay late to chart because I've been barely not drowning all night ?‍♀️.  Each increase in patient load has made me dread going in to work at night more, but the jump from 4 to 5 is coming, and I know I'm not ready for that.

So, the other night I worked a shift, and I just could not keep up. 4 patient assignment, 3 out of 4 were pretty confused, one of them assaulting us (advanced dementia), and a pretty complex neuro patient. 2 out of 4 without a CNA. Either way, I literally ran around all night, still had to ask for help from my preceptor to do things like hang an antibiotic, or change tube feeds in another room etc. And I left work feeling like a *** nurse. My preceptors only advice was "time management will come with time". Which is probably true, but it needs to come a little faster, LOL. Slept for a few hours, and woke up to a message from our Unit based educator asking me to call her.

Long story short, my night preceptor is not impressed, and thinks I'm not ready to be off orientation,  and now the UBE will be observing me on Monday for a few hours to decide what to do with me, since my day preceptor thinks I'm doing great. And they are both right. I'm not doing well at night, and I don't know why I cannot seem to just take what I do during the day, and replicate it at night? What is my problem? I know my migraines have been thru the roof from swapping btwn days and nights, and my ? is tired, but im a 2nd shifter at heart, third shift shouldn't be this hard to adjust to. Any thoughts appreciated ❤

[JKL33]

Why are they having you rotate shifts right now???

[NightNerd, MSN, RN]

I would be a disaster if I had to rotate like that too! Is there any system to how you move between days and nights, or is it completely random?

I wouldn't stress too much about the recommendation that you get a longer orientation. That in and of itself doesn't mean much, other than they want you to have a little longer to get comfortable. And it's trite but true, time management is something that develops over time and experience, and you just kind if of have to muddle through until you develop a routine that works for you.

[Hoosier_RN, MSN]

12 minutes ago, JKL33 said:

Why are they having you rotate shifts right now???

Exactly this. They should put you on nights to orient, so that you can build a routine, along with comeraderie

[Merrie82, RN]

27 minutes ago, Hoosier_RN said:

Exactly this. They should put you on nights to orient, so that you can build a routine, along with comeraderie

So, the UBE says that they used to do orientation during the day only, and then throw ppl to nights, which didn't work well, so they now have you rotate during orientation "to get a feel for nights ". As for why not just orientation on straight nights....they say its busier during the day ????. Honestly I haven't felt that at all, maybe bc we are a neuro floor and a lot of our patients are awake, and having confused party time at night. But thats the rationale. 

[SarHat17, ASN, RN]

Consider a longer orientation as a bonus, instead of a "punishment?" (I HOPE your hospital doesn't present that as punitive!) It's really difficult to switch back and forth in such a short time; it's really strange they are doing it all mixed in this way. We usually do the first 2-3 weeks on days, then switch to all nights for remainder of orientation for new night hires. Maybe approach the UBE with, "I am finding flipping back and forth between days/nights to be a really difficult way to get into a rhythm and utilize all my resources and time effectively because days and nights are definitely different. I'd really like to focus on my nightshift orientation experience while I have the time and support; can we adjust my schedule to consistently be night shifts?" They might really appreciate the feedback, especially for future new hires.

Also- having started out on a neuro floor at night as a brand new RN, neuro patients at night are a whole different kettle of fish than days! Hang in there!!

[Merrie82, RN]

48 minutes ago, SarHat17 said:

Maybe approach the UBE with, "I am finding flipping back and forth between days/nights to be a really difficult way to get into a rhythm and utilize all my resources and time effectively because days and nights are definitely different. I'd really like to focus on my nightshift orientation experience while I have the time and support; can we adjust my schedule to consistently be night shifts?" They might really appreciate the feedback, especially for future new hires

 

I have been thinking this. The UBE is very married to the day experience being needed to succeed. But im doing really well on days. It's nights I need more experience with. And possibly a more experienced preceptor. I guess I'll see what she says about stuff on Monday. 

[Hoosier_RN, MSN]

1 hour ago, Merrie82 said:

So, the UBE says that they used to do orientation during the day only, and then throw ppl to nights, which didn't work well, so they now have you rotate during orientation "to get a feel for nights ". As for why not just orientation on straight nights....they say its busier during the day ????. Honestly I haven't felt that at all, maybe bc we are a neuro floor and a lot of our patients are awake, and having confused party time at night. But thats the rationale. 

All floors are busier at night than TPTB believe

[speedynurse, ADN, BSN, RN, EMT-P]

Just my opinion- the rotating shifts or nights are probably throwing your body and brain into overload. I was physically sick when I was on nights the last go around.

I know I always had a hard time with hoverers or people who don’t communicate well. It makes me anxious and unsure of myself (even as an experienced nurse!) Do you feel like the educator would let you switch preceptors? Maybe be diplomatic and say something along the lines of maybe you feel like you might improve with the perspective of another preceptor.

[Merrie82, RN]

16 minutes ago, speedynurse said:

Just my opinion- the rotating shifts or nights are probably throwing your body and brain into overload. I was physically sick when I was on nights the last go around.

I know I always had a hard time with hoverers or people who don’t communicate well. It makes me anxious and unsure of myself (even as an experienced nurse!) Do you feel like the educator would let you switch preceptors? Maybe be diplomatic and say something along the lines of maybe you feel like you might improve with the perspective of another preceptor.

I did mention in our conversation  (with the UBE) that me and my night preceptor had just never really clicked,  but that I didn't think it was thru any fault of hers, just a difference in personality. I may speak with her about it on Monday. IDK. I hadn't mentioned it over the last 10 weeks bc I don't want to be seen as difficult or a complainer. The hovering does make me extremely self conscious and anxious, and I make mistakes that I would not normally just because I'm being watched.

My day preceptor is very chill, she helps when I need it, but otherwise she leaves me be. She will go into the IMC and help out,  but keep her phone on her, and if I have questions I call. Obviously at first she hung around more, but as I've gotten my feet under me she has taken a step back. And bc we have a good rapport I don't feel stupid when I do have a question. It will be great to work with her again this week. 

Nights, and especially rotating shift (its totally random, like day, night, night, or day, day, night, a day off then 2 nights, 2 off, 2 days etc) has been hell on my migraines. I actually had to call out last week (and yes, I know that looks horrible as a new employee on this floor) because I got a ??  migraine (I get migrains all the time, just not the pukey poop variety) for the first time in over a year, and I draw the line at nonstop vomiting as far as going in to work. I know its from the disruption in my sleep schedule, or rather the unpredictable nature of it. Plus stress...But I feel stuck. I agreed to this. There's not much else I can do other than suck it up if they won't let me switch to straight nights. Even nights will be a challenge, but at least its a consistent sleep schedule.

[JKL33]

See below.

[JKL33]

So, wait: Are you rotating shifts, or have they moved you to nights for the remainder of your orientation?

I wrote and erased a bunch of stuff because it occurred to me that you might be sort of using the term rotating in a way that isn't what is usually meant by that.