when the day shift arrives

brownbook · Jul 13, 2011

My 5 cents worth.

Being nice: day shift has a lot more demands on the nurses and patients. Doctors are there asking for results, a lot of "whys", ordering tests, patient needs to be in x-ray, etc. Busier and more stressful shift, families calling and visiting. The nurses want to, need to, know what is going on with their patients. Want a lot of answers from night shift staff, want a lot of the basics already done before they arrive, baths, lab results, etc. and aren't always understanding when these things aren't done.

Being catty: day shift nurses think they know more, are better nurses, night shift nurses couldn't handle the stress of day shift routine, night nurses have it easier, etc.

nursemike, ASN, RN · Jul 13, 2011

I've started telling them they have it a lot easier, since their patients sleep all day. Some get the joke. Some don't.

MillieT · Jul 13, 2011

I know for me, my attitude is different at work than at home, I would describe it as a need to get things done ASAP, in a very organzied, orderely fashion because if I don't the day can fall apart. The attitude does creat a sort of tension and is definitely high stress. 3 things that I see that contribute to it on days is: the huge amt of 0900 meds. Many of these are once daily meds, so it's the only time of the day when pts literally have 2-3 pages of meds to give. This must be done ASAP along with assessments or you are behind. The 2nd factor is treatments often done more often on days: blood transfusions and for me chemo. Blood can throw off everything. The 3rd is surgery pts who must be ready by a certain time or they're thrown off the surgery schedule and the wrath of surgeons will rain down.

For me it's a challenge and it does carry over into my home life. If I have several tasks that need to be done, I put on my work mode and bulldoze through them in a very business-like fashion that my family doesn't appreciate so much.

NurseSuzann · Jul 13, 2011

Day shift is ready to cannabalize everything because management will do the same to the them and it runs down the line. To think they have it easier is rather ignorant, depending on what type of unit. I find that on nights I am putting out a bunch of fires with less staff, and I find a lot of the patients do not actually sleep on nights and less staff to be there for them/more falls. But other shifts will never try to understand each other *smiley face* is my approach to these people who want to eat me in the morning.

Pepper The Cat, BSN, RN · Jul 13, 2011

Here's my take as a day shift nurse.

I come in - Nights say "You HAVE to get a different sedation for Mr X - he was up all night." Did Nights call the MD? No.

' You HAVE to move Mr B to room closer to the nsg station". Bed is avaiable - did they move the pt? No. Why not? They don't like to move beds. Newsflash - neither does day shift but we do it. Only takes 2 people to push a bed - you have 4 on nights so there are enough.

This piece of equipment is broken - an repair order needs to go in. Did they do it? No. Why not? I don't know how.

Mrs X c/o pain all night - you HAVE to call the MD and get new meds. Did Nights call? No.

And so forth.

Anything that went wrong on nights is my fault because I didn't get the right drug ordered, or I didn't do something. I certainly don't think I'm better than night shift nurses but I certainly don't understand how they can let someone be in pain all night because they don't want to call a doctor.

MomRN0913 · Jul 13, 2011

Here's my take as a day shift nurse.
I come in - Nights say "You HAVE to get a different sedation for Mr X - he was up all night." Did Nights call the MD? No.
' You HAVE to move Mr B to room closer to the nsg station". Bed is avaiable - did they move the pt? No. Why not? They don't like to move beds. Newsflash - neither does day shift but we do it. Only takes 2 people to push a bed - you have 4 on nights so there are enough.
This piece of equipment is broken - an repair order needs to go in. Did they do it? No. Why not? I don't know how.
Mrs X c/o pain all night - you HAVE to call the MD and get new meds. Did Nights call? No.
And so forth.
Anything that went wrong on nights is my fault because I didn't get the right drug ordered, or I didn't do something. I certainly don't think I'm better than night shift nurses but I certainly don't understand how they can let someone be in pain all night because they don't want to call a doctor.

I've worked both in the same unit, ICU. Why do nights ask the morning shift to call the dr for a new med? Because they don't want to be belittled and screamed at for waking them up for a med, or simply getting hung up on. However, in ICU I will call for a different sedation.... but the point is, I have worked both sides, in the same unit with the same Dr's. The same doctors which yelled at me at night were soooo nice, handing out orders like candy during the day. respectfully. Half of these doctors I was speaking with for years on the phone at nights, introduced themselves to me on the day shift like they have no idea who I am. Their attitudes are as different as night and day (no pun intended) when asking for the same things, just on a different shift.

I had a certain cardiologist very sacrcastically thank me for waking up his crying daughter when I called him at 10pm for his patient in rapid afib in the 160's. Did he give me the cardizem drip order? Yes. Did I have to get insulted for it? Yup. Same cardiologist, treated me very nicely on day shift when I called on a different patient in rapid afib during the day.

So, please do not judge until you experience both sides of the spectrum. It's not laziness. It's lack of resources.

