Jump to content

12-Hour Shift | Life of a Nurse

Rock Article   (778,107 Views 18 Replies 1,630 Words)
by Susan E. Susan E. (New) New Nurse

Susan E. specializes in sci/brain injury rehab. now outpatient clinic.

1 Article; 189 Profile Views; 1 Post

What is it Like to Work a 12-Hour Shift?

An article describing my personal experience during a 12-hour shift

12-Hour Shift | Life of a Nurse

0445  

Alarm goes off.  Day 3 of my back-to-back 12-hour shifts. I hear regularly from friends (none of whom are nurses) “You’re so lucky, you only have to work 3 days for a full-time job”.  Hmmm, wonder if any of them are getting up this early?

0615  

Wait in bitter cold parking lot for shuttle bus to take me to hospital. 

0630  

Even though I am on the floor and starting to look up my patients so that I can be prepared for the day, I can’t clock in until 0650.  I am in awe of the other nurses who just “slide in” right at 0700 safety huddle and start their day.  

0700  

Safety huddle with night shift and day shift.  One of the RN’s called out today, each of us get an extra patient, bringing the total to 6 patients per RN.  

0710  

Bedside report, an opportunity to meet the patients and discuss with outgoing RN what is happening with each patient.  One of our patients needs to use the restroom, patient requires both of us to get out of bed and put on his back brace. (In my mind I’m thinking, OMG I’m going to start my day behind because we still have 5 more patients to get report on, and I know I have 8 AM meds due).

0800  

Time to actually start some nursing!!  I usually do my assessment after I get my morning meds.   As I wait in line with the other nurses to get to the pyxis we have an opportunity to quickly “catch up” with each other.  “Julie, how are the little ones doing?” “Mary, how is your Dad, oh he’s in hospice, I’m so sorry”.   Why come to work if you can’t have relationships with your co-workers?  As nurses, we certainly don’t have time to discuss the day over a coffee break or at the water fountain but even in short spurts it makes such a difference knowing you’ve got others who are going through the same thing that you are.

0815  

Call light going off on my Ascom, patient just received their breakfast and until I go get their blood sugar they are not supposed to eat.  It has to wait, I’m next in line at the pyxis to pull my meds.  Each of my 6 patients have approximately 6-10 different medications.  Call light again, patient states their breakfast is cold now and will need to be re-heated when I come in for the blood sugar.

0830-1100  

Grab my WOW (workstation on wheels) and start rounding on my patients. Let’s be honest, some patients, in fact, most patients are nice but some are not.  The patient who didn’t get her blood sugar checked before eating her breakfast which is now cold was my “not nice” patient that day.  Got her problem settled (cold meal) and explained I wanted to do a quick head to toe assessment and a fresh set of vitals.  “Can’t you see I’m eating now?” Well, ok, at least let me take a quick listen with my stethoscope and get your pedal pulses…..AND I’m about to start, and the doctors and residents walk in!   The team discusses the patient’s care among themselves and with the patient.  One of doctors removes the dressing on a wound that the patient has on her lower leg, takes the dressing completely down and then leaves the room.  Remember now, I’m still on my first patient, I need to run out to the supply room to get the items necessary to re-dress the wound. (Hmmm, the night nurse must have forgotten to share with me that this patient has a wound on her leg).

1130  

I am finally getting to see my 6th patient.  I walk into the room and my elderly male patient is crying to himself.  “Mr. Jones, what is wrong? It looks like you’ve been crying”  Mr. Jones learned earlier today that he will likely have to go to a SNF (skilled nursing facility) for further rehabilitation.  “I just want to go home, my wife is in good health and she can take care of me, I don’t understand why everyone thinks I need to go to a nursing home to get better!”  Even though my phone was going off continually with alerts, I sat down in the chair beside his bed and just listened to him cry while I held his hand. 

