Just got home from another CRAZY shift and just feel the need to talk about it. I worked the evening shift, started with 5 patients, discharged 2, admitted 1 and accepted 1 transfer.
Don't you just love the needy patient that whines and claims they can't do anything for themselves? Call bell after call bell "I need someone to clean me, I soiled myself!" ...yet 100% capable of walking to the bathroom. This patient was also complaining all night that she didn't want to be discharged tomorrow...I don't know how many times I had to explain she wasn't going anywhere. Unfortunately not an uncommon patient, but still not my favorite to deal with.
Next we have the patient that's 100% independent...should be a breeze! But ah in fact she's a talker, beware if you enter the room you will never leave. She complained to me for about an hour about one of our LPNs who was late giving her meds yesterday and how it's CRUCIAL she has all her inhalers exactly at a specific time to a tee...luckily I was able to deliver she meds on time. On top of that her port-a-cath is clotted and we are now onto our second dose of alteplase since the heparin flush and first alteplase dose didn't work. Not a crazy complicated procedure but definitely time consuming and frustrating and of course still no blood return after all of that! I try towards the end of the shift to get a blood return when she's now laying flat with her arm behind her head and wala! Blood return! Thank god
Onto pneumonia and an altered mental status. Pt found to have mild hypoxia on 4L...doc says it okay since they've decided she needs a thoracentesis...after initiating IVF...stupid mistake on my part initiating them in the first place but just a total mess of a situation that easily could've been avoided. On top of this the pt arrived from an acute care facility where the paperwork got "lost" in travel so everyone was unaware of the MRSA history and exposed for the first hour or so...yay for spreading infectious disease around!
Thankfully my two discharges were simple.
And my transfer...a retired nurse! Haha watching your every move. Typically she came with about 45 minutes left of my shift so I had to pass most of her transfer work onto the next nurse...I hate that but after the night I had there was no way to avoid it unfortunately.
So lesson learned? 8 hour shifts are rarely enough time to finish your work but what can you do! How was your shift?
I just got my RN license, and I am currently working my last 8 hour shift as a CNA. I will start orientation for my RN position on Wednesday, and I am looking forward to working 3 12-hour shifts per week! Unfortunately, I did not know when I was going to start my full time position when I mailed in my availability for my PRN LPN job, so this week I will be working 57 hours. Two nine hour night shifts, one 3 hour respite shift, then my 3 twelves of orientation! Thank God I only have 2 weeks of this overlaping commitment, and the 2nd one is not as heavy. My current shift has been uneventful - I am doing a 1:1 supervision with a patient with dementia, but she has been sleeping since I came on at 10pm. Not that I want crazy, but this could be very boring if she doesn't get up at least once! Night shifts are easier when you have things to do...
8 hour shifts suck, unless you get the coveted 7-3. When I worked nights I much preferred the 12.
I was offered a 7-3 spot on my day shift, but I honestly hate interacting with my manager and she would just nag me to go from part time to full time (I CANNOT be at work 5 nights a week).
And yes, before anyone says anything about my use of the word, HATE, most of my coworkers hate my manager. My charge has stated "She is the worst person I have ever met."
Last night I was floated to a med/surg neuro unit. My home unit is incredibly heavy and acute - all the stuff you listed in your post and more - so floating is almost always much easier.
I got a three patient assignment, which usually has you wary but it was a piece of cake. One total care patient chronically ill recovering from viral encephalitis, still disoriented, tube feeding, unable to sit up, high risk for pressure ulcers, stooling a lot, worried (but nice) family which keeps you pretty busy.
Second patient, 89, in for COPD exacerbation. Getting better on steroids and nebs, needy, incontinent, peeing like crazy but standby assist to the BR with a walker and really sweet. Smile when you talk to her and it makes her day. (Nurses on that station don't smile much for some reason. Geez.)
Third patient in for a seizure. 81, pleasantly confused, sundowning a bit, up with standby assist and his wife there the entire night chasing him around.
First patient was a lot of work and the last patient needed a lot of supervision, but otherwise a relatively heavenly shift. Piece of cake.
Hard to believe they pay you sometimes.
You and me have different ideas of piece of cake shifts. Mine is all walkie talkies, few meds, and they sleep all night:)
I'm orienting on day shift. Oh, how I hate day shift! The rude doctors, the revolving door of pts going for procedures, the families who place coffee orders like we're starbucks. Ugh. Can't wait to get to nights.
I started with 4, discharged 1, one went to procedure for a few hours, leaving me with 2 for most of the afternoon. Then I spent a good hour fighting with ICU who tried to give me two hot messes that couldn't be on our floor. I'm on pulmonary right now, and they tried to give us a stroke pt and a heart attack waiting to happen. Thankfully, we said no thanks, assign them to the correct floors please. So I escaped my last shift on orientation with 3 patients.
I'm orienting on day shift. Oh, how I hate day shift! The rude doctors, the revolving door of pts going for procedures, the families who place coffee orders like we're starbucks. Ugh. Can't wait to get to nights.
I started with 4, discharged 1, one went to procedure for a few hours, leaving me with 2 for most of the afternoon. Then I spent a good hour fighting with ICU who tried to give me two hot messes that couldn't be on our floor. I'm on pulmonary right now, and they tried to give us a stroke pt and a heart attack waiting to happen. Thankfully, we said no thanks, assign them to the correct floors please. So I escaped my last shift on orientation with 3 patients.
We are Oncology and yet we still get people in traction who should be on Ortho, chest pain/elevated troponin, strokes, etc. We would get laughed at by supervision if we tried to refuse! We can really only refuse TB(no negative pressure rooms) and meningitis or high tele.
Specializes in Medical Oncology, Alzheimer/dementia.
I had the worst patient assignment last night. I really hate having to come back to it. I work the weekend program on night shift. So I can get thru anything when I can anticipate the next 5 days off. I just cannot stand super needy patients.
My shift will be over in 15 minutes. It was a typical shift. I work private duty Peds so I only have 1 patient. Right now he's pretty stable so I get to spend time reading on my Kindle & reading allnurses.com.
The Life! This is exactly where I want to end up working as a nurse in the long run, either home care with children, a doctors office, or small hospital.
Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.
Just want to chime in.... I had a crap shift yesterday, too. 3 assaults, client to client, I hospital admission, I return from the hospital with 5000 med changes. Must have been something in the air.... Or perhaps a full moon.
When I worked 3-11 I felt it was the "dump" shift. It seemed like I was always trying to finish up what days left and also trying to get stuff done so that nights didn't have to deal with it. All while getting admissions, keeping up with medication administrations, visitors etc. It is one of the harder shifts to do, I loved the hours, just seemed to feel overwhelmed all the time with the amount of work that needed to be done. Now that I am working 12 hour shifts again, I feel like I actually get to accomplish something!!! Twelve hours gives enough time to really get to know the patients, complet the tasks that are needed and even prepare for the next shift. Medications do not seem as heavy(night shift) and there is time to actually evaluate the patient's chart and see what direction things are progressing. There are 12 hour shifts that seem way too long, but this last weekend was good and I am thankful!!
Two nine hour night shifts, one 3 hour respite shift, then my 3 twelves of orientation! Thank God I only have 2 weeks of this overlaping commitment, and the 2nd one is not as heavy. My current shift has been uneventful - I am doing a 1:1 supervision with a patient with dementia, but she has been sleeping since I came on at 10pm. Not that I want crazy, but this could be very boring if she doesn't get up at least once! Night shifts are easier when you have things to do...
joanna73, BSN, RN
4,767 Posts
I prefer 12's also. I find 8 hours actually equals 9 by the time I'm finished my work. Then it's time to get home and repeat for five straight days.
I'm more tired from 8's than I ever was with 12's. The stretch of time off that comes with 12 hour shifts makes the work much more enjoyable too.