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

[Brita01]

Having worked the 12 hour night shift in many hospitals I find the same things. Day shift nurses leave us so much work to do that we're playing catch up all night. We start off 2 hours behind because we're finishing things left over from the day shift. I've had times when I'm still giving 9pm meds at almost midnite because things were so screwed up starting out. Then we have to do our night shift paperwork and deal with the patients who do NOT "sleep all night". Part of the night shift paperwork involves getting things proper and ready for the day shift to use. And I swear if something gets missed by us we WILL hear about it. It really burns my butt when they come in in the morning complaining about what the night shift didn't do because we ask their secretary to make a call or two for a consult. BUT it's ok for the day shift to pass things to us because it's a "24 hour care hospital". I'm just curious. How many day nurses out there believe that the night nurses should be able to do it all because we have nothing to do anyway?

[DutchgirlRN, ASN, RN]

NIght nurses as a majority do work hard. Just like we have some lazy nurses on days it's beyond me how they have time to sit on their butts. Where I work the night nurses don't deal with doctors to the extent that we do, not with the families, but having worked nights for 12 hours, I can assure anyone that nights is not a piece of cake. Not to mention what it does to your health. More power to the night nurses, keeping the pulses going all night long.

[Stray Kitty]

I work in a very small rural hospital on 12 hour night shifts. I am the charge nurse/house supervisor. I have worked both shifts and I can definately say that days and nights are different, but I can't say that one is busier than the other. We do encounter problems on our shift that day shift doesn't have to worry about. Days always has a unit sec. We never do. Shouldn't really be a problem, except that the doc who always has the most patients doesn't make rounds until our shift comes on. So, sometimes the unit sec sits around all day and does NOTHING, and I end up taking off orders on 10 charts. Another prob that we have is that after 11pm, there are only 5 nurses, 1 NA, 1 doc, and a lab tech in the WHOLE hospital. Until very recently they only had 1 nurse in ER after 11pm. Then if our census is down, they either cut the NA or a nurse. Makes life really interesting when there is a code or a multiple trauma situation. Day shift has a resp therapist, nurses in outpatient dept, paramedics who work in ER, and even "clipboard nurses" available to them in case of a crisis during their shift. We have just us. I am very thankful that those of us on nights work so well together as a team.

[pepperann35]

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

Amen;)

[grace90, LPN, LVN]

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.

A newer night nurse told me about a shift in which she got bullied to stay over an hour and a half past her shift because two of her patients had gotten orders to get transfusions right at the end of night shift, when critical labs start getting called up after the morning lab draws and day shift expected her to hang the blood, etc, when they should have been the ones doing it. I know who the nurse who did it was, and she's done it to me before, ONCE. I don't get bullied by day shift much anymore since I'm gradually getting less timid and more assertive, I've learned how to raise one eyebrow at 'em and just stare at 'em.

[YellowFinchFan]

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

I agree - I work Days - our day/night shift pretty much gets along great....it's a pleasure. When I have to leave something it's with much regret and understanding because during report they find out WHAT WENT ON.....Days is very busy - and we get tons of admissions/discharges = emergencies - etc....nights also gets slammed at times.

I treat people the way I want to be treated - and it's worked well for me!

Professionlism goes a Loooooong way....sounds like mgt needs to step things up --- communication needs improving so the unit works like a team.

[YellowFinchFan]

A newer night nurse told me about a shift in which she got bullied to stay over an hour and a half past her shift because two of her patients had gotten orders to get transfusions right at the end of night shift, when critical labs start getting called up after the morning lab draws and day shift expected her to hang the blood, etc, when they should have been the ones doing it. I know who the nurse who did it was, and she's done it to me before, ONCE. I don't get bullied by day shift much anymore since I'm gradually getting less timid and more assertive, I've learned how to raise one eyebrow at 'em and just stare at 'em.

The raised eyebrown thing made me laugh - I"m glad it works for you! :)

That's ridiculous (making nights hang the transfusion for days) As my manager always says "this is a 24hour JOB".....the next shift has to take over.

[traumajunkiegirl]

ok where i work this is what goes down....

Rural Hospital 20 beds, ob and l/d, er

Dayshift...

3 RNs

1 LPN

2 CNAs

1 Ward Clerk

Office staff to sign papers and register admits and paperwork

Dr. rounds once....

