day vs night shift?

[katypurry]

im a new grad nurse. i applied for a night shift amd luckily got the "last" position available in a Med-Surg floor. i was oriented on day shift for about 3 weeks and am about to go to night shift next week. Now, being still fresh from nursing school, the information is still there: cranial nerves, TSH and T3/T4, etc. basically the ideals. now i started liking days. ive never worked nights before. the only reason i took this job was the hospital where i used to work (orientation) had problems with us new grads. i never really considered the learning experience im gonna get. now im scared that since at nights, no procedures are done, not much doctors on the floor, patients are mostly sleeping or something, im not gonna be able to grow. i think day nurses get more expereince. im scared that i might get "stuck". i just realized that our firstreal job really counts. I was aiming for ER or ICU or at least a telemetry floor. I was a bit disappointed that i got the MS position.

Also, i also noticed that most nurses at nights where i work at least, are not as competent as i imagined them to be. some of them will give reports and then not even mention that a pt is going for a surgery. i mean, how can u miss that? and pt has a foley? how can u say he "wets his bed.. he's incontinent of urine i guess.." and then when we come to assess the pt, he has a Foley with bloody urine?? i mean, i dont want to be an ok nurse. i want to be a good nurse. well, maybe i am being too idealistic. for me, i wanna start my career in a straight line because i think if we start overlookiing things and its like we just go there for the money. and i dont want that. i want to start practicing being a safe nurse as early and as much as possible.

ok ill stop now. insight plleeeaasse.... TY!!!

[clemmm78, RN]

I know that you don't mean it this way, but I do find that sort of attitude frustrating and, in fact, a bit insulting.

Nights can be the busiest of all three shifts. There are fewer staff to deal with sick patients and fewer resources to help us. For sure, there are nights when the patients do sleep, but they also get sick in the night and have crises as well.

In my case, I hate working days because I can't work with just my patients. I have to deal with all the hubhub of days and it takes away from my care. In the middle of the night, I can hold a dying patient's hand, I can speak with his family for long periods of time. And yet, we can be so busy, we feel that we'll never get out of there. We are two nurses for 9 palliative patients (not geriatric, palliative). If they're all sleepng, it's quiet. The minute one gets into a pain or respiratory crisis, we're busy. If two patients are actively dying at the same time, then we're busier. If there are three, well, there's only two of us and we're really running.

I don't get paid extra for working nights. I do it because I like the challenge associated with it. And none of the night nurses I work with are incompetent. They are caring, competent and bright women who I would be more than happy to care for me or someone I love.

[mom2michael, MSN, RN, NP]

i mean, i dont want to be an ok nurse. i want to be a good nurse.

Night shift isn't going to make you be an "OK nurse", how you do your job is going to make you be an "OK" nurse. Night shift will have PLENTY to offer you if you are willing to take on the tasks and responsibilities. It's a tough shift and it's a shift where you learn to think on your feet very quickly. It's not filled with hours of nothing to do and sleeping patients, that's for sure. Over 1/2 our admissions are done on nights. The procedures that get done on nights are usually those heart racing emergency things that get done. Patients have to preped for surgery, plenty of meds to be given, consents to be signed, patients to be taught, vitals to monitor, patients who crash in the middle of the night. What you will find you don't have is missing patients who spend the whole day in procedures or in other departments, helicopter families and doctors who steal charts.

[Brooke13-RN]

I agree with the other posters. I'm a new nurse too only 3 months out and I am finding night shifts to be both challenging and rewarding. There is so much going on and I don't feeling like I am missing out on procedures, doctor interactions, or assessing skills. I'm sorry that the night shift nurses give poor reports on your floor, but let me tell you I've heard some pretty interesting ones from days. It has nothing to do with the shift that you work, it's the kind of nurse you want to be. Lazy nurse come on all shifts. Some of the best nurses I have come across work nights. You have to develope your critical thinking skills in a hurry becuase there isn't the abundance of the extra people to run things by.

I am curious about what procedure you are expecting to do on days that wouldn't be done on a night shift. I'm on a busy med/surge floor and just the other night I put in 4 IVs, dc'd a CVC line, administered blood, and reinserted the NG that my confused pt pulled out. I'm just saying give nights a chance and if it's not for you look for a day position. Just please don't think that because a nurse works nights they don't use their skills or knowledge. I oriented on days for 6 weeks and I can honestly say that I learned more about nursing in the first 2 weeks on nights because I had the time to focus on the pt.