1200-1500 

I pull my WOW to a corner on the floor (maybe no one will see me and I can get some charting done) and start to chart my assessments.  Call light, one of my patients needs to go down for an MRI and transport is here to get the patient.  I and the care partner get my patient ready to go down for the procedure.  Give a quick report to transport and then I can get back to my charting.  Call light, one of my patients is ready for their pain medication.  However, the patient is not due for the pain med until an hour from now.   Go to the patient’s room and explain that they are not due for their pain med until 1300 (I have written the times on the patient’s whiteboard when I started the shift).  “Well I am having breakthrough pain and I need the doctor to give me something.”  I page the resident and explain the situation. Resident orders a one-time dose, go to pyxis to get it and it’s not available.  Call the pharmacy to ask them to tube up the medication.  Pharmacist states, “It’s going to be a while before we can get it up there”.   Just as I head back to do some charting one of the other RN’s needs a witness to pull a narcotic, back to the med room. Oh, my goodness it’s 1400 and I know I have more meds due and have to hang an IV medication.  My “not so nice” patient is due for the IV medication, however, when I arrive in her room she has pulled the IV out.  I now need to start a new IV.  My stress starts to rise since I am not very good at IV’s, but I at least have to try.  Sticking this patient more than once is not going to go over well.  “I don’t like being stuck and I want to talk to the doctor about why I even need this medication!  Please page the doctor for me and get him in here.”  I am able to get out the rest of my 1400 medications.

1500  

Lunch break, finally! I will never understand the logic behind only getting 30 minutes for lunch in a 12-hour shift.  I sit down in the break room to gobble down my lunch, we are supposed to have other RN’s carry our phones during lunch, but that doesn’t happen, no one has asked me to hold their phone for lunch, so I certainly don’t want to ask anyone either.  It’s just an “unwritten” rule I guess among nurses.  Just as I sit down, phone goes off again, “pharmacy has tubed up that medication for you Susan and the patient is waiting.” So much for 30-minute lunch, it was about 10 minutes at best.

1600  

Patient’s family has arrived to pick up patient for discharge.  My sweet elderly patient is being taken to the SNF by his daughter and his wife.  I go into the room to review the discharge papers.  My patient says to his family, “Susan has been the best the last few days, she seemed like the only person that really listened to me, everyone else just talks over me.”  I am about to cry myself but I don’t.  I take my patient in a wheelchair out to the entrance of the hospital after he gives me a big hug he gets in his car and leaves.  It’s a gorgeous sunny day out, the fresh air feels wonderful!

1700 

Susan, you’re up for first admission the patient should be arriving soon.   That’s actually a good thing at 1700, I’ll get the new admission and I should have plenty of time to get them settled before the night shift arrives.  Oh, my goodness, I forgot to call the SNF with report on my patient that was just discharged, they are on the phone now.  I should be in the med room starting to pull my 1800 medications for my patients, but I’ve got to give report first.

1800  

Starting to pass my 1800 medications, the nurse is on the phone with report for my admission.  Patient arrives on the floor at 1830. It takes at least a half an hour to get a patient settled.  

1900  

Safety huddle for both day and night shift. 

1920-2000  

Bedside report for all 6 patients.  I explain to the night nurse I will finish up the admission and get the meds out for that patient (they were left over from the nurse who didn’t have time to give them on the floor he was coming from).  Hand my Ascom phone over to the night nurse. FINALLY!

2000-2100  

Complete my charting.

2100  

Wait on cold street corner to get shuttle bus back to my parking lot.

2130  

Arrive home.  

Job Satisfaction

I cannot think of any job that is more satisfying than being a nurse.  Six people put their trust in me to care for them at a time when they’re not feeling their best; did I do it perfectly, no I did not. It’s a privilege to do what I do and I wouldn’t have it any other way!

Susan E., RN soon to be BSN.

