Is it best for the new nurse to start with night shift?

Nurses General Nursing

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Is it best for a new nurse who wants to work in medsurg at a hospital to start with the night shift? I would think it would be a slower pace so that you can focus more on how to use the computer and how to document on it, etc. For those who have worked both day and night shifts, what do you think?

Specializes in ED, Cardiac-step down, tele, med surg.

Go for the shift that's best for you. you'll learn on any shift. It's hard to be a new grad, day or night shift. My first 6 months as an RN were brutal, such a steep learning curve. I started on day/evening rotations not night shift. I worked nights once and found my body and mind can't tolerate it.

I think the absolute best option (for all units) is for new grads to be trained to both days and nights, even if they eventually go to nights. I really wish that all residencies would rotate new grads through both shifts during orientation. It seems to be a fairly common occurrence in NICU (at least from what I've seen), although I don't know if it's standard in the adult world.

The workflow and nursing tasks can be so different between day shift and night shift; by orienting to both shifts, you are exposed to more learning opportunities, practice a broader variety of skills, and have a better sense for the big-picture unit workflow. On days, you collaborate with more healthcare team members (PT/OT, social work, etc.), you hear the updates during rounds, you see more routine procedures, and you learn how to multitask like crazy. On nights, you learn to work more independently (since the provider isn't constantly around to answer clarifying questions), and you have more time to read through notes and ease into time management. I don't know about other specialties, but in NICU there are certain tasks you only do on one shift or the other; for instance, day shift might change lines and hang complex drips, whereas night shift draws all of the labs. If you only work one shift or the other, you don't become proficient in the skills utilized by the opposite shift.

This also helps combat the issue of night shift being flooded with a bunch of new grads all at once, disrupting the ratio of experienced nurses to inexperienced nurses on at any given time.

That said, as a new grad you'll probably end up on night shift whether you want to or not. As you hypothesized, I found the slower pace of night shift to be a much easier transition than jumping right into days.

I'm a night shifter at heart (I sleep much better on nights than days), but I actually recommend going to days early on in your career if you can (though not necessarily right out of school). I always learned much more much faster on day shift than night shift, simply by being present during rounds, asking the providers questions about the plan of care, being present for procedures, and listening to the providers and specialists educate family members about the various conditions. I much prefer the pace, laid-back culture, and shift differential of working nights; even so, I try to pick up day shifts when I can as a learning opportunity.

Although I adjusted poorly to nights I must confess it was better for learning due to the pace. On days you are running around like crazy with admits + discharges. And then there are the omnipresent family who sometimes help but more often drain your emotional and physical reserves with constant demands, there is more micromanagement, much more.

For aforementioned reasons I vote for nights as an overall learning experience.

I also agree with Ninjanurse51 in that it is a tough adjustment; I never did adjust and am amazed I did it for 1st 5 years but there are a lot of nurses who adjust quite well and spend entire career and I thank God for them as nights are no longer a mandatory at new jobs. Only job-seeking experience I've had a a seasoned RN in which the hiring manager wanted only nights (a few years back) and I tole her I was physically/emotionally unable to work nights she stated "So you are UNWILLING to work nights?" I reiterated I was just unable to and it would not be safe for me to be half-awake, drive home falling asleep at the wheel and adversely impact my state of sobriety she just reiterated "So you are UNWILLING to work nights?" I get it, she only had nights open but she was unwilling to entertain idea of reapplying should a day position pop-up. Ironically it was for alcohol/drug rehab. It wouldn't have fazed her if I fell asleep behind the wheel or fell into using benzos for sleep thus I decided I was UNWILLING to go any further with that establishment. Most employers are more flexible on this and want a safe nurse. If you are a night owl it is a good match but if you wake up with the Roosters type it can be such a bad match it may not be worth the extra learning if you are too exhausted to retain it.

As mentioned there is more opportunity to learn and develop more autonomy if you can adjust to it.

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