when the day shift arrives

ICU, RN, BSN, B.S. · Jul 13, 2011

Here's my take as a day shift nurse.
I come in - Nights say "You HAVE to get a different sedation for Mr X - he was up all night." Did Nights call the MD? No.
' You HAVE to move Mr B to room closer to the nsg station". Bed is avaiable - did they move the pt? No. Why not? They don't like to move beds. Newsflash - neither does day shift but we do it. Only takes 2 people to push a bed - you have 4 on nights so there are enough.
This piece of equipment is broken - an repair order needs to go in. Did they do it? No. Why not? I don't know how.
Mrs X c/o pain all night - you HAVE to call the MD and get new meds. Did Nights call? No.
And so forth.
Anything that went wrong on nights is my fault because I didn't get the right drug ordered, or I didn't do something. I certainly don't think I'm better than night shift nurses but I certainly don't understand how they can let someone be in pain all night because they don't want to call a doctor.

That sucks. Sounds like overall those night RNs aren't that ballsy. I paged the interns/residents overnight for whatever I felt was necessary to page them about :)

ICU, RN, BSN, B.S. · Jul 13, 2011

Many of them were awake all night anyways; we got a lot of night admissions in the hospital I used to work at .

RNKel, ASN, RN · Jul 13, 2011

That's such a generalization... maybe it's just specific to your place of employment and the personalities working there.

Where I work we don't have this issue.

Forever Sunshine, ASN, RN · Jul 13, 2011

My take -- every shift, every floor, every unit thinks they've got it tougher than anyone else. Usually I just let it roll of my back, but they've really gotten on my nerves recently:
1) Dayshift has at least one person late, every single shift. They come in complaining "you don't know what it's like to get up at 5 am." Uh, yeah, I do, did it for 20 years when I played in computers, and had to be at work when the sites in Europe came on line. And I was on time. And did you have a neighbor cut down a tree or mow the lawn at 1 am? FedEx make a delivery at 3 am?
2) We had a cardiologist who wanted to know why no one had called him about something. I told him it was because he bit the head off of every nightshift nurse who called him, we didn't like to wake people up, but when you don't give us parameters, you're going to get woke up. He acted like he was shocked. He makes 10 times what I do, he needs to put on his big boy pants and deal with it. I wore a pager for those 20 years, it was part of the job, and I didn't cuss people out when they woke me up. It was what I got paid for.
3) Dayshift says they're dealing with doctor's orders, families, etc. We have to sort out all those conflicting orders, the meds double ordered, families calling all hours of the night, spending the night in the room where we're basically running an ICU and a hotel. Nothing like tripping over a family member's junk spread all over the floor because they cuss you out when you turn the lights on. And God help you if the patient needs a portable CXR stat, you're going to spend 5 minutes moving all the worldly belongings of the patient's family out of the way.
4) If a patient goes bad in the middle of the night, we're IT. There's one in house MD, and he's in the ER, that code's either back or not coming back by the time the MD gets upstairs.. There's no CNA, there's one person doing 2 jobs. One week we had 10 patients, 6 were active GI bleeds, 3 were getting GI preps, 4 nurses, 1 tech, and we were all giving blood; I was giving blood to both of my patients. We literally ran out of linen and trash bags, and the first thing dayshift said was, "you didn't take out the trash." We have to bathe every vent patient, document the wounds, restock rooms, reorder supplies, tag defective equipment and haul it to the pickup point, We have to do 24 hour chart checks, finding tests not run, meds not ordered, meds not give, meds that were supposed to be DC'd given...and to get clarification on anything, we have to wake someone up who starts off the conversation with: "Why didn't dayshift call me?"
5) PACU packs up at 6pm. When we have an emergency surgery, they want us to do the PACU hour, too, where we don't leave the room. That's in addition to my GI bleed with a hgb of 4 or acute MI. If someone needs an emergency CT, off we go with the patient, leaving our other patients as additions to the other nurses, and you know there's only 2 folks in radiology, instead of the normal 10 if something goes wrong.
6) I've worked days. Extra nurses, at least 2 CNAs, anybody you need to call is awake, you're talking to the MD who actually knows the patient instead of who's on call, tons of spare hands for turns, dressing changes, linen changes, able to call for housekeeping, materials management, plumbers, electricians, MDs are awake and not grouchier than normal. The only reason I don't work days is I can't afford the pay cut.
Grrrrr. It's been a bad week.....

My pet peeve is lateness. I am on time for work. I arrive 5-10 minutes before my shift begins. Most arrive 5-10 AFTER the shift begins. I am ready to start at 3pm..because every minute is precious and a fall or a resident being sent out can suck up time like a vacuum.

3-11 always has parking issues so I don't say anything if they are late. 7-3 CNAs are the worst for lateness. Theres no parking issues so its a personal reason as to why they are late.. whatever it may be, I've stayed charting sometimes from my shift and its 7:25 and they are still strolling in the door.. coffee in hand.. bagel in the other.

