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?
I really hope that the OP returns after working night shift and tells us all about the nice relaxing shifts.
Seriously, even as a student nurse how can you not understand that medications are passed around the clock, that the pt with Cdiff does not stop having diarrhea just because it is dark outside, that pain is not relieved when the patient is supposed to be asleep?
Yep, we work on nights. Work being the operative word.
Now to address the doctor issue really quickly. They don't just write new orders. I don't know where some of you work, but where I work doctors do focused assessments on patients to prevent infection and help progress patients to wellness with their treatment.
Whaaaa?????
Some doctors do focused assessments, some read the chart and make decisions from lab work and what the nurse charted, and some walk in and look at the patient and leave.
Doctors, just like nurses (and engineers, and cooks at McDonalds) come in different calibers. Some rock, some don't.
Someone commented that there are more codes on day shift. I did not note that to be true on my unit. Is this generally the case in the experience of the posters here?
Actually there's never been a code on my day shift at my workplace of 5 yrs...Theyve all been on nights. Statistics even show that more MIs occur in the very early morning like 5-6 am. Just happened on my unit this week.
News flash patients do not turn off at 1859...nor do facilities...you better believe they can and do go downhill at anytime. When they do on nights, you better know what you're doing, as there is less staff and resources and YOU have intervene before the night docs get there. On the more mundane side, there are still med passes, admissions (at 20:30 as you are trying to pass said meds or 0530 as you're trying to do final documentation or any time really), gotta get your assessments done and take everybody to the bathroom as they wake up and need to go, comfort family who held it together during the day but cracked in the loneliness of night, watch a completely walkie-talkie tank, arrest or almost arrest, code, rapid call, get them into the ICU, get people ready for procedures, get another IV in so radiology doesn't yell in the morning...etc.
You may not feel night nurses do anything, but why not wait until you have done some of your clinical? And you are throwing gasoline on the fire by starting a thread like this but I suspect you know that already.
Oh boy. Larry, doctors do assessments and write notes...yes that is their job. However, we have to do our own assessments aside from that and it is never a defense to say "Well the doctor didn't catch that either." We also sometimes see things they miss in their assessments because we are with the people 7p to 7a.....
What do you mean night shift doesn't do assessments?
Every nurse on Every shift should assess their patients! If you don't bother to go look and seriously once over your patients you really need to reevaluate your ideas of What nursing is. Also, I have had admissions at 9:30pm-10pm from the hospital to my nursing home. I have to do a complete admission by myself as the only nurse on my unit with 53 patients, including arranging pharmacy deliveries after hours.
I as a night nurse am constantly finding orders not finished or papers stuck everywhere that are actually important that need to be addressed or labs unaddressed. Also, as a night nurse with 1 QMA and 2 CNAs for all these patients I am often doing check and changes, toileting people, and dealing with emergencies on top of regular charting and etc.
As a night nurse I can promise you i have learned an exceptional amount of information from dealing with something i have never seen before and having no management there to help me to making those snap decisions that can mean life or death for my residents. I have had to sharpen my clinical evaluation skills 100 fold so I can know when I go home I did all I can. And I have no idea what hospitals at night are like but if you want to believe night shift nurses do nothing or are lazy, go work in a nursing home or long care center filled with behavior residents and tell me there isn't much for us to do and we just check in with sleeping patients every hour or so. Again as the only nurse on the unit I am the one there to handle any and all emergencies and have to wake I don't know how many sleeping doctors when they pop up and we all know that can be a pretty terrifying thing to do depending on who is the on call.
I am sorry if this post seems rather terse but this stigma is seriously annoying and rather hurtful anymore.
I too was a student (up until last month). I have had day & night clinicals & night practicum. As a student, the night clinical experience is an amazing one. It gives you a chance to connect with your patients and the nurses. The teams that work at night (I've found) appear to be tightly knit across disciplinary lines. They work together very well. As an FYI, the floors I worked on had both admissions & discharges ALL NIGHT LONG....
Trust me, when you're running to a bed alarm for the 50th time in a 4 hour period, you'll realize. When you're toileting, or pulling labs, samples, passing meds or cleaning up your client for the 50th time in a 4 hour period, you'll realize. When you get screamed at for calling in a critical lab at 5am...you'll realize.
You'll realize that nursing is ABSOLUTELY where you want to be. Embrace the evening, it's not hot, tempers are cooler, families are more tired & receptive. Teams are more willing to let you "work". I'm sure you'll have a very meaningful experience.
Good luck!
(A little advice though, don't verbalize these feelings to anyone on the floor when you get there. Just a tip from one older career changer to another. It's impolite to walk into someone else's home & start insulting.)
I think you guys are all way overreacting. Larry is just telling it like it is, after all.
I mean, look at my job. As Larry's theory applies to my specialty (L&D) in particular, everyone knows that:
1. After 1900, women are no longer pregnant. They resume their pregnancies at 0700 sharp, though some of them resume at 0600 when the day shift charge nurse rolls up, because technically, a day-shifter is present and they know it's safe. Overachievers.
2. Babies are never born at night. Fetal training during the 2nd trimester makes it very clear to all fetuses that all births shall occur between 0700-1830 on weekdays, never on weekends, never on holidays, and, my goooodness, never on nights! We night shift nurses would hardly know how to catch an overzealous baby now, would we?
3. Because of items 2 and 3, night shifters on L&D never find themselves in STAT C-sections. That would be way too much work for the laid-back environment we've come to enjoy and would probably interfere with my midnight hot chocolate break.
4. Clearly, based on item #1, patients with pre-eclampsia, GDM, PTL, PPROM, PROM, PIH, HELLP syndrome, placenta previa, and a whole slew of other antepartum conditions don't need to be assessed, so we do in fact forego all assessments on nights.
5. Night shift L&D nurses are never inundated with triage to the point where we're putting triage patients in the OR staging rooms because we're out of triage beds, and we certainly wouldn't find ourselves in this situation with no one to call in as backup in the middle of the night (manager, CNS, on-call, postpartum nurses, etc).
Yes, Larry, you should probably stick to day shift. I'm afraid on night shift, you'd... *sigh* ...just get bored!
qaqueen
308 Posts
I really hope that the OP returns after working night shift and tells us all about the nice relaxing shifts.
Seriously, even as a student nurse how can you not understand that medications are passed around the clock, that the pt with Cdiff does not stop having diarrhea just because it is dark outside, that pain is not relieved when the patient is supposed to be asleep?
Yep, we work on nights. Work being the operative word.