Do Day Nurses Really Feel that Night Nurses Do Nothing All Night?

fergus51 · Apr 18, 2002

I work L&D, and it's said that nights are busier than days.... Med-surg, I have no idea, but in my hospital night shift nurses care for more patients in order to make up for the fact that there is a little less to do.

Brownms46 · Apr 18, 2002

Less to do?? Are you kidding?? You are kidding right??

mattsmom81 · Apr 18, 2002

This is always an issue everywhere I work. When I was a new grad we were required to swing shift....we had to work at least 2 out of the three shifts, and there was less infighting for this reason. We walked in each other's duty shoes....:)

Fgr8Out · Apr 18, 2002

First off... I have worked all the shifts. Currently, I'm working an 8 hour day shift, but for the past 2 years I was working 12 hour nights.

Each shift has its own unique challenges. Days are filled with Doctors, PT, OT, RT, Case managment, implementing the many new orders placed during the day and the like. In general, it seems to me somewhat chaotic for the Nurse trying to get his/her own work accomplished while satisfying the needs of all these other entities.

PM shift is encumbered with a higher number of post-op arrivals (in the Med-Surg setting), so the task becomes one of implementing care to the patients already there, in addition to the additional time required with newly arrived post-ops. Also, there are just some tasks that cannot be completed before the PM shift arrives and this falls to them as well.

Nights... I don't know about anyone else's facility, but, there are plenty of medications to be administered (2100 and 0600, to be exact). These times can be a bit tricky because they are early in the shift, and then right near the end. Any paperwork needs, generally, to be done in the time in between. And let's not forget our patients!! For them, nights are sometimes the worst ... alone in an environment that is certainly not the norm, usually in some sort of pain or discomfort, unfamiliar noises at all hours of the night (which make it nearly IMPOSSIBLE for them to get any quality sleep, constantly on the alert for the next interruption or disturbance), a roommate that may make sleep difficult, etc... an unending list of reasons for patients to be awake and desiring the attention of a Nurse. In addition, non-nursing duties are turned over to Night Shift Nurses because of the perceived idea that they have more time available to them to perform these tasks.

The question I usually try to pose is this: Are the tasks assigned the various shifts done so because of any study that shows these are the BEST times to perform them? Or is it just "tradition"?

And why do Nurses always make the assumption that the shift prior INTENTIONALLY leaves work for the next shift? Shouldn't a Unit be a TEAM? And shouldn't we, as "Professionals", have the GRACE to understand that, when a job wasn't completed the shift before it was more than likely due to too many tasks needing attention all at the same time, rather than some conspiratorial effort on the part of the previous shift Nurses to "dump" on the next shift?

I used to subscribe to this sort of mentality. It drained all of my energy though, and left less for my patients. That's not to say that in any Profession there aren't those "slackers" who try to pass off tasks to others, or that we don't work with folks whose disorganized behavior keeps them from finishing their work, leaving it to the next shift to deal with. But I so often see Nurses pawning themselves off as "victims"... always being put upon or mistreated in some way.

OK, so I just lost my train of thought....

The point is this... Nurses allow the continued perpetuation of myths, old grudges, stereotypes and the like ... which fosters ill will among us. We're not in competition, folks... we're supposedly working towards a common goal: Patient health and well being.

So go ahead, pick up the slack for a co-worker once in awhile... go that extra step, BE the bigger person. Set an EXAMPLE of how YOU would like to be treated by first, treating others in that manner.

Only when more of us walk the talk and refuse to listen to the nay-sayers, will those stubborn heel-diggers either change their way, or move on to bleaker pastures.

Brita, no, I didn't forget you and your dilemna. It's horribly frustrating when teamwork isn't the norm, and shifts pit themselves against one another. BTDT, and of course, whenever you move to a new facility or unit, you may very likely encounter the same scenario all over again. All you can do is be the example... even the exception sometimes, and ignore the invalid complaints and comments that come your way. Look at how your own shift is run and see if there aren't things that can be changed to make the night shift routine flow a bit more easily. Talk with your Supervisor or Manger and ask for input. And please, please, give your coworkers the benefit of the doubt. Their day may have been just as chaotic as your night.