Zen123 · Jul 13, 2011

I work all shifts. Some people are just anxious. Some are calm n cool. And some just needs to be zap!:cheers: :jester:

Pepper The Cat, BSN, RN · Jul 13, 2011

So, please do not judge until you experience both sides of the spectrum. It's not laziness. It's lack of resources

Actually, I have worked both sides. I stopped working nights because I couldn't deal with the nurses who refused to care for pts or call doctors.

And the doctors we work with are great. And get angry when they learn that their pt went 12 hours in pain because a night nurse didn't want to page them.

nerdtonurse?, BSN, RN · Jul 13, 2011

My take -- every shift, every floor, every unit thinks they've got it tougher than anyone else. Usually I just let it roll of my back, but they've really gotten on my nerves recently:

1) Dayshift has at least one person late, every single shift. They come in complaining "you don't know what it's like to get up at 5 am." Uh, yeah, I do, did it for 20 years when I played in computers, and had to be at work when the sites in Europe came on line. And I was on time. And did you have a neighbor cut down a tree or mow the lawn at 1 am? FedEx make a delivery at 3 am?

2) We had a cardiologist who wanted to know why no one had called him about something. I told him it was because he bit the head off of every nightshift nurse who called him, we didn't like to wake people up, but when you don't give us parameters, you're going to get woke up. He acted like he was shocked. He makes 10 times what I do, he needs to put on his big boy pants and deal with it. I wore a pager for those 20 years, it was part of the job, and I didn't cuss people out when they woke me up. It was what I got paid for.

3) Dayshift says they're dealing with doctor's orders, families, etc. We have to sort out all those conflicting orders, the meds double ordered, families calling all hours of the night, spending the night in the room where we're basically running an ICU and a hotel. Nothing like tripping over a family member's junk spread all over the floor because they cuss you out when you turn the lights on. And God help you if the patient needs a portable CXR stat, you're going to spend 5 minutes moving all the worldly belongings of the patient's family out of the way.

4) If a patient goes bad in the middle of the night, we're IT. There's one in house MD, and he's in the ER, that code's either back or not coming back by the time the MD gets upstairs.. There's no CNA, there's one person doing 2 jobs. One week we had 10 patients, 6 were active GI bleeds, 3 were getting GI preps, 4 nurses, 1 tech, and we were all giving blood; I was giving blood to both of my patients. We literally ran out of linen and trash bags, and the first thing dayshift said was, "you didn't take out the trash." We have to bathe every vent patient, document the wounds, restock rooms, reorder supplies, tag defective equipment and haul it to the pickup point, We have to do 24 hour chart checks, finding tests not run, meds not ordered, meds not give, meds that were supposed to be DC'd given...and to get clarification on anything, we have to wake someone up who starts off the conversation with: "Why didn't dayshift call me?"

5) PACU packs up at 6pm. When we have an emergency surgery, they want us to do the PACU hour, too, where we don't leave the room. That's in addition to my GI bleed with a hgb of 4 or acute MI. If someone needs an emergency CT, off we go with the patient, leaving our other patients as additions to the other nurses, and you know there's only 2 folks in radiology, instead of the normal 10 if something goes wrong.

6) I've worked days. Extra nurses, at least 2 CNAs, anybody you need to call is awake, you're talking to the MD who actually knows the patient instead of who's on call, tons of spare hands for turns, dressing changes, linen changes, able to call for housekeeping, materials management, plumbers, electricians, MDs are awake and not grouchier than normal. The only reason I don't work days is I can't afford the pay cut.

Grrrrr. It's been a bad week.....

ICU, RN, BSN, B.S. · Jul 13, 2011

My 5 cents worth.
Being nice: day shift has a lot more demands on the nurses and patients. Doctors are there asking for results, a lot of "whys", ordering tests, patient needs to be in x-ray, etc. Busier and more stressful shift, families calling and visiting. The nurses want to, need to, know what is going on with their patients. Want a lot of answers from night shift staff, want a lot of the basics already done before they arrive, baths, lab results, etc. and aren't always understanding when these things aren't done.
Being catty: day shift nurses think they know more, are better nurses, night shift nurses couldn't handle the stress of day shift routine, night nurses have it easier, etc.

Haha too funny. Kind of true. I worked both shifts. Day shift is usually constantly busy. Nights can get crazy sometimes. Plus, you have to stay awake when it's not normal to be awake, it's much harder on your body. Both are hard shifts. Bottom line, being a RN in a hospital on the floor is hard! lol

Katie5 · Jul 13, 2011

Actually, I have worked both sides. I stopped working nights because I couldn't deal with the nurses who refused to care for pts or call doctors.
And the doctors we work with are great. And get angry when they learn that their pt went 12 hours in pain because a night nurse didn't want to page them.

That was not night shift- that was incompetent nursing I would say.I work all and just learn to move on. I do my best on either shift, same as I would want or expect of the nurse coming after or before me.