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?
You will learn on night shift. Trust me. I just started in October on a med surg floor at a busy teaching hospital ratio 1:5 . I did most of my orientation on day shift and it is just complete chaos. I am now off orientation and working night shift and it is still great for learning. U have time to actually stop and think in between tasks (most of the time) but you are still required to do assessments and pt teaching and you always have to pass meds , start Ivs, hang fluid, give tube feedings, suction pts, communicate with Drs and pharmacy, document, transfer pts, admit pts, clean pts, etc. pts still go to the bathroom and need medication once the sun goes down. Not to mention any possible emergencies and other craziness that can still occur at night. In fact my shift the other night was so crazy I was telling my coworkers it might as well have been day shift. I'm not sure if ur a troll or not, but I do know that too many ppl on this website freak out or are just incredibly rude whenever someone asks a genuine question. If you don't have anything substantial to put into the conversation why don't you just not comment instead of complaining about how offended you are. OP is obviously either a troll or just genuinely really confused and inexperienced with the reality of night shift so no need to get all bent out of shape.
OP, I'm sorry for the previous experience you describe from nights you've observed. I assure you, that is not the way it should be.
I bounce around between night shift and day shift. My preference in terms of patient care is night shift. My preference for purely circadian rhythm reasons is days.
On day shift, there will be staff all over the place. We don't have extra nursing staff. That remains the same. We have more hospitalists, more ancillary staff (PT, OT, RT, lab etc.), more specialty providers, more ED providers, etc.
At night, you have limited RTs, which is a big deal when someone isn't breathing but your floor's RT is downstairs for an emergency surgery. You have limited MDs, which complicates a LOT when your patient's 4 peripherals aren't enough and you need a central line, but that one doctor doesn't place central lines.
You don't have staff visiting that patient frequently every hour, placing eyes on them and giving reassurance that the patient is okay. That's on YOU. Will you feel strong enough in your nursing skills to spot the subtle signs of impending crash? More is on your shoulders, because less people are there to help.
I freely admit that night shift, when smooth, may bring with it a chunk of down time. Night shift can also talk every last bit out of you because not one single thing will go right. I've never been afraid on day shift (knock on wood). I've had 3 nights in the last 1.5+ years that have scared the hell out of me.
Why?
One hospitalist, two codes at the same time, both of which my patients.
A patient bleeding out faster than I could put blood and fluids back in him. No OR team on site. Had to call ED MD up because he had to place the line and intubate.
An afib RVR patient suddenly unable to breathe, fighting hard against his bipap. This was the night after we had a guy intubated and later, dead, with the same exact decline pattern. I held that thing on his face, bringing out my mom voice as fiercely as I could, knowing all the rest of the nursing staff was passing meds and doing vitals, many rooms away, RT wasn't on the floor, and I'd left my phone God knows where.
Day at shifts has its own, more visibly obvious, stresses and busyness. Night shift comes with totally different stresses.
After you have had some time with your preceptor, I do hope you come back to share your thoughts. Best wishes to you in this next step of your education in nursing!
I have been a nurse for nearly 30 years and almost all of it has been on the night shift. It was 11PM to 7:30 AM to start then it was changed to 12.5 hour shifts hour shifs. I love the 12 hour night shifts. I workred MED/SURG, the CCU and currently have been in E.D. for about 13 0r 14 years. I work in a small rural hospital. If the ED is busy, all the other departments are busy Lab, XRAY, Resp. Therapy, Med/ Surg because we send them admissions. We usually have a lot of patients when we get to work at 1800 and sometimes it doesn't stop. i work with great people. We all jump in and help each other, no matter what has to be done and that would include helping on the Med/Surg floor if needed. We have slower nights on occassion and when that happens we may try to sit down and eat our meal in one sitting so it doesn't get cold. We do extra cleaning nd other things, We always do patient teaching with discharge and explain things to our patients and their families. There have been people throughout the year that have said that "Night shift does nothing". That statement is simply not true.
Try working the shift before judging it. You may find out that it's not so bad. You will learn a lot.
If indeed night nurses do nothing please consider the following questions:
1)Why do people try to get off night shift as soon as possible?
2)Why is there often a night shift differential?
3)Who gives the multiple q4 antibiotics and q2 PRN pain meds?
4)What exactly goes on at 2200, 0000, 0400 med pass?
5)Who draws all those 0600 labs and does all the 0500 daily baths?
6)Are there more codes on days than nights? Ie: do people wait for day shift to decompensate or do complications happen at any given time?
I think some critical thinking is in order at this point in your career. It's not as if patients are dropping like flies from complications related to the neglect of night shift caregivers. As always when lumping people together in a group, choose your words carefully, you don't want to irritate the very people who may one day save your new grad behind.
LM NY
388 Posts
You will learn during the night shift. I work in the day, but it is total chaos. The day and night nurses do the same stuff, just at a different pace.