Peace :)

moonrose2u · Apr 18, 2002

nah, they are busy...but its a different kind of busy..u know, all those "paperwork" responsibilities they are given..

and lets not forget our patients...they all come alive at night..:)

fergus51 · Apr 18, 2002

Browns, when I say less, I am talking about things like bathing (am care is done by day shift and pm care is supposed to be as well), phoning for new orders (usually done on day shift unless it is urgent), patient teaching (most of the time we try to let them sleep), meds (there tends to be more meds on days), talking to family members on the phone (they tend to call during daylight hours) etc. I am not saying they don't work. But they can work with less staff than days because they don't have to do the things listed above. Our hospital cuts the number of LPNs on nights because of this and it seems to work just fine.

duckie · Apr 18, 2002

I think as long as we having nursing this will be an ongoing arguement between the shifts. I do not work 1st shift, never have and never will cause I am just NOT a daytime person. BUT, I have noticed that the majority of our new admits are usually scheduled to arrive after the 2nd shift arrives. Now this ticks me off as the there are double the nurses on each unit. Many time there are 3 LN's on each unit for dayshift but I am usually the only LN on my unit for 2nd shift. I work with a QMA, which means I have to completely over see everything on the unit of 41 residents, handle emergencies on both ends, admits on both ends, doctors order, call MD's, scheduling for the staff assignments, deal with incident reports, falls, plus I do all meds and treatments for 22 of the residents, plus deal with family members that have questions and concerns. I serve as the mediator for staff conflicts, console residents that cannot understand why their needs are not more important than everyone elses, plus anything the QMA is not allowed to do, I must do on their end. In the past 4 months I have not had one break during my shift while I am at work for 9+ hours each day. My hall is heaviest in regards to level of required care, plus we have many residents that require much "TLC" to keep them happy. In other words, they are rich, very spoiled and expect to be placed above all others. Well I flatly refuse to do this. I don't see their bank book so be they rich or poor, they all rate the same in my book. I work many late hours trying to make sure none of my work is left over but the other nurses that replace me on my days off do not do this. I took a vacation a while back. The day before my return, there was 2 patients admitted to my unit. The 2nd shift LN did nothing on either admit. So you would think that 3rd shift would have made some attempt to at least start the admission process but they did not, and since the admits came in on 2nd shift, the dayshift nurses also did nothing to admit these folks. I came in and blew my cork!!!!! I told my supervisior that I'll be damned if I'm doing the work of other nurses that replace me on my days off. So, someone else was sent to the unit to complete these admits. A few days later, I found out that an admit had come in on my day off and a nurse was pulled to do just the admit on the unit. I never get this luxery. If I have admits, deaths, emergencies, I am expected to stay till what ever time it takes to get my job done, no offer to help Duckie......nope, she's a super nurse. She don't mind no breaks, eating while charting and going without BR priviledges until the bladder starts to rupture. I think Duckie is a sucker, what about you???? I love my job and I'm willing to bust my butt but the same should be expected from the other nurses and they are cut slack because manay of them are just plan lazy. You know the type, call off all the time, especially if they've seen the schedule and don't like where they're going to be. As for 3rd shift where I work, I see them coming to work with books, craft projects, constant carry ins as they get hour lunches, so in our case, yes I think the negativity is valid. If they have to pick up somethin my CNA's don't get done, they get rude about it and I toss it right back at them saying that they hold the same certification my staff does so deal with it. We have one lady that take 70 minutes to walk from her chair to the bathroom. I'm not kidding. She's very large and does most everything for herself but when she's ambulating you have to be with her, she's frightened of falling. So my shift walks her to the bathroom and then 3rds must walk her to bed. They gripped about this. Many of my CNA's have pulled doubles and know for a fact that 3rds are double padding, which explains the zillion TX's I have to broken down bottoms, but yet the say they are overworked. I think not!!!! They are supposed to be bedchecking and toileting every 2 hours but wait till 5am and just change all the briefs and let it go at that. They have minimal other assignments so I would think they could at least do the scheduled bedchecks but they do not. The nurses on the other hand run their butts off because there is only 2 LN's, and sometimes one to cover the entire complex at night. Don't know how they get past this with state but I guess money talks somewhere in this deal. This is only the deal at my facility and I'm certain it changes according to where you work and the amount of staff assisgned.