Sunnyday2235 · Jul 13, 2011

i work nights and would not allow a patient to be in pain all night without calling an md. i try to assess my patients and determine if the dr. should be called at the beginning of the shift, to avoid making calls after midnight.

we have a rule that we must obtain approval from our charge nurse before calling the doctor. i don't agree with this as 90% of the time we are not allowed to call the doctors or anyone else at night. this leads to a major lack of communication between the night staff and mds, the charge nurses feel they can answer all of our questions; however they often do not have an answer or the correct answer. it is very frustrating and our day shift nurses do not understand.

rnlately · Jul 13, 2011

Day shift is ready to cannabalize everything because management will do the same to the them and it runs down the line. To think they have it easier is rather ignorant, depending on what type of unit. I find that on nights I am putting out a bunch of fires with less staff, and I find a lot of the patients do not actually sleep on nights and less staff to be there for them/more falls. But other shifts will never try to understand each other *smiley face* is my approach to these people who want to eat me in the morning.

:yeah: :yeah: :yeah: :yeah:

Somehow management automatically ASSumes that just because we work night shift we don't need an aide or that "extra" nurse. Nights can be pure H3LL; sure you may only have 12 pts on the whole floor that holds 18 but things can go south in a hurry if you half of them are very high acuity pts; all of them are full codes; and about 3 or 4 have the potential to go bad in a hurry. Then if 6 or more of them are total care with runny bowels that's a whole other story; not to mention the family members that stay over night with some of the pts and are at the desk as if their (insert relative) is the only pt you have wanting you to come in every 10 minutes to fluff a pillow, give a sip of water, etc.

~Mi Vida Loca~RN, ASN, RN · Jul 13, 2011

Just a quirky question. I worked the day shift for years. It made me precise, great at time management, almost a Supernurse....but also almost a total #$%&!.......now I work nights. When the day shift comes in; no matter how STAT the night has been......the emotional voltage goes up 150%. It is easy to get "waterfalled" into that hard-nosed, frantic energy. QUESTION: Why is it that after a long night of even very eventful negatives...the night shift folks are calm and supportive.....while the day shift folks are ready to cannabilize anything?;...It is an interesting study in human nature....what do you all think? Besides the constant drain of stress with the outer social chaos? Is it really just about "too many rats in the cage".....or what???Blessings!!!!!!

HAHA that part had me cracking up. You can definitely notice a different vibe between the 2 shifts.

rnlately · Jul 13, 2011

My take -- every shift, every floor, every unit thinks they've got it tougher than anyone else. Usually I just let it roll of my back, but they've really gotten on my nerves recently:
3) Dayshift says they're dealing with doctor's orders, families, etc. We have to sort out all those conflicting orders, the meds double ordered, families calling all hours of the night, spending the night in the room where we're basically running an ICU and a hotel. Nothing like tripping over a family member's junk spread all over the floor because they cuss you out when you turn the lights on. And God help you if the patient needs a portable CXR stat, you're going to spend 5 minutes moving all the worldly belongings of the patient's family out of the way.
4) If a patient goes bad in the middle of the night, we're IT. There's one in house MD, and he's in the ER, that code's either back or not coming back by the time the MD gets upstairs.. There's no CNA, there's one person doing 2 jobs. One week we had 10 patients, 6 were active GI bleeds, 3 were getting GI preps, 4 nurses, 1 tech, and we were all giving blood; I was giving blood to both of my patients. We literally ran out of linen and trash bags, and the first thing dayshift said was, "you didn't take out the trash." We have to bathe every vent patient, document the wounds, restock rooms, reorder supplies, tag defective equipment and haul it to the pickup point, We have to do 24 hour chart checks, finding tests not run, meds not ordered, meds not give, meds that were supposed to be DC'd given...and to get clarification on anything, we have to wake someone up who starts off the conversation with: "Why didn't dayshift call me?"
Grrrrr. It's been a bad week.....

I swear we MUST work at the same place...lol.

germanshep · Jul 13, 2011

I know! I always feel they are soooo disapproving and judgement on everything. One nurse asked me at change of shift this AM why a TDAP was not given. I told the nurse the patient requested not to be bothered. I am not going to wake someone up from a much needed sleep to give them a shot. I am sure she will have plenty to say to me tonight. I find it frustrating that there is so much miscommunication and hostility towards the night shift. Hopefully once the busy time ends on the unit, we will get along better.

ObtundedRN, BSN, RN · Jul 13, 2011

I work ICU, and have done both day and night shift. I currently work nights because I enjoy it more. As far as meds, most of our patients don't have many if any daily meds, everything is at least twice a day if not q4. Lets not forget that TID meds and tasks fall twice on night shift and only once on days. Also, chart checks and MAR reviews are on night shift, which can take a good bit of time if they are screwed up, but they are important, I catch error frequently. Sure, scheduled tests happend mostly on days. But there are some scheduled, plus all of the unscheduled trips to MRI, CT, etc. that happens on nights. Nights also draws AM labs. ICU patients are some of the hardest sticks, and you can find yourself trying for blood for an easy 45 mins, not to mention if they are not sedated/intubated, they like to cuss you out for sticking needles in them at 3am. As someone has already mentioned, we also have to manage a hotel at night for the families.