Non-emergent ERs are routed to the clinic

Nightshift

1 RN

1 LPN

1 CNA

same patients...and ER goes nutz after the clinic closes at 5pm

Dr. rounds in the evening.

all the blood infusions never seem to get done and are left for us

phone rings like hell

I alone am in charge of the entire floor and ER.

we get to make out dayshifts paperwork for them and check charts to make sure they noted thier orders correctly, and make out new mar's

we have more meds, more orders to note, and more er's

but amazingly ....less staff ????

Guess what else...major trauma/code comes in, its all on me, a lpn, and the doc on call...i dont have a team of 4 nurses to help out!

Not only do you have to be independant and skilled at ER you gotta be good enough that you can handle a code/trauma alone.

:angryfire

[End Game RN, RN]

O.K. I am not speaking for any other unit or floor or service in our facility. Just the neuroscience where I have been forever, actually I am, along with just one other critical care RN (a brillant former mentor of mine) are the most senior staff members in our unit.

I have watched a hundred or more nurses and other staff members move on, move out of the profession or move up in other areas of nursing such as arnp or nurse anesthetist, administration, business management, nursing education, etc...

I have also worked some oddly structured shifts early in my carreer in this facility..i.e. 11 am to 7 pm, 11 pm 7 am 12 noon to 12mn, 12 mn to 12 pm, 3 pm to 11 pm, 7 am to 11 pm, 3am to 3 pm, 3 pm to 3 am. This was during a traditional 8 hour shifts with the exception of a couple of twelve hour shifts thrown in. The problem was to balance this with a covering nurse to work the other side of the odd hour shifts.

I eventually went to modified Baylor weekends. Every Friday, Saturday, Sunday, 7am to 7 pm. The rest of the week at this time I took care of my parents who were very ill, arranged for friends and family to assist with this and was able to get a home health care RN and CNA, but this was the exception, not the rule. I also continued practicing Judo (stress relief for having no social life), total years in Judo, 20...with the early part of my participation in this sport spent in extensive training, six days/week and competition, State and National and International.

Because of having the experience of working all 24 hour possible shift schedules I can honestly say that no one shift, I don't care who you are..is busier than the other.We are solely responisble for what we do at work. There is the professional side, the side that knows what is right from wrong, the side that knows what needs to be done and does it, triaging the most important nursing care, the side, more importantly, that understands that nursing is 24 hours and does not have time to ***** about what another nurse does or does not do.

This is an issue between nurses reporting off, when you are receiving oral report with the patient's chart and the flowsheet, checking the last orders towards the end of your shift to see that they are taken off per your units P & Ps and discussed between the two nurses. Questions regarding the documentation, performance or pending performance of the last orders should be dealt with.

Then "round" with the off going nurse and check lines, dressings, any infusing medications, mix of drips and check labels. Review ventilator settings and pending changes and/or labs for ABG or other labs and when they are due. Discuss known or potential complications of patient's and interventions to be performed or have been performed. Check all wound dressings and wounds uncovered and have sutures or staples. Discuss psychosocial issues as a heads up to the oncomming nurse if issues with family/friends.

Report time is the time to discuss concerns you have with what has been done or not done for the patient and/or family in a calm and professional matter. This is not a personal issue, this is not a time to fight over what should or should not have been done.:angryfire

The above is our typical report for each patient in our unit. We check our neighbors to keep us on tract as a unit. Yes we will fight, but shift wars are not tolerated, this being a strict, unwritten law that we can not violate without compromising our professionalism and our personal relationshipsl. Our unit is unique in so many ways. We will fight like family, but God forbid if a stranger comes between us or decides to intervene in an issue between nurses.

Our unit is on 12 hours shifts, nights and days with no other shift options at this time. The outstanding thing about our unit is that we know each other so well, we integrate new staff as soon as possible.

For example, I rewarded one of my excellent orientees when she not only passed the ICU clinical program at our facility with outstanding performance and grades, but actually got through my orientation with a minimal of growing pains, I invited her to one of our farms and she rode my mare, the mother of the gelding who threw me on my ass this past June) After she rode, took pictures with other horses, I took her to Shorty's Bar B Q and told her she deserved recognition and I told her I knew she would go far in this profession..I took this time to counsel her to return to school and decide what she wants to do in nursing. This "away" time from the hospital environment is what I choose to do for outstanding orientees. It is casual and non-threatening.

