Night Nursing: Precepting & Perception

[Larry2016]

Before I write this post, I want to say I am not a traditional student. I am 43 years old and switching careers. I just started as a Nurse Student Tech, and I had a rough time at first, but getting into a "smooth groove" (for lack of a better phrase) to organize my time and work.

Forgive me for my ignorance in advance, but I just got news for my placement in precepting. It is at a hospital I really enjoyed being at for 2 of my clinical rotations. The staff is really willing to teach you and allows you to spread your wings to learn.

The problem, however, is they only had night shift open. I saw a post about this on here from 2002, and I was shocked that during a poll 70% of the people believed night nurses work hard.

I understand we take what we can get when precepting. But here is my view - and please, remember I am just starting a new career and am not familiar with night shift nursing. However, I do not have a good perception of night nursing, and vowed that I would do something like work at a doctor's office before working night shift, and it is because I see night nurses never do assessments, never pass medications, never do discharges and never are involved in patient education. I had a patient complain to me once how rude night shift nurses were on my floor.

When I heard I am precepting on night shift this semester, I got frustrated, because the only experience I have with night nursing is what I mention above. My perception is they really do not do much. I am not disrespecting night nurses, I just don't know what it is they do because of this limited exposure I have with night shift. There have been several times I come on shift and people that I have gotten squeaky clean, at 7 am in the morning, smell so bad that the devil himself would run away.

The only positive experience I have had with night shift nurses was when I was pulled to Emergency. I usually show up 30 minutes before work, and when I went to Emergency, they were on top of everything.

Again, I don't mean to disrespect night shift nurses. I know that there are thousands more out there than my little corner of the world. My frustration, however, is twofold: I don't want to be labeled as a nurse that does not do anything just because I might be on night shift, and I want experience at my precepting site...not just watch or "check in" on sleeping patients once every hour. Precepting is supposed to give us experience as a nurse, and I fear I will not get that - because, as I have observed in my little corner, night nurses do not do assessments or pass medications or even clean up patients. How are we to get experience if we are on a shift where there is really nothing to do?

I know this is a large post and sorry about that. I am someone who tries to be proactive, so...after all that I have said, here is my question: How can I make the most of this placement to do well? I was hoping for day shift because I see how active the nurses are with assessments, passing medications, new admits, discharge and patient education. I really want this to be a positive experience, but how can that be when there is a perception that there is really nothing to do?

[Been there,done that, ASN, RN]

You have limited observation of the night shift, yet you have leapt to the conclusion that there is little to do.

I can assure you night shift nurses do it all, with more patients and less ancillary staff.

Here is an excellent example of what a good nurse does.. gather your data before you jump to conclusions.

Best of luck on your orientation. Keep us posted.

[Wolfe24]

because I see night nurses never do assessments, never pass medications, never do discharges and never are involved in patient education. I had a patient complain to me once how rude night shift nurses were on my floor.

Let me get this straight - you're basing your entire opinion of all night shift nurses not off of any actual experience, but off of one complaint from one patient? Does that not seem a bit unreasonable?

My frustration, however, is twofold: I don't want to be labeled as a nurse that does not do anything just because I might be on night shift

Then don't "do nothing." You'll have plenty to do to avoid being labeled. Once you work two hours on a night shift you'll realize just how much there is to do.

I really want this to be a positive experience, but how can that be when there is a perception that there is really nothing to do?

You're the only one with this perception. Throw all of your misguided, preconceived notions out the window and wait until you have actual experience on nights before judging us all as lazy and incompetent. If you go in to your clinicals with this holier-than-thou attitude, I guarantee you, your experience will live up to your expectations.

[heron, ASN, RN]

Don't feed the troll ...

[CBlover, BSN, RN]

You know, I've always been a day shift nurse except for a 2 month stretch when I covered for a coworker's illness. I have DEEP respect for night shift. I've NEVER thought night shift nurses are the lazy or incompetent ones. They work just as hard with less staff AND they're up all night while we're all in bed snoozing. After doing the 2 months I definitely respect them even more. It's TOUGH to be awake all those hrs. I can't do it.

[NurseOnAMotorcycle, ASN, RN]

I hope I never meet Larry NSUA in real life. It would not go well for him.

