IS this norma for Med/Surg night shift...or is it just my hospital?

[raindrop]

I get to work at 7pm and I get my assignment - between 7-9 patients (Med/Surg). I work from 7pm-7 am

I get report; there are so many interruptions during report, report last from 40 minutes to an hour.

I start my assessments.

I start discharging whoever needs to get discharged.

I then find out of an admission that I am getting.

I take care of issues - ABC's

And then at around midnight - I have to file stuff from dayshift. It is mandatory.

And then I have to start getting papers ready for the next day - assessment sheets, I /O sheets). I have to stamp those with the appropriate date, put patient labels on them, and put them in the charts for the next day.

I then have chart checks to do. I have to make sure that all orders received on days (7a-7p) have been correctly entered into the computer. I have to ensure that all labs/test have been ordered right, that test have been done, etc, etc.

I have to make sure the Kardex is up to date

And then I have to check the new MAR's and ensure that there isn't anything on them that shouldn't be, like a newly dc/d drug....and that new orders are on it.

I then find out of another admission.

CNA is going to dinner, now I have to answer call lights.

Hey look, it is almost time for me to go......but first I have to add up everyone's I/O's for the past 24 hours. (hopefully the CNA has emptied everyones foley by now)......and then chart those in graphics.....and then file the I/O sheet from yesterday. Adding this stuff up, recharting it, is very time consuming.....as is filing. The CNA's aren't allowed to do this anmore because apparently there were too many mistakes in their calculations.....?

We don't have a clerk on my shift. Admission/discarge paperwork are 100% on the nurse. Once in a while the house supervisor will help enter orders, but that is rare.

A friend of mine who lives in a different state says that her job is nothing like this - no chart check, no filing, and they have a clerk. She works at a Magent hosptal and claims that is the reason why her job is easier than mine. What do you guys think?

[ILBCNU]

I am right there with you! Only I have been doing it for 11 years now and am really tired of it. I want out of floor nursing. AND I do agency work on the side...and it may be better at some places on some nights, but nursing is nursing and I'm in need of a career change!

[EmmaG, RN]

I can honestly say we have a very supportive group @ night and truly value the work "team work".

That is the absolute best thing about working night shift. We not only could depend on those from our own unit, but the entire hospital. We'd go to each other's floors to help with paperwork and 24 hr checks, and if there was a code or other emergency, nurses from other floors would come man the desk and help answer call lights while the unit staff was busy. We consulted each other all the time regarding our specialties. It was wonderful :)

[RainDreamer, BSN, RN]

Magnet or not, that has nothing to do with it.

You need a unit clerk, it's that simple. I can't imagine not having a unit clerk, she's invaluble.

Also, we do all computer charting .... clicking a button sure makes adding up the I&Os all that much quicker.

[Mulan]

Magnet or not, that has nothing to do with it.

You need a unit clerk, it's that simple. I can't imagine not having a unit clerk, she's invaluble.

I agree.

However, every hospital where I have worked med surg never had

a ward clerk on the night shift (only days and evenings) so I don't think it's that unusual.

[plumrn, BSN, RN]

Our night shift has 5-7 pts (not bad really), a ward clerk, and 1 CNA per 16 pts. They do chart checks and check the new MARS for the next day. I couldn't imagine having as many pts as the OP does AND having to put a chart together and entering all the orders. Who takes care of your new pt and all of the others while you are sitting at the desk getting the admission orders in and chart put together?

Much worse the respondent that said they have no ward clerk on Sundays at all!!

[Nursebarebari]

I get to work at 7pm and I get my assignment - between 7-9 patients (Med/Surg). I work from 7pm-7 am

I get report; there are so many interruptions during report, report last from 40 minutes to an hour.

I start my assessments.

I start discharging whoever needs to get discharged.

I then find out of an admission that I am getting.

I take care of issues - ABC's

And then at around midnight - I have to file stuff from dayshift. It is mandatory.

And then I have to start getting papers ready for the next day - assessment sheets, I /O sheets). I have to stamp those with the appropriate date, put patient labels on them, and put them in the charts for the next day.

I then have chart checks to do. I have to make sure that all orders received on days (7a-7p) have been correctly entered into the computer. I have to ensure that all labs/test have been ordered right, that test have been done, etc, etc.

I have to make sure the Kardex is up to date

And then I have to check the new MAR's and ensure that there isn't anything on them that shouldn't be, like a newly dc/d drug....and that new orders are on it.

I then find out of another admission.

CNA is going to dinner, now I have to answer call lights.

Hey look, it is almost time for me to go......but first I have to add up everyone's I/O's for the past 24 hours. (hopefully the CNA has emptied everyones foley by now)......and then chart those in graphics.....and then file the I/O sheet from yesterday. Adding this stuff up, recharting it, is very time consuming.....as is filing. The CNA's aren't allowed to do this anmore because apparently there were too many mistakes in their calculations.....?

