Do night shift nurses try there best

qt_rn · Jul 12, 2010

I've worked both days and nights. From what I can tell, there are nurses who are excellent in that they do all their work, plus look for ways to improve the patient/work environment in their spare time. Then there are nurses who just don't do any more than they absolutely have to. It would be amazing how much better things would be if everyone worked as hard as each other!
On our unit, we have "side duties" on each shift -- like stocking IV trays, cleaning up the nurses' station/lounge, etc. Some nurses do their duties, and then some extra -- while others just sit and watch the hard workers pick up their slack (sad). When things are ridiculously busy, obviously some things just aren't as important as emergent patient care. Unfortunately, those are the time the nurses on the other shift tend to fuss about what wasn't done. I have found that both shifts tend to do this. Each shift has its difficulties and benefits.

Sounds like my floor! There are always going to be those that come in to work their hardest and go the extra mile and there will always be those that come in to work so that they can make $ and do the minimal amount of work as possible.

I am the new grad on my floor and its hard to fit in with the staff. If I work work work all night long and don't join in on the relaxing it seems like I a making myself an outsider to the rest of the group that is relaxing... I bring in a book and read on a night shift, but only after everything else is done, including extras. Our night shifts are pretty quiet...everyone is generally in bed by 2300 and then we have charting and med checks to do. That takes until about 1am depending on how many call bells ring during that process. We do hourly rounds and t+r as indicated by skin integrity and patient preferences, and bum changes and toileting depending on the patient. If they are the patient that has not had a good day and has finally settled for the night then we check up on them and lightly reposition them without waking them up. 5am comes and its time to do another set of rounds, change and reposition everyone, do 0600 meds and lab work and then report. This is when I tidy up trays and bring fresh water for the day, although some mornings are hectic and occasionally this does not get done. Usually between 1-5am, most nurses on my floor will read a book, surf the internet, watch a movie or nap as long as everything else is taken care of. The ones who nap take one of those phones with them and check to make sure with other staff that its ok for them to go into the quiet room for a quick snooze.

Generally the complaints that arise between shifts involve the dishes in the break room, the table in the break room, and things not being stocked or charts not being stuffed. I do think that some of the night staff come in believing that they are there to make sure nothing goes wrong and do minimal pt care or other work, but generally most of them are great and make sure to get all work done before they move onto their movies or knitting etc.

Keep in mind I work on a sub acute unit so the patients are stable and some are independent and I do work both shifts

scoochy · Jul 12, 2010

Every nurse has their "down" days/evenings/nights. That is not to say the care delivered is not efficient and effective. It's just the little things that might not get done, such as disposing of the three cups of water at the bedside, cleaning up the work space to a "spic and span" shine, etc.. Some nurses are neat freaks, others not so much. Yes, a clean working environment displays pride in one's work. But, let's not forget that nursing is a 24 hour/day profession. What doesn't get done on one shift for one one reason or another is passed to the oncoming shift. However, a consistent pattern of passing work on is when I sit up and really take notice. In the past, I would get perturbed when I would come in to work, seeing the off-going shift sitting, "shooting the breeze," or "chomping at the bit" to give report, only to find "something" was left for my shift to complete. Did I ever consider that the shift could have been horrendous, and perhaps it was the first time that my colleagues were able to sit down for 10 uninterrupted minutes? Was that "something" that wasn't done worth "getting my bowels in an uproar?" No, it never crossed my mind. I was critical of colleagues who did not aspire to the same work ethic I did; "perfection." It took me years to "get off my high horse;" no one is perfect, and that includes ME! The workload can be shared in some way, shape or form.

I try not to "sweat the small stuff;" some days are easier than others to keep to this "canned" (but true) expression in mind. Nursing is a caring profession; we need to care for each other just as we care for those who entrust us with their lives. :twocents:

scribblz, BSN, CNA, LPN · Jul 12, 2010

I've worked all the shifts in LTC/ snfc rehab units, currently i do 7p-7a on a 45 bed ltc unit as the only nurse on and that is a busy 12hrs let me tell you. It can be overwhelming at night because you are the only nurse if something goes wrong. If you have poor quality aides you're really in trouble. Night shifts have the reputation of being very "quiet" shifts but depending on how heavy your list of duties is ie a very heavy 12a & 6a med pass, chart checks, treatments, drug order, restocking, editting. Throw in a fall or 2, behavioral residents who might req 1 on 1 to maint safety and you might actually not even have time to eat the entire 12hrs. I put a lot of effort in being time efficient so i can get all my work done and I've definitely noticed over the past 3yrs steadily the job seems to be getting busier. So people should be aware of the nature of what the night shift may have to put up with at their job. sure some people are lazy or sloppy. but also some night shifts are really heavy to work. just my :twocents:

sugarbush · Aug 13, 2010

I work nights and our shift goes like this:

19:00 Get report

19:30 start passing meds and doing assessments, BGs, Changing past due IVs left over from days, Check charts for orders left undone by days, call pharmacy 100 times for drugs that are not on the floor and due at 2100. Do dsg changes that are due.