Anyway good luck with your new career.

[Lorie P.]

Give night shift a chance, where I work we get most of our admissions form ED/ER in the middle of the night, have to insert Ngt, foleys and start IV's, We also have to do lab draws on all the patients on the floor, do pre-op and other preps for am procedures.

Where people get the idea that patients sleep through the night is beyond me. We have patients that stay up alnight because of Sundowners, have dementia. I work a busy med/surg floor and very rarely do we get what we call a quiet night.

[DolphinRN84, MSN, RN, APRN, NP]

I think it really depends which floor you work in. I work in a med/surg floor as well (vascular surgical unit) and the day shift actually is the busiest shift of all. I'm a new grad as well and am still on orientation. I'm day/night rotation and I actually started nights this week and it is A LITTLE slower paced than days...but as a few people posted here...we get most of our admissions during the night labs to draw (if they have PICCS or CVLs) but we are lucky that at the hospital I work at, we have supervisors and educators during the night...so we are free to call them if we need help or ask them questions. In my opinion...I like nights a lot better...and I actually do learn more when its not so chaotic.

[RNsRWe, ASN, RN]

I'm guessing by now you're getting a bigger picture than you were seeing before: night shifts on a busy med/surge unit can be quite taxing on your skills and abilities (and of course I won't "go there" with the idea that night nurses are less competent....I'm too tired after having just gotten home from night shift myself).

Nights means less staffing available to help with emergencies and near-disasters. Night nurses MUST be able to think on their feet FAST and handle whatever comes up without having six more experienced people nearby to help you out. That's much more likely on days, where more bodies= more help, period. When one of my patients decided to crap out in respiratory distress when I had nine OTHER unstable patients, I can tell you that I was challenged to the fullest. Not "grow" as a nurse? Really? Then you're not going to grow at all anyway. If you're willing to learn and can pick up info and skills quickly, you just might make it through one of our nights

I start IVs (and restart them when disoriented patients rip them out), I run to bed alarms (same type of patients), I hang blood and handle reactions. I drop NGs, foleys, do dressing changes and enemas. I deal with hypoglycemia from patients who get loaded up on insulin in evenings and then don't eat dinner. I have post ops that go bad, pre-ops that decide to rupture before they get there. I draw blood for a.m. labs regularly (never done on days). There's seizures and strokes that happen with fewer people to notice or help. Think you won't learn enough? I challenge you to NOT learn more than you imagined!

[Wendy_RN]

I have to agree with the other posters here. It really is an insult to say that night nurses are not as competent as you would have expected them to be. Nursing truly is a 24 hour responsibility. Patients do not suddenly become free from all ailments when night shift is working. From what I have seen thus far in my career, most patients deteriorate more at night. (don't flame me for saying that, but that is the trend that I have witnessed) I had outpatient surgery last month and had a complication from it. My husband had to page my physician and guess what??? It was at night after I had gone to bed. There are less resources and higher patient ratios. I am not sure from you post if you are unhappy with your facility, the floor, or your coworkers. Whatever issue you have it is unfair to make insulting comments. I can honestly say that I worked with some horrible nurses on days, but this is not reflective of the shift, just the nurse themselves. The type of nurse you become has nothing to do with the shift.

[Sassybottom]

As a new grad, nights are an excellent place to start. On nights, you will have more patients thus you have legitimate access to more charts. You will come across more diagnoses and more personalities. You will definitely grow as a nurse on the night shift.

There will be nights where the patients are more quiet and sleeping and this is a great time for you to go through their charts, read their histories, look at their orders and think of why certain things are done. You will have more time to look up their medications.

There are some very strong nurses on the night shift. They are strong because on nights, you need to be able to work independently - there are less people to run things by. Find these strong nurses and learn from them. It will help you become a stronger nurse to see how these strong nurses deal with crisis situations.

I think every new grad should start off on nights and move on to days (if they want). On days things can get so hectic you don't have time to think of the rationales for certain orders. You don't have time to look up an unfamiliar med. You definitely get busy with a lot of patient care things i.e., walking a patient, helping with bed baths, making sure a patient is eating ... etc.

I loved working nights and feel that it has helped me grow like crazy without making me crazy.

[kendel]

i am new grad also and i am suppose to be starting night shift after orientation

please tell me how to adjust to the night shift when you are accustomed to days

how did you adjust to it and stay awake?

does it seem like the night go by realy fast also?

is it true it messes up your sleep rhythm?