For all you night owls

CapeCodMermaid, RN · Jan 12, 2009

I am not in the least confused, thank you. Apparently tongue in cheek doesn't go over well in here.

achot chavi · Jan 12, 2009

[quote=KullyLPN;3368160 just recently switched to 11-7 d/t family issues. My issue isn't the staying awake it's trying to get to bed in the morning.

I an definitely relate- which is why I didn't try to go to sleep right away- i straightened up, did a load of laundtry till I was sleepy- amazing how quickly housework will make you sleepy!!!

My night usually goes like this go over 24 hour report with the CNA's, CNA assignment, Accu check machine calibration, VS, 12 AM med pass (3 res.), initiate my 8 hours of 24 hour report, Treatments (15 res.)

DIDN'T YOU READ CAPECODMERMAIDS POST_ WE ARE NEVER TO DO DSG AT NIGHT IT MIGHT WAKE UP THE PT-

I'm just kidding- I too had to do my treatments at that time when I worked nights, I'm sure you do them gently and quietly as i did so as not to disturb the peace. After all it is in our best interest to keep them all sleeping and quiet.

, straighten up the med room, clean & organize med/tx cart, 3 AM resident rounds, charting on what i can, apply TEDS (5 res.), apply ACE wraps (1 res.), 6 AM med pass fluctuates depending on weekly meds (Fosamax, Actonel, etc.) usually b/n 10-15 res. Accu checks 2-5 res. depending on what day it is, Q 3 hour checks on all res. during cold weather, Change bubblers/clean filters on concentrators/Change NC wkly on Saturdays, wkly BP's on Fridays, set up cart for 7-3 nurse, finish charting, do bath book, behavior book, order supplies for floor, and in between all of that assisting any res. or CNA who needs anything throughout the night. My advice is to set up some sort of schedule and try to follow it. Easier said than done some nights believe me I was one of those people when working 7-3 thought what does 11-7 do. I found out quickly that u really have 2 work a shift before u can have an opinion of it. For me organization is a big priority. Good Luck on your new shift.:)

:clphnds: Well Put!! and thanks for reminding me of all I used to do on nights,. Since my 7 yr stint (for family and financial reasons as well) I have always appreciated a good night nurse

I am printing your list for my staff!!

CoffeeRTC, BSN, RN · Jan 12, 2009

Oye...

For the most part...everything Kully mentioned. The only dressings we do on 11-7 are IVs and Gtubes....don't ask me why and of course, any dressing that fell off or was soiled. I always do the IVS and Gtubes on my 3-11s when they are due for that 11-7.

I've worked all 3 shifts...enjoy 11-7, but work 3-11 now because of family. Each and every shift has its challanges. For the most part 11-7 is slower paced, but remember that you have a skeleton crew and not everyone sleeps.

I find it would be helpfull to train on an other shift so that you can find out what they do and what you can do when you have extra time to make up for what doesn't get done or can't be done on the day shifts. Also helps with the paper work too.

A lot of housework type of duties are assigned to 11-7 and what they do really does help the other shifts run more smoothly. IE, stocking and ordering supplies, copy charts and extra notes etc.

You also get to know or see your residents in a different way than days. Sometimes you can have excellent conversations and learn a ton about them. Funny, I took care of this lady for over a year and didn't know she could walk until I saw her up on 7-3.

Relax and enjoy your new job!

achot chavi · Jan 13, 2009

Michelle reminded me- work nights for a while - come in during the day for whatever reason and visit the unit- YOU WILL NOT RECOGNIZE THE PATIENTS. They look so different by day than by night!!! Maybe its the dentures, glasses or the posture- but I remember my shock when that happened.

Still the night nrs is a very important member of the team

Take advantage of the slower pace to notice things that need improving or fixing and leave a note. It will be appreciated.

Try not to drink too much coffee at night- a hole I fell into!! I had to switch to cinnamon tea.

graceyjane · Mar 10, 2009

I am a night nurse myself and we do dressing changes on the night shift. I have one that takes 1 and 1/2 hours. I do not think it is right or fair to wake a resident up for that long in the middle of the night. I have other dressings that dont take as long and can quickly get them done. I have had residents say "why are you waking me up at this time of night to do a dressing?" I have also explained this to the DON and she looks at me like I am crazy and tells me to just explain to them why. Well why is it? Why can this once a day dressing not be done on day shift? Beats me.