This is one way to develop the "young ones" and NO, we do not permit the young to be eaten by others. There have been a few difficult transitions for new staff when working either shift, we have found a way to make transitions easier by "adopting" and "nurturing" the new staff. To make them "ours"

Individual conflicts between staff members from either shift are encouraged by the "group" to be resolved between the persons involved. More commonly, senior staff may advise and assist with restoring communication. Other staff, perhaps with less experience but possesing a good dose of common sense, compassion and good people skills are also important in assisting with potentially toxic intershift relations. Administrative action would only be taken for issues that persist and potentially become destructive to the group as a whole.

Being human, none of us are perfect. Mutual respect, understanding the people you work with, the level of experience, the age of the "new" nurse and that individual's life experiences (we are nosy, we learn a lot about each other, this is a big plus when helping staff to integrate into the group). Never refering to the oncomming staff in a way that defines them as different from us, but as friends and colleagues. Looking objectively, despite how you feel how an assignment has been left for you to "clean up".. Learn first from report what has happened, maybe the patient just came from the OR or from another proceedure, or just admitted, regardless of what the time is. Maybe its a fresh trauma with tremendous challenges to support the patient requiring multiple staff to jump in a help and yet much more must be done for the patient as the new shift walks in.

Now, if you find a nurse hanging around the nurses station or computer checking out the latest Pottery Barn catalog...Well...Communication has to begin somewhere, but not with public display of anger, disgust, and repeating over and over to sympathetic staff how you were screwed. Sooooo COUNTERPRODUCTIVE.

No matter how you feel , get the staff member aside to discuss your concerns, especially if end of shift orders were not recognized, or recognized but ignored for the "other" shift. Perhaps last 7 am hourly vital signs still need to be documented, or the urine bag is bursting because it was not emptied and measured regularly..just a lot of **** you find and want to blow up, but don't! Missed medication at the end of the shift, especially if there are no emergencies, CTs, admissions of trauma or transfers for example, is unacceptable, after all, don't we take pride in our profession?

In our unit, I am day shift, 7 am - 7 pm, I can objectively state night shift gets a majority of trauma, brain and spinal cord, usually, depending on when the patient was completely worked up in Resus and cleared to be transported to the unit, sometimes early evening or maybe around 2,3 6 am. There is a great deal that needs to be done for this type of patient admission, as you know. I have seen days when night shift staff not only received trauma and transfers late at night, but also at the start of their shift receive scheduled post op patients, many with 8 or 10 or 14+ hours of surgery, many with profound medical issues, sketchy medical historys or with no know pre-existing medical history, or develop complications of diagnosis and/or surgery requiring aggressive multi-ICU nurse availability to support the nurse and the patient he/she is admitting/caring for.

And yes, there are also many days, though not usually back to back..where the unit is status quo..Admissions, Discharges, Trauma and Transfer admissions just seem to flow smoothly through each receiving shft.

Any of the above sceanarios can occur during any shift. The trick is to realize that there is no unit conspiracy to deliberately sabotage either shift by any one person. No one is that powerful. **** happens 24 hours a day.

End of my epistle....

Have fun..End Game RN

[jelorde37]

ive worked pms and nocs. when i worked pms i found out that i was running most of the things that the am shift didnt get to finish. when i work noc, i would run the things that the pms didnt finish as well as getting things ready for the ams.

[Sean 91]

At my previous employment at an HCA facility as a 12-hr nightshift nurse we had an ave. 8-10 patients at night (several times 12 pts) on a Med-Surg tele floor (and the night where I floated to Trauma with 11 pts) (that's HCA for you), sometimes with only 1-2 aides for a 36-pt unit, and I did so much walking I developed constant burning aching feet. I worked my tail off. (Always a few who seem to be down at the nursing station much of the time.) Often didn't get a break.

Now working at a different facility as a dayshift nurse with 4-6 patients often with total care pts it seems just as busy. But I'd like to try nightshift here because they get no more than 6 pts each, which might be breeze compared to 8-10 ave. before.

[chibear55]

We Rotate Every 2 Weeks Between Nights And Days. No One Can Grip That Way.

[akcarmean, LPN]

I have worked both day and noc shifts

I prefer nocs b/c you don't have to deal with the politics to much

but I do and have worked very hard at night

i worked in a LTC facility there were 2 nurses and 2 cna for 174 pts. talk about being busy!! you had your work to do plus help the cna with there work. I never got out of work on time and was always getting in trouble for that but what can you do. This LTC facility always put the full weekly skin assessments on the noc nurses.