Fgr8Out · Apr 18, 2002

I will stand by my statement that, until we start acting like professionals... we will continue to be treated in an unprofessional manner. And so long as nurses continue to "toss it back at them", the only response anyone should expect is more of the same.

Peace

**SKM-NURSIEPOOH, BSN, RN** · Apr 18, 2002

where i work, all three shifts have duties unique to them, something like what fgr8out laid-out above. in my facility, which is a ltc facility, both days & evening shifts have x2 staff nurses (lpn or rn) per unit as well as 5-6 cnas & no unit sectretaries. four units have 58 patient capacity & usually are full, and there are x2 units with 34 patient capacity because one is a step-down medicare a unit (which requires at least x1 rn for documentation purposes due to the insurance issue), & the other unit is designed to be a palliative care unit...& both units have x2 nurses plus 2-3 cnas. i too have worked all three shifts & there are crazy situations on all; however, i do see a situational pattern happening with what the over shifts think what the night shifts does.

usually days receives & take-off those doctors' orders; have am care, feedings, therapy & treatments, admissions & or discharges, send patients out to medical appointments plus prepare the paper work prior to them leaving, send patients to the beauty salon, sign-out those patients who are going out on pass with family or friends, do weekly skin assessments, monthly summaries, emergencies as well as their med passes. many have to float around from one unit to another, even after starting out on a unit; nurses have been pulled in the middle of their shift for one reason or another. they tend to leave things (usually non-urgent orders & some treatments) for the evening shift. it happens.

the evening shift have those things left over from days, plus their own duties such as changing all feeding tube formulas & tubing, provide all new syringes for peg tube medication administration, pm care including checking for impactions, administering all fleet enemas or suppositories & any lady partsl hormonal creams @ 9pm, treatments & meds including the removal of nitro patches, weekly skin assessments, monthly summaries, new & re-admissions plus discharges that were left-over from days, emergencies, sign-in those patients returning from being out-out on pass. evenings has to do all of this in addition to answering all of the patient's family questions & concerns. they leave things for the night shift, but usually one or two things & it almost always happen whenever there an emergency occurred.

the night shift has duties similar to that of days & evenings like treatments & meds, discharges (when patients expire, a discharge summary is written on our shift or whenever a patient was transferred to a hospital & admitted there, on our time, a discharge summary is written as well - doesn't matter whether evenings had sent them out or not), weekly skin assessments, & monthly summaries. nights are responsible for the 24 hr chart audits, checking the monthly re-caps & do all of the mars/tars for each month. we're responsible for ordering supplies for the unit, do daily calibrations on the glucometer, check the temps in all of the refrigerators, check the crash-cart meds & supplies nightly, change all o2 tanks (yes we still have tanks), clean the o2 concentrator filters & tubing's weekly, & we do all of the am blood glucose check & give sliding insulin coverage because days don't have enough time before breakfast. night cnas have to get-up x10 patients for the day shift & we, the nurses, have to inspect those patients because days have complained about how night cnas where dressing/shaving them. the night nurses have the same number of patients but the only difference here is that each unit only has x1 nurse on the shift & 2-4 cnas, depending on the unit & whether it's the weekend or not...the cnas tend to call-out a lot on the weekend, especially pay weekend. now, more that ever, we've come on shift & there's approximately 10-20 charts with orders not taken-off because they're non-urgent & both shifts didn't get to it...guess who has to take them off before the 24 hr expiration. nights also inherited all those am, 1 hr before meal meds because breakfast is served between 7-7:30am daily...never mind the fact that those same meds could be given 2 hrs after...that doubled the amount of our am med pass from an average of 15-20 to 25-40 patients...try to wake-up these people in the am for x1 pill & see how readily they take them...most hate having the last minutes of sleep interrupted, especially because they're checked q 2hrs at night for changes... but we're not suppose to complain. the thing we night nurses hate the most is the fact that whenever a u/a or stool specimen is needed...guess who has to get it...i mean, an antibiotic med not supposed to be given until the u/a - c&s is obtain...so the patients suffer almost an entire day until we get the specimen & the lab department pick it up at the end of our shift...as if days or evenings can't obtain this on their shifts when ordered. we also have those night owl patients who enjoy the peacefulness of the shift...we have to feed them whenever they're hungry...& they like to socialize with the staff...they enjoy the attention. naturally, whenever an emergency occurs, things get backed-up but days still doesn't like it when we have to turn anything over to them...so we often stay at least a 1/2 or a full hour over to avoid the confrontations. one observation that i noticed was that the only time day's nurses go-off on the night nurses is only when they know that the night nurse(s) have a timid demeanor; they usually leave the more assertive night nurse(s) alone. i believe fgr8out's last post says it all...:kiss

