Night shift -- can you just take it easy, please?

[SoundofMusic]

I'm a day shift nurse. I usually handle 5 patients on days on a busy cardiac tele unit. On any given day shift, there are usually ten different tasks on 5 different patients, many more demanding family members with zillions of questions and demands, interns who sit around dreaming up new stat orders to write, never enough techs or techs who want to help, endless lines of little old ladies who need to visit the bathroom 10 times a day . . . managers who seem to rove around, checking out paperwork and whether you've fufilled each and every educational requirement scheduled.

...If I don't get to that ONE urine test, or that ONE timed blood draw ...can you just stop rolling your eyes for once and just HELP me make up the slack? Surely you've got at least a few free minutes at night to do this ...

I've worked nights, too. I know how it is . ..you get busy, too ...but you DON'T, I repeat, you DO NOT have to deal with what we do on days ...diets, tests, procedures,, and many more meds to give. It's likely I am NOT going to get it all done ...not w/ 5 demanding patients, NOT with discharges and admissions ...no way, no how. I am also NOT going to reach every doctor and solve every single problem all day long so YOU can have a "quiet" night and not have to call a doctor once in a while ....

Sorry -- know I'm going to be flamed for this ...but I just can't stand it anymore. Nurses need to work together and stop putting down their co-workers constantly for not completing every single freaking task in one shift.

[KeechieSan]

Whatev .. .maybe I should go to nights. I AM stressed ...absolutely. We have a big time problem w/ lack of tech support, which isn't helping.

Yessss, come to the dark side.. we have cookies!

[That Guy, BSN, RN, EMT-B]

What i hate is hearing how day shift will say to me "oh since you wont be busy tonight I figured I could pass this on to you" Great, thanks a lot.

But the icing on the cake comes when that same person writes you up for not getting everything done on your shift.

[elthia]

I really would love to work at a place where night shift is slow between 1200-0400. Please don't over generalize, We have Glytec insulin drips, and sometimes the it can require chemsticks up to q 30 minutes, we have cardioactive drips,all our pts have q4 vs. If you have a "unstable"insulin" drip you have a 3 pt ratio, and if you have a LVAD that has been having suctioning events you also haove a lower pt ratio. But the nurses who float to our floor don't "get" it and now float pool is starting to refuse our floor, or have crappy attitudes.

[netglow, ASN, RN]

HIRE MORE FRICKEN NURSES AND LOWER THE RATIO.

just DO IT you administration idots.

[Katie5]

You okay buddy?

[netglow, ASN, RN]

No I'm PO'd. Half our problems with each other wouldn't be if we were not set up like this.

[imintrouble, BSN, RN]

I had a manager once, not a nice person, who told me management liked and promoted hard feelings between different shifts and nurses.

She said that when staff nurses fought with each other, they could not be fighting with management. When they were mad at each other that was less "mad" left over for the bosses. A little simplistic, but it can work.

That thought reduces us to single minded little rabid animals that growl and snarl. Unreasonable, and easily manipulated. I don't like to think that's me, but the part about us fighting with each other is pretty accurate.

Onaclearday is right. Most of the problem is staffing, and that falls directly in the lap of management. So why are we fighting with each other?

[canesdukegirl, BSN, RN]

The nurses I work with get irritated when it is the same person(s) on a shift who passes the buck. There are a few of them whose favorite phrases are "I didn't have time to do it." "Can you follow up on this?" I know because I hear the same people say that during report.

If this is habitual behavior for them, then they should find themselves in the NM's office to discuss time management skills.

Accountability is a MUST. I understand that everything can't always be done on either shift, and I am completely understanding of that. However, if the SAME nurses tell me at least 2x/wk this same line, I will make sure that:

A. I ask them if they had an unusually heavy pt load that particular shift, and let them 'splain.

B. I ask them if they feel 'disorganized' much of the time, and wait to hear them out. If the answer is 'no', then I will gently prod a bit more to see what info I can get from them that tells me why they can't seem to get their work done. It's hard to do this without the nurse raising his/her hackles a bit, so you gotta be gentle.

If they seem indifferent or snarky after I ask the first two questions, I explain to them that while I certainly don't mind finishing up tasks that were not done, it puts added pressure on me to do my own work when I find myself having to finish tasks on a regular basis.