1 Article; 189 Profile Views; 1 Post

Share this post


Link to post
Share on other sites

28 Posts; 257 Profile Views

Thank you so much for creating this schedule. I am a pre-nursing student and this gave me a more realistic view of what a typical workday looks like. 

Share this post


Link to post
Share on other sites

CKPM2RN has 3 years experience as a ASN, EMT-P and specializes in Med-tele.

215 Posts; 7,501 Profile Views

That's my day minus the shuttle and add a whole bunch of call lights, family phone calls, and a mid-day medication schedule on top of morning and evening. It a nutshell, it sucks.

Share this post


Link to post
Share on other sites

8 Posts; 395 Profile Views

My night last week,

 

Receive an admission from the previous shift. His temp is 101 and he is projectile vomiting. He’s diaphoretic. Take his vitals again. Ice packs everywhere. Tylenol isn’t even ordered. Couldn’t give it to him anyway because he’s nauseous. Call service. Doctor puts in order for Tylenol without talking to me. Call again. Ask for nausea medication and something IV for his fever. Ultrasound calls me. Same patient had abdominal ultrasound ordered. It’s 2000.  No transport. Everyone is busy besides my tech. Wheel patient down with me and my tech. Meanwhile other patients IV is infiltrated. Still not good at IVs so I attempt once and ask someone else. Same patient needs to use the bathroom. He has a prosthetic leg, walker, and boot due to an injury. Try to talk to patient into using a commode. Patient refuses. Walk with patient to bathroom. Uh oh ultrasound is calling and they want you to pick up your patient. Everyone is busy including your tech. I stay with the patient using the bathroom because he’s a high fall risk. Walk with patient back to bed and they fall along the way. Have to do a fall precautions bundle. Call the doctor vitals etc. ultrasound calls again telling me to pick up patient. Recheck temp and it is still high. It’s 2100 and I haven’t seen my other patients. Overload with wet cloths. Doctor puts in more orders which I have to carry out. Patients vitals indicates sepsis. Draw lactate and CBC. They come back negative. Told to monitor patient. Finally give meds to my other patients 3 hours late. Need to draw H&H and type and screen for a patient because his hgb was trending low. Also need IV access because IV expired. PATIENT REFUSED. He’s AAox3. Stated he didn’t want to be poked anymore and wanted to die. Tried to talk patient down because I knew he was stressed. Had resident come talk to him. Patient still refused. Told to just document. 0500 patient finally agrees and lab was ordered for 0000. He doesn’t want to die. He’s just not happy about his situation. Put in new IV and drew labs from the IV. At 0600. Lab calls and tells me I used the wrong tube for the type and screen. I smack myself. It’s 0630 and I haven’t had a chance to take a break or sit down. I’m tired. I’m worn down. I redraw the type and screen. Results do not come back until change of shift. I tell them what happened that night. I don’t think they believe me. I can tell they are mad that they have to give blood at change of shift. I volunteer to stay for the first 15 mins of the blood transfusion to document vitals. I leave at 0830 and my shift ends at 0730. I’m in a haze. I don’t know what happened. I look online for a new job 😂

Share this post


Link to post
Share on other sites

809 Posts; 11,780 Profile Views

Thank you all for making me realize my decision to get out of clinical is the right one.  Too many of these kinds of shifts took their toll.

I admire those of you who can (still) do it.  Someone has to take care of the patients!

P.S.  To OP - you're very lucky if you frequently chart until 2100 (I did many, many times) if your manager doesn't call you into her office to tell you to manage your time better.  The standard line used for blaming nurses who can't get the excessive workload done in 12 hours because they take good care of their patients rather than taking the shortcuts required to leave on time.

Edited by DeLana_RN

Share this post


Link to post
Share on other sites

Ella26 has 2 years experience as a BSN, RN and specializes in Allergy and Immunology.

402 Posts; 9,647 Profile Views

 My gosh... Wow...

Thank you for sharing your work day! Very eye opening. 