We don't have a clerk on my shift. Admission/discarge paperwork are 100% on the nurse. Once in a while the house supervisor will help enter orders, but that is rare.

A friend of mine who lives in a different state says that her job is nothing like this - no chart check, no filing, and they have a clerk. She works at a Magent hosptal and claims that is the reason why her job is easier than mine. What do you guys think?

Are you a unit clerk or a nurse? Your duties sound more like that of a clerk than a nurse.

[NurseJi]

We usually have 5-6 patients, very rarely 7....but no cna, and no unit clerk...we also do mars and 24 hour chart checks.

[lenz1977]

You are doing way to much work for the day shift.

they need to file there own papers

I get to work at 7pm and I get my assignment - between 7-9 patients (Med/Surg). I work from 7pm-7 am

I get report; there are so many interruptions during report, report last from 40 minutes to an hour.

I start my assessments.

I start discharging whoever needs to get discharged.

I then find out of an admission that I am getting.

I take care of issues - ABC's

And then at around midnight - I have to file stuff from dayshift. It is mandatory.

And then I have to start getting papers ready for the next day - assessment sheets, I /O sheets). I have to stamp those with the appropriate date, put patient labels on them, and put them in the charts for the next day.

I then have chart checks to do. I have to make sure that all orders received on days (7a-7p) have been correctly entered into the computer. I have to ensure that all labs/test have been ordered right, that test have been done, etc, etc.

I have to make sure the Kardex is up to date

And then I have to check the new MAR's and ensure that there isn't anything on them that shouldn't be, like a newly dc/d drug....and that new orders are on it.

I then find out of another admission.

CNA is going to dinner, now I have to answer call lights.

Hey look, it is almost time for me to go......but first I have to add up everyone's I/O's for the past 24 hours. (hopefully the CNA has emptied everyones foley by now)......and then chart those in graphics.....and then file the I/O sheet from yesterday. Adding this stuff up, recharting it, is very time consuming.....as is filing. The CNA's aren't allowed to do this anmore because apparently there were too many mistakes in their calculations.....?

We don't have a clerk on my shift. Admission/discarge paperwork are 100% on the nurse. Once in a while the house supervisor will help enter orders, but that is rare.

A friend of mine who lives in a different state says that her job is nothing like this - no chart check, no filing, and they have a clerk. She works at a Magent hosptal and claims that is the reason why her job is easier than mine. What do you guys think?

[bethin]

Magnet or not, that has nothing to do with it.

You need a unit clerk, it's that simple. I can't imagine not having a unit clerk, she's invaluble.

Also, we do all computer charting .... clicking a button sure makes adding up the I&Os all that much quicker.

We have computer charting but.....the NM still wants input and output charted on a piece of paper that has the pt's sticker on it along with a date. At the end of shift, the column is added up and then the 8 hr total is put in the computer. No longer can we empty a hat or foley, run to the computer, chart it and have the computer do the math for us. If we don't follow this, we will be forced to come in even at 2am and fix our mistake. To me, it seems like a waste. The computer isn't going to make addition mistakes.

Wouldn't you like to know when your pt urinated? If it had been very early in the am and it's now afternoon, wouldn't you be concerned?Well, you can't tell when someone urinates or has a bm anymore. You can also tell our NM "doesn't know how to work the floor" (those are her words).

[RainDreamer, BSN, RN]

We have computer charting but.....the NM still wants input and output charted on a piece of paper that has the pt's sticker on it along with a date. At the end of shift, the column is added up and then the 8 hr total is put in the computer. No longer can we empty a hat or foley, run to the computer, chart it and have the computer do the math for us. If we don't follow this, we will be forced to come in even at 2am and fix our mistake. To me, it seems like a waste. The computer isn't going to make addition mistakes.

Wouldn't you like to know when your pt urinated? If it had been very early in the am and it's now afternoon, wouldn't you be concerned?Well, you can't tell when someone urinates or has a bm anymore. You can also tell our NM "doesn't know how to work the floor" (those are her words).

Oh wow, that's crazy! We chart everything in the computer .... all voids/stools, and everything in. It totals it up and there you have it.

[zhx711108]

hello, we are doing 10 hours night shift here, not every patient is on I/O chart, we normally do it at midnight, only once daily, here we RN have the right to cease the fluid balance chart, if you think the pt is all right, you do not have to follow the Dr blindly.

[Conrad283, BSN, RN]

You need a unit clerk, it's that simple. I can't imagine not having a unit clerk, she's invaluble.

Hey, that's discrimination. I'm a guy and I'm a unit clerk. Ah, I'm just kidding.

At our hospital there are unit clerks from 7A-11P and then there is a float clerk who goes to all of the floors, or stays on just the busiest floor, and does all of the over night admits. The filing is usually done by the day and evening clerk and doesn't take more than 10 minutes if you have a good system. But other than that, everything is the same. Chart checks ... etc.