Then I wait for a week or two to see if there is any improvement. If there is none, then I take the issue to my NM.

I agree that the "Us v. Them" mentality gets old. Focusing on effective, safe and efficient patient care should be our top priority.

Kudos to all of you who work your fool a$$es off to provide a 'clean slate' to the nurses whom you report off to. You guys ROCK!

[SoundofMusic]

Wait a minute. I DO work my a%%$ off, every single shift to "attempt" to provide a clean slate for the next shift. Every shift I do this .. .I'm as efficient and fast as they come ....what a lot of folks still don't get here, is that it's STILL not possible, even at the nursing speed of LIGHT, sometimes, to get it all done!

This is what I'm getting at .. .it's impossible. I feel many night shifters who work it permanently don't get this. Or they just forget once they move to nights permanently.

I also worked on the unit where the night shift partied, chatted, laughed, and gossiped a good deal of the time, had pizza parties, etc. loudly, on most nights .... where most patients would complain about the "party atmosphere" all night long. And then we'd come in and would find patients sleeping in poop, IV's falling out, rooms a mess, etc, etc. This same bunch would be as crabby and snotty as all get out, would pass stuff onto YOU, without really saying much about it ...and yet don't EVEN TRY to pass it onto them the next night ....

I'm really not generalizing ... sorry if MY OP came off that way. Most of the time it's not a problem, but when it is ....it's a definite morale killer. Esp if you've really TRIED to get it all done, as well as TRIED to be good and kind to patients, but the clock just ran out on you.

And I agree -- we're set up to fail ...by all of them from the unit manager on up.

Yes, guess I will have to toughen up. Or find another job. I'm in a masters program, so I won't be at the bedside for too many more years .. ..for these very reasons. I'm tired of a job where I'm automatically set up to fail and to be at war w/ my colleagues. It's really wrong.

[canesdukegirl, BSN, RN]

wait a minute. i do work my a%%$ off, every single shift to "attempt" to provide a clean slate for the next shift. every shift i do this .. .i'm as efficient and fast as they come ....what a lot of folks still don't get here, is that it's still not possible, even at the nursing speed of light, sometimes, to get it all done!

oh, sweetheart, i didn't mean to imply that you weren't working your rear end off...i was agreeing with you! your post was very clear in that your goal was to do just that. please accept my apologies if you read otherwise.

this is what i'm getting at .. .it's impossible. i feel many night shifters who work it permanently don't get this. or they just forget once they move to nights permanently.

i also worked on the unit where the night shift partied, chatted, laughed, and gossiped a good deal of the time, had pizza parties, etc. loudly, on most nights .... where most patients would complain about the "party atmosphere" all night long. and then we'd come in and would find patients sleeping in poop, iv's falling out, rooms a mess, etc, etc. this same bunch would be as crabby and snotty as all get out, would pass stuff onto you, without really saying much about it ...and yet don't even try to pass it onto them the next night ....

if this keeps happening, get your nm involved. this must stop. work is...well, it's work! party time commences after we punch out. if patients are actually complaining about the 'party atmosphere', then the nm needs to address this stat. this is a patient safety issue. if you don't get an adequate response from your nm, keep climbing the chain of command and get risk management involved. this is serious.

i'm really not generalizing ... sorry if my op came off that way. most of the time it's not a problem, but when it is ....it's a definite morale killer. esp if you've really tried to get it all done, as well as tried to be good and kind to patients, but the clock just ran out on you.

i feel you. i get it. i understand exactly what you mean.

and i agree -- we're set up to fail ...by all of them from the unit manager on up.

what is your plan of action?

yes, guess i will have to toughen up. or find another job. i'm in a masters program, so i won't be at the bedside for too many more years .. ..for these very reasons. i'm tired of a job where i'm automatically set up to fail and to be at war w/ my colleagues. it's really wrong.

it is wrong. do you feel up to the task to change the way things are run?

[highlandlass1592, BSN, RN]

Wait a minute. I DO work my a%%$ off, every single shift to "attempt" to provide a clean slate for the next shift. Every shift I do this .. .I'm as efficient and fast as they come ....what a lot of folks still don't get here, is that it's STILL not possible, even at the nursing speed of LIGHT, sometimes, to get it all done!

