Night owl...night shift?

[NewGraduate2010]

I just graduated nursing school in the beginning of december. I have a job lined up for me starting in january on an oncology floor. I will be working days & nights for only 8 hour shifts to start. I am very excited, yet nervous at the same time. I have never worked a night shift in my life, however, I would consider myself a night owl. All through high school and college I would stay up until 3 or 4 in the morning and not have a problem sleeping my day away. I had to change my ways when I went to nursing school, because I would have mostly day clinicals. I felt days went by so fast because there was so much going on...doctors, new orders, surgeries and other procedures, etc. I had about a dozen times on afternoon shift and loved it because it was a little more laid back than day shift, but there was still plenty of things to do to keep busy until 11pm rolled around and I was on my way home. However, I have no idea what to expect on night term. I feel like there will definitely be work to be done, but patients will be sleeping most of the night. Of course there will be nights where something goes wrong and you have to call a code or rapid response...but for the most part patients will be sleeping. Getting your assessment in, administering medications and keeping a close eye on your patients will be it. I am just concerned that night shift will not have enough going on to keep me going all through the night without it dragging on. I am the kind of person who loves working & hates when I just stand around with nothing to do. Does anyone have any input about night shift. I could have a totally wrong perspective about night shift, but I have never worked a night so I really do not have a clue of what to expect. How hard is it change your sleep pattern? Does anyone think that I will have a problem working nights if i am a definite night owl?

I just want to put my mind at ease. I'm super nervous about working night. I do not want to hate it and be stuck working nights....I would appreciate any input on this matter!

[Susie85]

Congratulations on graduating and getting a job! I have yet to even start nursing school but am already a little nervous/worried about getting that first job. I'm also quite the night owl sometimes but have never worked a night shift doing anything. I'm obviously not very well prepared to adequately answer your question but look forward to hearing others responses. Thanks for the post and congrats again :)

[talaxandra]

Welcome to AllNurses and nursing, both of you :)

Although the popular perception is that night time = sleeping, if more than half your patients sleep at all you're working somewhere considerably less acute than my hospital! I work on a medical specialty ward, not oncology, so the composition of my night shift is different that yours will be. Some truths, however are universal :) Even if they're able to sleep, interventions mean that a lot of the time you need to wake your patients up, and that's if nothing heads south.

Acutely ill patients need frequent monitoring - that's visual surveillance, and vital signs 4-6/24 if they're sick but stable, more frequently if they're febrile, hypotensive, post-op, newly admitted etc. Dependent patients need to be repositioned and incontinent patients need to be changed. Catheters and drains must be measured and emptied; enteric feeds cleared, changed and H2O flushes given; IV hydration hung, lines changed and old or tissued cannulas replaced.

Around half of my patients need medications overnight - most often antibiotics, antivirals and antifungals, but also analgesics, antiemetics and intravenous PPI's etc. That's without the PRN meds they request - sleepers, analgesics, antispasmodics, antacids and antiemetics.

We also get admissions 24-hours a day - I'm waiting for one now, which is why I've got time to post mid-shift; that means writing referrals, an admission and treatment plan, getting out meds, obs and assessment. Ditto post-op's.

Patients die, families need support, sometimes the Coroner's involved...

Confused patients tend to be worse at night - more disoriented, more aggressive, and more prone to falling, particularly because there are fewer nurses around to catch them.

There are certainly nights where we get to sit around and chat, but they're significantly outweighed by nights that are comfortably busy, and by nights of frantic insanity. Just like days :)

There are a lot of things I like about nights - I get to know my patients and colleagues better, there are far fewer relatives getting in my way and no allied health, and there's more autonomy, with fewer people looking over your shoulder - but it's not an easy ride of quietness. Of course, YMMV but in my experience these things are fairly universal. I'd love to hear how your first lot of nights go - good luck :)

[NewGraduate2010]

Thank you so much for your opinion. Your detail of night shift was fantastic. As soon as I start night shift I will be sure to let you know how it went :-)

As for Susie85, nursing school was the longest, hardest thing I've done in my life, but the feeling you have on graduation night is remarkable. It is well worth the struggle! Good luck with school!

[NewGraduate2010]

I had three 12 hour shifts overnight....I loved it! It kept me busy enough, but it was a more relaxing than a day shift! Just thought I would update you!