I have not worked in a hospital as a nurse, so this gives me plenty of insight. I only saw a glimpse of it in clinical with just 2 patients and that terrified me! I thought: “how will I be able to complete everything”, “what if I forgot to do something”. It was endless ruminating... I knew it wasn’t for me. 

I was getting anxious reading it. But, you lived it! Ten minutes for lunch on a 12-14 hr shift!!! 😳😩Luckily, no codes... I know I would not be able to handle all of that. But, you did with a positive outlook! Kudos! 

Thank you for your service! Much respect to floor nurses! 

 

Edited by Ella26

Share this post


Link to post
Share on other sites

BlueShoes12 is a BSN, RN and specializes in Stepdown ICU, Trauma.

104 Posts; 1,684 Profile Views

Sounds like the very worst days on my unit! Here's the thing - unless someone is unstable, you are entitled to a freaking lunch break and bathroom breaks. My blood sugar drops if I don't eat and then they'll be scraping me up off the floor and finding a new nurse to cover the rest of the shift! 

Share this post


Link to post
Share on other sites

jeastridge is a BSN, RN and specializes in Faith Community Nurse (FCN).

5 Followers; 104 Articles; 430 Posts; 149,352 Profile Views

Great article! Thanks for sharing. You are a credit to the profession! Joy

Share this post


Link to post
Share on other sites

jrbl77 has 42 years experience as a RN and specializes in Med Surg, Parish Nurse, Hospice.

248 Posts; 8,753 Profile Views

Reading this post has made my pulse race. It sounds very much like days that I have had. So glad that I'm retired. Although, I often have dreams that have me running around all night doing pt care! Once a nurse, I guess, always a nurse!

Share this post


Link to post
Share on other sites

DallasRN specializes in ICU/ER/Med-Surg/Case Management/Manageme.

132 Posts; 3,155 Profile Views

Good for you, Susan E.  I'm glad you find satisfaction in this type of day.  However, I personally find it frustrating so many of us look at this type of work day as the norm.  In the last lines of your article you said, "I cannot think of any job that is more satisfying than being a nurse.  Six people put their trust in me to care for them at a time when they’re not feeling their best; did I do it perfectly, no I did not. It’s a privilege to do what I do and I wouldn’t have it any other way!"

I look at that a bit differently.  A day (actually a "good" day on some units and as someone else said, thank goodness no code or any other time consuming event occurred), you didn't have time to eat, not a moment of stress relief throughout the shift, you were unable to complete your charting as you worked and we all know the perils of that - omissions, incompleteness...were you really able to deliver safe patient care with that load and those multiple interruptions?  Not to criticize because we've all "been there, done that", but I don't think it's possible.  Most patients now-a-days are older/geriatric with multiple health issues, fall risks, multiple meds with multiple side effects, risk of IV infiltration in paper thin skin, and the list could go on for a hundred pages.  

We are doing a disservice to our patients, to ourselves, and to our colleagues by thinking this type of day/schedule is OK.  It isn't.  Find any other profession with the educational requirements, the hours, and especially the responsibility of a nurse (we are responsible for human lives! Just one error...) that is routinely denied meal breaks within 12 hours, that often don't have a chance to sit down for 12 hours unless they somehow manage to slip off to the bathroom...not even a 10 minute coffee break...I just shake my head and thank my stars I no longer do that.  I don't make as much money, but I'm happier (and healthier).

Share this post


Link to post
Share on other sites

dreamer7157 specializes in 8 yrs LTC, 12 yrs school nursing.

3 Posts; 488 Profile Views

I don't know how you guys do it. I worked at telemetry for one month and couldn't wait to get out of there. I guess the acute setting is just not for me- it is very stressful. Thank goodness for public health/school nursing. Best wishes to all of you who work at hospitals.

Share this post


Link to post
Share on other sites

317 Posts; 1,791 Profile Views

And this is why bedside reports should be abolished!

Share this post


Link to post
Share on other sites
×