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

[Merrie82]

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 ❤

[Merrie82, RN]

44 minutes ago, JKL33 said:

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.

Rotating until mid June. 

[JKL33]

So they are having you go back and forth between days and nights until June and then you will be off orientation and on straight nights?

[Merrie82, RN]

4 minutes ago, JKL33 said:

So they are having you go back and forth between days and nights until June and then you will be off orientation and on straight nights?

I'm actually off orientation (unless they extend mine) in 2 weeks. Then I have 12 additional weeks where I am on my own, but still rotating btwn days and nights (More days than nights). Mid June I'm finally switching to straight nights, which is the shift I was hired for. 

[JKL33]

Oh boy. They are quite the innovators, aren't they.  Innovators being a euphemism for idiots. ?

They need to know there's this thing where orientees who are hired for nights start on days so they have exposure to that and are able to form a bit of a rapport with the day shift, then move solely to night shift where they finish out the remainder of their orientation (hopefully at least 50% of it is left at that point) and then begin working on their own on night shift. This rotating business is ridiculous.

Their ideas about rotating aren't helping their night shift preceptors, either. They never get the chance to participate in the whole process of getting a new nurse on their shift and helping them ramp up to independence. It's a nuanced process and these poor preceptors are only being allowed to participate in little stints that have no continuity.

Gotta say I don't like the attitude (and maybe the lack of brain power) of these people. They are full-on treating night shift like an after-thought.

I would go to your UBE and let them know you agree with having your orientation extended and that you need to have it strictly be on the shift you will be working; night shift. Starting pronto. Of course, on the rare occasion I put my foot down (as I would here) I am prepared to accept the consequences.

Good luck!

[Merrie82, RN]

3 hours ago, JKL33 said:

Oh boy. They are quite the innovators, aren't they.  Innovators being a euphemism for idiots. ?

They need to know there's this thing where orientees who are hired for nights start on days so they have exposure to that and are able to form a bit of a rapport with the day shift, then move solely to night shift where they finish out the remainder of their orientation (hopefully at least 50% of it is left at that point) and then begin working on their own on night shift. This rotating business is ridiculous.

Their ideas about rotating aren't helping their night shift preceptors, either. They never get the chance to participate in the whole process of getting a new nurse on their shift and helping them ramp up to independence. It's a nuanced process and these poor preceptors are only being allowed to participate in little stints that have no continuity.

Gotta say I don't like the attitude (and maybe the lack of brain power) of these people. They are full-on treating night shift like an after-thought.

I would go to your UBE and let them know you agree with having your orientation extended and that you need to have it strictly be on the shift you will be working; night shift. Starting pronto. Of course, on the rare occasion I put my foot down (as I would here) I am prepared to accept the consequences.

Good luck!

So the gist I am getting from you and others is that there isn't necessarily something wrong with me that I'm having a hard time getting my feet under me at night? Because I'm sure feeling pretty stupid right now. I'm generally a pretty confident person who picks things up quickly,  but I feel like a fish out of water at night right now, and I feel stupid because I can't seem to adjust. My brain is a cluster **** at night right now.

The other night I couldn't figure out which way the freaking BEDPAN went under the patient. I've been a CNA for 3 years! I turned that sucker around like 5 times while the patient was on their side bc I could not for the life of me figure it out ?‍♀️?. Thats not normal, LOL. I feel like rotating is melting my brain, or perhaps causing it to leak out of my ears! And I wish it would just stay where it belongs between them. I'm running the conversation I could have with my UBE around in my head like a hamster on a speedy wheel, and I need to be calm, not crackhead-like, tomorrow so they don't think I'm a horrible investment. Anyway, guess I'm just venting at this point. Thank you all for your advice.

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

The bouncing around among different shifts can really throw your body and brain for a loop. I knew when there were a few weeks that I was surviving on an hour maximum of sleep before every night shift and couldn’t remember anything someone just said to me that it was time to get back onto a shift that was better for my brain and body.

I do think honesty with diplomacy can go a long way - now not everyone will appreciate this, but in many units this will be appreciated.

[JKL33]

2 hours ago, Merrie82 said:

So the gist I am getting from you and others is that there isn't necessarily something wrong with me that I'm having a hard time getting my feet under me at night?

Having a new nurse rotate shifts during orientation is one of the dumber things I've heard.

There are plenty of us who believe any nurse rotating is probably not strictly necessary as far as staffing goes, and believe that it wreaks havoc on a lot of people. Having new grads rotate in the way you describe while on orientation is...??‍♀️ really, really dumb.

It isn't just the disrupted sleep and all of that but also the very real dynamics of bouncing back and forth between various people on different shifts who are supposed to be guiding you based on a sustained observation of your progress.

There isn't necessarily something wrong with you.

[LibraNurse27, BSN, RN]

33 minutes ago, speedynurse said:

The bouncing around among different shifts can really throw your body and brain for a loop. I knew when there were a few weeks that I was surviving on an hour maximum of sleep before every night shift and couldn’t remember anything someone just said to me that it was time to get back onto a shift that was better for my brain and body.

I do think honesty with diplomacy can go a long way - now not everyone will appreciate this, but in many units this will be appreciated.

Yes! Lack of sleep and even sleeping enough but getting poor quality sleep due to messing with your circadian rhythms, plus the inability to have a stable routine messes you up at work. I could feel the difference even just not getting enough sleep before day shift: disorganized, kept leaving room to get supplies I normally would have gathered all at once, bad time management, frazzled, late meds, couldn't get IVs and Foleys, stressed out behind... with an assignment I could have handled well on more sleep! You are not a bad nurse! They just put you in a bad situation.

I think when you are on straight nights you can develop your shift routine plus your sleep/eating/work out/fun time routine! And you will do much better. Being new is already hard, so give yourself grace. This weird rotating thing on top of new is too much. I would have trouble with it as an experienced nurse.

[Merrie82, RN]

So just an update. The thing today turned out to be basically nothing. The UBE followed me around (on a day shift) for like 2 hours, said I was doing well. I did speak with her this afternoon and voice my concern that I wasn't doing as well on nights, and would like more opportunity to work nights. I told her I thought rotating shifts was really messing with my brain, but she is insistent that I continue on this course. I have 2 wks orientation left,  well, 5 shifts (only 2 are nights). Then on my own with rotating shifts until mid June. I don't think there is much else I can do. I'll just have to suck it up for 14 more weeks. Hopefully by the time I switch to straight nights I'll be feeling more comfortable as a new nurse, and it won't feel like this. 

Thanks all. 

Side note that is slightly irritating to me, on my very 1st shift with my night preceptor she decided not to put in a Foley on someone,  and then apparently said I decided? That came up today. I just said, oh, we ran out of time.