Get done with all that about 0100 and start charting without stopping for a break.

0230 round before starting chart checks.

0300 Start chart checks and reconcile MARS for am shift start.

0430 finally have time to stop for a quick break before it is time to start am med rounds, consents for procedures, am BGs, Discharges for am shift etc.

I don't know about day shift, but we earn ever red cent on nights.

RedhairedNurse, BSN, RN · Aug 13, 2010

I work nights and our shift goes like this:
19:00 Get report
19:30 start passing meds and doing assessments, BGs, Changing past due IVs left over from days, Check charts for orders left undone by days, call pharmacy 100 times for drugs that are not on the floor and due at 2100. Do dsg changes that are due.
Get done with all that about 0100 and start charting without stopping for a break.
0230 round before starting chart checks.
0300 Start chart checks and reconcile MARS for am shift start.
0430 finally have time to stop for a quick break before it is time to start am med rounds, consents for procedures, am BGs, Discharges for am shift etc.
I don't know about day shift, but we earn ever red cent on nights.

Well mine goes like this -

0645 - get report

0700 - pull my meds from pyxis to get early start on day

0730 - look at labs and report abnormal if needed

0745 - start passing meds insulin and doing assessments

0800 - first discharge of the day

0830 - helping passing breakfast trays

juggling 6 pts that are calling for pain meds, I didn't realize I went to

school to become a legal drug pusher.

1030 - attempt to start charting so that I may have a lunch

1100 - start getting called by doctors and dieticians, p/t, o/t, etc etc

dressing changes, etc

1200 - more blood sugars, insulin, meds, passing out trays, pain meds AGAIN

1300 - try to take a lunch, but could not, too many requests from pts

1330 - arguing with doctors trying to get pt med she needs so badly

1400 - got a short lunch,

1500 - 2nd discharge of the day, passing pain meds, other meds, sending

pt to surgery after having to bathe in hibiclens because night shift will not do this for reason??

1645- blood sugars, meds, insulin again

1700 - 3rd discharge of the day, arrival of new patient

1730 - arguing with pharmacy about the retiming of meds

1745 - trying to settle in new pt start IV, check off meds, orders, etc etc

1800 - Last call for pain meds before night shift comes on

1945 - staying late to finish charting WHEW!!

I just came off night shift, worked nights for many years. So yes, each

shift has it's own problems. BUT, from experience, there is no downtime

during the day like there is at night. Many nurses I worked with at nights

sleep, yes they sleep, read the Bible and do as less work as possible. There are some nurses at night that work hard but all nurses during the day work hard because we can have it no other way. I've been on days

for a few weeks now and it is HARDER and less pay, but my days off are

more quality. That is MY OPINION!!

anticoagulationurse · Aug 15, 2010

I have worked days and nights in the same unit. I cannot speak of the intentions of the other nurses working nights or what they do or do not do.

When I worked nights I did find myself, cleaning, restocking, peeking in on patients, sorting through the trashed papers and charting area, reviewing charts, passing meds, tending to pain, and surfing the web for HOURS, taking my breaks and "lunch", charting, sitting around, faxing doctors things left over from day time. All the while still finding time to prepare the med pass for the morning shift nurses so all the doses were out of Pyxis into their respective cups and ready to go and be double checked on the MAR. I got very bored on night shift.

franciscangypsy · Aug 15, 2010

I figure if I'm bored on nights, there's always someone else who isn't or needs help. On those good nights, I'll help the aides out (leaving them sticky notes to let them know that the job is taken care of and that they don't have to wake my patient again) and check to see if the other nurses need anything. Nothing is worse than feeling harried and feeling that everyone else is relaxing and kicking it back but you.

Then, if I've taken care of all my people's needs for the night and have made sure my coworkers are all okay, I start discharge paperwork for the dayshift and start seeing if there is anything else I can do for them -- more research, 0700 meds before they come in (as long as they aren't blood sugar related)... anything to make their jobs a little easier.

I rarely have a completely boring, kickback night. There's always something for me to do.

The one thing I won't do is wake pts up for stupid stuff. In MHO, waking up a pt to change an IV that it is working just fine but is a little outdated is a cruel and unusual. IV therapy is available in the morning. They can take care of it if the day nurse is too strapped for time. If the IV is painful, not working, or comes out, or I have time early in the night (rare), I'll take care of it. But otherwise, I'm really sorry, but I'd probably punch someone in the face if they woke me up to replace an IV that was working perfectly fine. The Hospital isn't the Ritz, but I do want to be at least a little considerate of my pt's sleeping needs. Makes your job easier during the day too if the pt isn't crabby about me bugging him for stupid stuff all night. :nurse: