I'm a Monkey...

Are there any openings on days? Maybe a long shot I know, but somehow our unit had more people wanting PM and night because day was so busy and less pay. Worth a shot!

10 minutes ago, LibraNurse27 said:

Are there any openings on days? Maybe a long shot I know, but somehow our unit had more people wanting PM and night because day was so busy and less pay. Worth a shot!

Sadly no, but I did hear that a person who works 2nd shift might want out of it, so I may approach my manager in a bit and just let her know I wouldn't mind working 2nd. But first to get thru the next 12 weeks ??

1 hour ago, Merrie82 said:

I am on a preventative medication called Aimovig that I inject monthly, and my migraines have greatly improved overall.

I have had patients say the same about Aimovig. That's great to hear.

From reading what you described, I think it sounds more like an issue of your body adjusting to nights which more orientation will not help. 

Dayshift is much busier typically - heavier med pass, physician rounding, family updates, 3 meals, consults, etc. If you feel well organized and successful on day shift I think your time management skills and system and serving you well— you just need to learn how to best function on nights. 

For instance I work day/night but fortunately more day than night. I have felt similar to how you feel as I have tried all different sleeping strategies to prepare for an overnight. I have stayed up all night to sleep consecutive hours during the day before shift and that use to make me feel so terrible, like you described, my head in a fog. I learned I don’t sleep well enough during the day. Now I sleep normally the night before as I normally would, and nap from 1-3 before an overnight. Then I get the kids from school and make dinner and everything before leaving for work at 6. Now I still feel tired by the morning, but this works much better for me. I suggest brainstorming different times to sleep and eat that is going to help your body feel best. Working nights (for those of us who are not night people) is so tough. It took me nearly two years of trial and error before I found a system that helps me feel the best. 

I’m not sure if you mentioned how often you rotate or if you have any say, but I learned I like working nights back to back. I get my required night shifts out of the way in a row rather than having a night shift each week (we self schedule.) I actually have learned to appreciate sleeping the day after a few nights. My body is so tried I can sleep pretty deep and I get the bed to myself. ??

Good luck, You will find your rhythm soon. Hang in there. 

On 3/20/2021 at 7:50 PM, NurseLy said:

I’m not sure if you mentioned how often you rotate or if you have any say, but I learned I like working nights back to back. I get my required night shifts out of the way in a row rather than having a night shift each week (we self schedule.) I actually have learned to appreciate sleeping the day after a few nights. My body is so tried I can sleep pretty deep and I get the bed to myself. ??

Good luck, You will find your rhythm soon. Hang in there. 

Thanks! I sure hope so. I don't have a say, and during this orientation part its been totally random. Like 2 days and then a night, or 1 day and then 2 nights. This week I have 3 night shifts back to back for the first time. So we will see. Fingers crossed. Im not really a morning person, so you would think a night shift would be a blessing,  but my brain apparently has other ideas. Just hoping for a migraine free clear headed week before im off orientation ❤?

No wonder you are a mess. Rotating shifts are hell. I have migraines and I know just rotating the way I do, mostly evenings and one early shift every other week plays hell on mine. And by early I mean at 0430. Normally I work 1330-2200. It's hard but I make do. I have to work every other Saturday and this is the only shift on those days.

Hugs and try to go evenings. I feel best on an evening schedule!

21 minutes ago, SmilingBluEyes said:

Hugs and try to go evenings. I feel best on an evening schedule!

Thank you! Its funny evening shift is definitely my best time to work, too. I think bc it aligns with my natural sleep schedule,  which is basically 0130 or 0200-0930. Maybe its a migraine thing. 

Proud of you for speaking up!  Your patients deserve a nurse who recognizes her own limitations, and asking for a little more shift-specific training is completely reasonable.  I hope your time with the different night preceptor helps things click into place. Be really clear with her what your goals are at the beginning of your shift so she can help!

when I was new, I got there 45 minutes early,

got assignment,

added pts to myself in the computer

printed the previous nurse notes on each of my pts (screen print=your best friend, haha)

printed the MAR on my pts (our MAR showed all meds and when they were due) some meds change after doctor visits, BUT you'll know if room 1 has no meds tonight and room 2 has 14, it helps with prioritizing

I walked into each room to check the status of each IV ( what was running, was it near empty? write that down) I always said, Hi I'll be your night Nurse, Just checking your fluids, I'll be back shortly with Jane to do bedside report) later during bedside report I always checked the gauge and location of the IV, it's often not where or what you hear in report, don't be the one who has the wrong info ?  

I stapled a report sheet  to the nurse notes, & mar for each pt and put it in my clip board

  .  ..seems like a lot, BUT the more I knew, The more comfortable I felt.

  eventually you can pare down .

once in a blue moon I still do that, if , for example someone call in sick and we all have extra pts and they are all complicated. plus I use those sheets for my own arbitrary notes

So, just wanted to update all... had my last 3 shifts of orientation,  and they went soooo much better. Not sure if it was the patients, the new preceptor, the fact that I did 3 in a row for the first time at night, or if it just clicked, but I felt way more organized and less fuzzy headed. Makes me hopeful that once I'm on straight nights life,  and my migraine brain, will be less complicated ??

Thanks All ❤❤

On 3/28/2021 at 2:02 PM, Merrie82 said:

they went soooo much better

Glad to hear that it went well for you. Sounds like your confidence is back up, I think you'll be fine when you're on your own! Best of luck. 

On 3/19/2021 at 9:17 PM, Merrie82 said:

So, I had a meeting with my Unit Based Educator and Manager as a follow up to my meeting the other day with the UBE/it was supposed to be my last mtg bf end of orientation. 

I told them that while I felt ready on days, I did not on nights. That I am disorganized, and have no routine, and haven't been assigned 5 pts yet on nights. That was definitely, clearly, Absolutely ? % NOT what they wanted me to say, and I had a very hard time saying it as such. I was rebuffed. Basically told that since I am doing so well on days, nights should be just the same... and why isn't it?? I told them I wished I knew, but I suspected rotating shifts and only having worked 2 weeks of nights, intermittently, was likely at least partly the issue.

Their solution is to put me on 1 extra orientation night shift with a different preceptor (for a total of 3 shifts next week) and reevaluate after this. But they clearly intend to put me out on my own following next week regardlessof what I say. 

I feel...disgruntled, and stupid for feeling disgruntled and somewhat surprised by their reaction. Obviously I am putting a monkey in the scheduling wrench. But saying I feel ready when I don't think I am would be wrong, so there's that. Not sure how I'm feeling about my floor after all this drama and discombobulation. Maybe a bit sad that I picked the wrong floor. 

If anyone has any organization tips, or even feels like giving me a snapshot of what your routine is on nights, I would really appreciate it.

Everything is a recipe! Everything! 

How do you scramble an egg? You do things in a certain order! How do you end up in the gym? You pack your bag, get into your car, drive there, swipe your card etc etc! 

How do you work your shift on days? Organization! 

Pretend that you are a video recorder. Write down exactly how you negotiated your days. Handover, job assignments, meds, txs etc etc.... exactly what you do when you work days, however you do it, in whatever order you choose. Go over it a few times and then do the same with your night shift. How do you begin, progressing in which order. 

It's a recipe! Writing it down hopefully reinforces that it's a recipe and the formula is practice. 

In just one night shift, if you shadowed a successful nurse and then repeat her recipe, you will be fine! 

Also Psych Nurse 24 gave you the exact formula. Don't reinvent the wheel that Psych Nurse gave you! 

You should apply the recipe for your migraines as well. I know a few people who have charted catalysts or situations that have repeatedly led to their migraines and avoided them when possible also identified certain factors that relieved their migraine progression and incorporated it into their routine. Don't know if that could work for you. 

Good luck!