...until we start acting like professionals... we will continue to be treated in an unprofessional manner. and so long as nurses continue to "toss it back at them", the only response anyone should expect is more of the same.

night owl · Apr 18, 2002

I really don't know where to begin here. I've worked every shift ever made at my facility and being on nights for the past 5 years I've come to one conclusion... the night shift IS the shift that gets dumped on. First of all we get treated as third class citizens. By this I mean that when it comes to any inservices or classes of any kind,the education department thinks 12-8 shift doesn't count or it's not the time to go in and TEACH anything because I have to sleep! I've c/o this many, many times, but nothing gets done. Then at the end of the year management comes saying, ''Well I see you didn't get your 40 hours of CEU's in...'' and then I blow up!

We have a resident on our unit who has this suction type machine hooked up to his decube on his butt. He's had this machine for about a month now and it seems that he always has trouble with it during the night shift. "Is it working? It doesn't seem that it's working." I've told the day shifters that as long as I have no idea how this thing works, I'm not touching it. They are the only ones who know how to work it because they were the only ones who were taught how to work it, and no one else counts. Finally, last night a day nurse was scheduled to work our shift and she took the time to show me how to properly change the sponge, where to place the tubing, how to secure it and how to operate the machine and I let them know in report that I FINALLY know how to do this THANKS TO SALLY!!! They laughed and thought it was a joke. How can I do my job if I don't know HOW to do my job???

Any extra jobs to be done is given to 12-8. Two days ago we were ''ELECTED'' to obtain all of the occult blood stool specimans. Like they only cr@p on our shift! So if all of these specimens aren't collected, now they have someone to blame. There are only about 10 people and each get 3 samples. {{{phew}}} My new nick name is now "The Stoolie" need I say more...

The day people are ALWAYS coming to me asking things like, "why weren't ALL of the residents fed?" "why is so n so still in bed?" I say, "Well with 3 NAs, myself and an RN for 60 residents, they all won't be fed and they all won't be up!" They don't like it, but that's the way it goes AND then I say to them, "Aren't YOU supposed to take over when we leave???" Where is the continuity of care here??? Absolutely NO teamwork on my unit. If they weren't fed on 12-8, chances of them getting fed on days are NIL. Days wants everything nice-nice when they come in so they can (and do) sit and have coffee and Dunkin Donuts. God forbid they had to do something when they first arrive. I know this because I'm still there an hour or so after 8am (for free)

finishing up my notes etc that I didn't have a chance to do and I see what goes on and boy do they hate it..."When are you going home???" and "You're still here???" I even over heard one say, "I think she's just being nosey..."

I like the "quiet" of 12-8. No bosses, no big shots and no one trying to impress the other, but I don't like being "dumped on," blamed for and criticized for most everything we did or didn't do.

Many mornings I drove home in tears just for DOING my job and doing all of the "extras'' they dump on you. Sometimes I wonder, "Is it all worth it?" I always thank the evening shift nurse when she leaves to go home at night..."I'll see you, drive safe and hey, thanks alot." When I leave and say, "Good bye everybody, have a nice day," No one utters a word. Just goes to show you how much you're appreciated.

Fgr8Out · Apr 18, 2002

Originally posted by Fgr8Out
I will stand by my statement that, until we start acting like professionals... we will continue to be treated in an unprofessional manner. And so long as nurses continue to "toss it back at them", the only response anyone should expect is more of the same."

And I will continue to reiterate this statement until such time as Nurses finally understand and begin to implement it.

It isn't THEM... believe me, it's YOU

Do Day Nurses Really Feel that Night Nurses Do Nothing All Night?

Do day shift nurses feel that night shift nurses have nothing to do?