[NOADLS]

There is always something to do on night shift. Hard to get bored playing candycrush or doing coursework.

[amoLucia]

Don't feed the troll ...

Thank you - I was thinking it was popcorn time.

[VANurse2010]

I think it's hysterical that you "admit" that you don't know what we do....but then go ahead and assume we don't do anything. Actually, we do everything without being spoon-fed from 800 staff members on the floor, thank you very much. It's easy to tell who the consistent night shifters are in an emergency situation where I am, because the night shifters are intervening immediately without waiting for 50 doctors to show up.

You literally have no clue.

Eh, I think you're mistaken if think that dayshift has vastly more staff to get everything done. They typically have somewhat more staff to get vastly more done. I've done plenty of night shift work, and continue to rotate, but let's be real about the work balance, especially on floors with many discharges.

[brandy1017, ASN, RN]

As a 12 hour night shift nurse I find your post both ignorant and insulting. You will soon learn first hand that we do work and we are busy, we even do some teaching, perhaps less than day shift, but we still assess patients and pass meds, we help the CNA's, and not all places have CNA's, turn and clean patients, sometimes we have dressing changes to do. Granted it is not usually as busy as days but that does not mean we don't work! We do admissions, sometimes we even have to pull sheaths on a late night cath patient.

The slower pace of nights gives you time to read up on the patient, their H & P, consult notes, labs & tests and you will find many patients are up and you will have time to talk to them. Not to mention it can be a challenge just to keep them all safe and in their bed when you have the many confused and altered patients that don't sleep at night!

[annabanana2]

You know, saying "I admit I don't know anything about this topic, but I'm going to provide my unsolicited opinion anyway" is a lot like starting a statement with "I don't mean to be racist, but..." Chances are, if you're putting that phrase at the beginning of a paragraph, the following paragraph is going to be racist, and your little disclaimer at the beginning doesn't cancel that out. Putting "I don't mean to disrespect night shift nurses" in front of a paragraph that very clearly disrespects night shift nurses doesn't cancel it out.

[Mavrick, BSN, RN]

This mistaken notion that patients sleep all night is somewhat baffling. Sick people generally don't sleep very well and most hospital routines don't allow them to sleep for very long if they do fall asleep.

First night post operative patients need frequent assessments as well as pain medication, antibiotics, dressing changes and toileting assistance. If your hospital has an ER , people often admitted for "observation" need assessments and interventions if necessary. Night shift can be particularly busy long before day shift gets there. People who have been sleeping are awakened for vital signs then start hurting, need to use the bathroom, require blood draws, x-rays, blood sugar checks etc.

Opportunities for learning on night shift are abundant but are admittedly different than day shift with their plethora of physicians, technicians, therapists, visitors and service personnel.

I see no reason to bash OP for his confusion about night shift. We've all heard the scuttlebutt about lazy, do-nothing night nurses from day shifters who wouldn't work a night even if they got paid extra to do it. Oh how they groan when a night nurse takes a vacation or maternity leave and they have to fill that gaping hole.

[lunchboxRN]

I am a night shift RN on a ortho/neuro/trauma floor with med surg overflow. My duties from 7p-7a include....all the duties of day shift. The only difference is that they occur at different times.

Yes, there are some variations :

I don't deal with set meal times. However, people still eat at night.

I don't deal with rounding doctors. I get to wake them up at 2 am instead.

I get to wake people up throughout the night for meds, treatments, and assessments. They LOVE that. I warn them ahead of time when I will be waking them and that usually helps.

Day shift sees more family members, I usually don't have that many past bed time.

Nights are not quiet where we all sit around and watch Netflix. Dementia people sundown, post-op pain doesn't go away at night, people need things around the clock.

No one shift is better r harder than the other. If you have people slacking off on night shift, they are individually a crappy nurse. They would do the same on days. I honestly can't imagine how anyone, let alone a whole unit, could get away with never giving meds or doing assessments. Do you honestly believe that? They all sit around typing out false documentation on 5-6 people every shift? I find this totally, utterly farfetched and I wonder who told you this, since you have not actually worked this shift yourself. In fact, how would anyone know what EVERY single nurse is doing? Another nurse? A CNA? Really?

Maybe..it's a unit full of psychics. They don't need to assess their patients, they already know!