Days, they seem to think they are busier all of the time, which in fact I've notice (from my own personal time working days) they just FEEL busier because they have more people walking around the unit. More doctors, PT, OT, speech therapy, etc walking around, grabbing your chair etc. BUT, when I worked days it was nice having them. When I needed something from a doc, it was easier to get a call back. When my patient had orders to get OOB, PT/OT often was there to do it. So it actually took some work off of me.

I feel that the work is pretty well split. But as I mentioned, Days just FEELS busier. However, I didnt' feel quite as exhausted at the end of a shift on days, and I didn't have lawn mowers, kids outside playing, and people knocking on the door/calling the phone when I was trying to sleep. I like nights not only because it pays more, but I enjoy being a night owl. And I really enjoy the team I work with on nights. The night nurses work together WAY better then the dayshift nurses.

All that I has mentioned is my own experience on my unit at my hospital. It may differ where you are...

BTW, I have never had a problem calling a MD in the middle of the night. But I also work in a teaching hospital with at least an intern always awake on call. I don't like leaving something for day shift to do, because it often is forgotten about or not done right.

~Mi Vida Loca~RN, ASN, RN · Jul 13, 2011

I work ICU, and have done both day and night shift. I currently work nights because I enjoy it more. As far as meds, most of our patients don't have many if any daily meds, everything is at least twice a day if not q4. Lets not forget that TID meds and tasks fall twice on night shift and only once on days. Also, chart checks and MAR reviews are on night shift, which can take a good bit of time if they are screwed up, but they are important, I catch error frequently. Sure, scheduled tests happend mostly on days. But there are some scheduled, plus all of the unscheduled trips to MRI, CT, etc. that happens on nights. Nights also draws AM labs. ICU patients are some of the hardest sticks, and you can find yourself trying for blood for an easy 45 mins, not to mention if they are not sedated/intubated, they like to cuss you out for sticking needles in them at 3am. As someone has already mentioned, we also have to manage a hotel at night for the families.
Days, they seem to think they are busier all of the time, which in fact I've notice (from my own personal time working days) they just FEEL busier because they have more people walking around the unit. More doctors, PT, OT, speech therapy, etc walking around, grabbing your chair etc. BUT, when I worked days it was nice having them. When I needed something from a doc, it was easier to get a call back. When my patient had orders to get OOB, PT/OT often was there to do it. So it actually took some work off of me.
I feel that the work is pretty well split. But as I mentioned, Days just FEELS busier. However, I didnt' feel quite as exhausted at the end of a shift on days, and I didn't have lawn mowers, kids outside playing, and people knocking on the door/calling the phone when I was trying to sleep. I like nights not only because it pays more, but I enjoy being a night owl. And I really enjoy the team I work with on nights. The night nurses work together WAY better then the dayshift nurses.
All that I has mentioned is my own experience on my unit at my hospital. It may differ where you are...
BTW, I have never had a problem calling a MD in the middle of the night. But I also work in a teaching hospital with at least an intern always awake on call. I don't like leaving something for day shift to do, because it often is forgotten about or not done right.

That's the same with me, I am a night owl so I prefer nights. I love that I get paid more for a shift I WANT. Everyone has made comments to me as a new grad how crappy it is I got stuck on nights and I was like "UMMMM I want to be on night" I did my Sr. Practicum on nights as well. I do notice that the day does seem busier because of all the people in and out all the time. Most of my clinicals were on days. I know I saw family around more in evenings because most worked on days and for my unit you get a huge influx of family in the evenings. I think it is also hard with the resources limited. For example, had a patient come up from the ED and the hospitalist didn't come around for 4-5 hrs. We usually wouldn't have taken a patient like this on my unit normally but the hospital was full. So Doc finally comes around and thinks the Pt. has TB. The patient has the trifecta of what you see at night. So we then have to move pt. to a negative pressure room, which we use the "in between" room for storage stuff, so we had to move all that, move the patient, we also were exposed for the 4-5 hrs it took for Doc to get there. We usually don't have aides on the unit at night on my unit unless we are full. We do our own labs and IV's. The Day shift Aides come in at 6 and they start the baths, I am certainly not going to wake my pt. up at 3-4 for a bath when usually it is close to then when they are finally falling asleep. They don't want to bath in the evening because they have all their visitors coming and they prefer to shower in the morning.

Anyway, from what I have seen so far, I wouldn't say either shift has it "harder" then the other, but I think they are just completely different vibes and things that make the shift difficult in it's own respect.

3dayRN · Jul 13, 2011

My experience with day shift....they are usually late or strolling in right at 7. Then they have to put their belongings in their locker, get a cup of coffee, change their shoes, gossip.........gossip some more ......then they are ready for report. I get there early and I am ready for report on time or earlier. The beginning of my shift is cleaning up.....finding orders not done, labs not called etc. Day shift , for the most part, are in a bad mood as soon as they walk in the door. I hate giving report to a grouchy nurse, I should be the grouchy one I just worked 12 hours and I had to wait 20 minutes for you to take report.