CapeCodMermaid, RN · Mar 11, 2009

You might want to tell your DON that you're risking a tag during DPH survey. If you change a once a day dressing at night for the convenience of the staff, you're likely to get a tag.

achot chavi · Mar 11, 2009

Our night staff does it at 6:30am with rounds, but if the pt is due a bath, its done by am staff. Sundays I do dec rounds so all dsgs are done by am staff. I guess the surveyers here where I live were happy with that as they checked it.

graceyjane · Mar 11, 2009

It is for convenience, because when I asked about the change, she said they were to busy with bariatric residents during the day. We have 2 on the hall of 32. I do not know why they are so busy with them, but that was the excuse I was given.

jschut, BSN, RN · Mar 11, 2009

In our facility, we've recently acquired a whole new bunch of administrative nurses (Haha!), and they have decided to put almost all of the treatments on night shift. Not that I mind doing treatments, but I do agree with not liking to wake folks up in the middle of the night, and according to our nurse mentors (from corporate), we aren't supposed to be doing dressing changes in the night, either! But whatever....

On night shift, what I do....

treatments

Prepare appointment paperwork for the next day

Pass night time meds

Do glucometer checks in the AM

Change water bottles and tubing for O2 tanks

Assess certain patients (we rotate and have certain ones due on certain nights)

Do Medicare charting

Vitals

Check fridge temps

Check glucometer strips

Do a nightly census

And I try to do rounds and peek in on my residents at least every couple of hours or so, just to make sure no one is in distress....

It isn't AS busy as some of the other shifts by way of patient care and med pass, but each shift has its own battles to deal with. As was stated in a previous post... night shift has a skeleton crew and contrary to popular belief... they DON'T sleep all night! LOL!

Good luck with your new job and enjoy yourself! :wink2:

evilolive, BSN, RN · Mar 12, 2009

My rundown of night shift, like many others:

*Census sheet

*Refrigerator temp

*24 hour order checks

*0000 med pass

*Glucometer check

*Treatments (my ADON wants me to look at every butt that has "special compound" ordered for, oye). .. and as a note for treatments, if I find a wound that has not been addressed yet I usually put one of the dressing changes for my time, so that I know it will get done. My other treatments are usually o2 sats, skin checks (whyyyy on night shift, whyyy?) etc. No major wound treatments.

*Check code cart for supplies (this usually only really gets done 1-2 nights/week for me... just don't have time, and most everything is there anyway)

*3am med pass (only one resident)

*6-7 accuchecks

*0600 med pass

*Consult paperwork for any day appointments (this is a convenience for the day staff)

*Monthly summaries after the 15th of the month

*Assessments, both quarterly and annual as they are due

*2 Medicare notes, 4 hospice notes, and notes on any fall patients or patients on antibiotics, or with stuff going on, to put it lightly.

*Anything else they want to dump on me

... oh and all the behavioral patients who I contend with. All the needy patients, especially the one with the G-tube constantly falling out (hooray for foley caths as a GT), and all of the "PRN med patients." In the past month, I have been called away from nearly all of my lunch breaks, but I swear to you, if I had my ADON sign a slip for me every morning they'd probably be having a meeting with me by now.

I really don't understand how the 3-11 nurse can be playing computer blackjack, say she finished up around 9pm with EVERYTHING done, and then pass a straight cath off to me because the woman was hitting her earlier.

such is the life of me, the 11-7 nurse, on a daily.

melz34 · Apr 8, 2009

I work on a paediatric childrens ward so I generally just monior patients, comfort small children ,give meds, change IV bags if needed ,take obs every 4 hours on my assigned patients ,answer to call lights ,sign back in patients out on pass answer phonecalls from worried relatives, have a tidy round ,and help different patients

sweetpeanurse · May 6, 2009

The night shift for me is 7p-7a. 12 hours!! List of my duties

get report

stock med cart (never have what I need)

Stock accucheck caddy

pass 2000 meds

help residents to bed

accuchecks (about 10)

insulin

treatments

temp control

accucheck controls

stock supplies (which we never have)

24 hour chart checks

skilled charting

72 hour charting

ABTX charting

q2hr bed turns

daily wts

0600 meds.

0600 accuchecks

keeping CNA awake

help answer call lights

lets not forget the bed alarms

And no matter what anyone says the residents do not sleep on night shift. We have to answer call lights c in 10 minutes or it goes to CEO and DON. Well it is like they get together @ dinner and say 300 all call. So out of 16 residents @ least 6 have to go to the bathroom @ once. Mind u we can't leave one on the toliet to help another b/c FALL risk. I do my nurse duties and do CNA duties throughout the whole night.