This is what I'm getting at .. .it's impossible. I feel many night shifters who work it permanently don't get this. Or they just forget once they move to nights permanently.

I also worked on the unit where the night shift partied, chatted, laughed, and gossiped a good deal of the time, had pizza parties, etc. loudly, on most nights .... where most patients would complain about the "party atmosphere" all night long. And then we'd come in and would find patients sleeping in poop, IV's falling out, rooms a mess, etc, etc. This same bunch would be as crabby and snotty as all get out, would pass stuff onto YOU, without really saying much about it ...and yet don't EVEN TRY to pass it onto them the next night ....

I'm really not generalizing ... sorry if MY OP came off that way. Most of the time it's not a problem, but when it is ....it's a definite morale killer. Esp if you've really TRIED to get it all done, as well as TRIED to be good and kind to patients, but the clock just ran out on you.

And I agree -- we're set up to fail ...by all of them from the unit manager on up.

Yes, guess I will have to toughen up. Or find another job. I'm in a masters program, so I won't be at the bedside for too many more years .. ..for these very reasons. I'm tired of a job where I'm automatically set up to fail and to be at war w/ my colleagues. It's really wrong.

As a night shifter, have been for almost 13 years now, your posts are a bit concerning. You make quite a few generalizations which I'm sure apply only to your situations but it still riled me.

You see, where I've worked the past few years, exactly the opposite has occured. We night shifters don't get breaks from the dayshift staff. The acuity in our ICU is incredibly high but frequently the brown noser for the nurse manager who is frequently in charge, would cut the night shift staffing below anything resembling safe..with the blessing of the manager. I can't begin to tell you how many nights I ran my bottom off, coded mutiple patients, dealt with things other nurses have only read about..not had a lunch nor a bathroom break..attempt to give report to a dayshift nurse who's only concern in report was why I didn't bother to bathe my patient! Uh, hello, I was a bit busy trying to keep him alive!

I think the issues you try to bring up are ones of respect and professional accountability. I feel your frustration and your pain but I humbly suggest you need to be proactive in your approach. When I was a younger nurse, I'd feel frustrated when coworkers would dump on me with the "oh, I didn't get a chance..." I'm not talking about the occasional incident but that one person who would try to not do most of her/his work. What I learned was I needed to hold that other nurse accountable for their actions. Didn't pass a stat med cause pharmacy didn't get it down here for the past 4 hours? Well, guess what: we're going to stop report, you're going to call pharmacy (which is one flight of stairs up-believe me, I walk it all the time on night shift) and you're going to give that med. When you've completed your work, I'll be happy to finish taking report. I don't play that game anymore. Again, I use this tactic with those frequent nurses who try to manipulate me into doing their work and mine.

I work pretty hard to try to leave next to nothing for oncoming nurses. I realize they will have their own issues to deal with just as I do. I don't have as much staff, many fewer resources and work like heck to try to "keep 'em alive till 6:55 a.m." I don't really like the days vs. nights arguement, as someone else said here management frequently uses that as a tool to divide staff. I'm not playing that game anymore.

[wooh, BSN, RN]

The problem with "nothing to do from 12 to 4am" if you actually work in someplace like that, is there are only certain things you can do during those hours.

Hello alert and oriented patient! My name is wooh and I'll be your nurse tonight. I'll be in at 2am to do your daily dressing change! I'm sorry sir, I can't wait until 3 am because that's when I'll be nextdoor doing their scheduled IV change. Well yes sir, I know it's very painful and will keep you up all night, but our day shift is busy, and since I've got nothing to do from midnight until 4am...

Here's my thing, if you really think the the night has it so easy, go work it!! It's rare that there's a facility that wouldn't happily trandfer an experienced day shift employee to nights. I got my transfer ok'ed IMMEDIATELY. You are more than welcome to come sit on your butt with us lazy folks who don't do anything all night.

And I can guarantee, I get more eye rolling from day shifters than from night shifters. I can name 4 dayshifters in particular, only 2 nightshifters. Obviously, that statistic proves that ALL dayshifters are eyerollers... Or..... It could just be that some people, whatever their profession or whatever shift they work are ridiculous.