Night shift nurse responsibilities

Specialties Geriatric

Published

Can anyone please fill me in on what their night shift duties consist of in their subacute or ltac facility ? I currently have a position as a day staff RN on a subacute rehab unit. I have a total of 20 patients just like the other shifts but I have the heaviest med pass and heaviest treatment orders to fulfill in just 7.5 hours. I'm finding myself resent the night shift nurses more and more everyday. Asking myself what the heck do they do? I get report from them every morning and almost every day they have a check list of things I have to do aside from my already demanding workload plus charting. Such as : find supplies, order meds, call doctors, clarify orders etc etc... They even leave pending orders for me to pick up. Night shift differential is a total of $2 more than me a hour. I literally break my butt daily and stay late daily just to finish my work and these nurses all do the same and rush through report with their bags In their hand to run off the unit. Please someone explain what they do on the regular on their night shift ..... Thanks all

Specializes in Gerontology, Med surg, Home Health.

On my subacute unit, the night nurses are responsible for doing the discharge papers for the next day. They used to do 24 hour chart checks but now we're electronic. They make rounds with the CNAs, check IVs, gtubes....we try not to have any meds dispensed on 11-7 because people need to sleep, but they do havesome every 4 or 6 hour IVs to hang or pain meds to give. Walk a mile in their shoes before you judge them.

On my subacute unit the night nurses are responsible for doing the discharge papers for the next day. They used to do 24 hour chart checks but now we're electronic. They make rounds with the CNAs, check IVs, gtubes....we try not to have any meds dispensed on 11-7 because people need to sleep, but they do havesome every 4 or 6 hour IVs to hang or pain meds to give. Walk a mile in their shoes before you judge them.[/quote']

Thank you for your response. Your right I should because then maybe I'll truly understand what they do for all that time if they aren't giving meds or doing wound txs or contacting doctors. I'm considering picking up some night hours. It's pretty cool your nurses do the dc papers. That would help the charge nurse a tad. I'm not judging them, I'm just interpreting my observations over a long course of time. Hahah .

And don't forget they have to deal with Sundowners!

Specializes in Gerontology, Med surg, Home Health.

Sundowning occurs literally when the sun is going down....not on the overnight shift. But, you're right....they have their share of behaviors to deal with.

Specializes in Home Health.

We sit at the nurses station and talk crap about 1st and 2nd shift while we plan how we can make work more difficult for them, of course.

Specializes in HH, Peds, Rehab, Clinical.

Well, I rarely get my allotted total hour of breaktime, I can tell you that! SOME of my responsiblities, on top of the med passes, treatments and helping CNA's answer lights (yes, I do this), the RN's on NOC's: take care of ordering meds, pharmacy deliveries, stocking med and treatment carts, all scheduled blood draws, changing out all O2 tubing as scheduled, writing and sending C2 orders, exchanging sharps boxes, restocking dialysis fluids and supplies, get all paperwork ready for out patient appointments and hemodialysis, prepare as much of the d/c paperwork as possible, complete admission paperwork, do all TB skin tests---off the top of my head. We also split the med A's and weekly summaries, right now I have 9 med A's and can have between 0 and 4 weekly summaries to chart each night I work.

So in a nutshell, yes, we are running our heinies off, I invite any day nurse to pop in and see the "magic" that happens at night. I phrase it that way because somehow they never go to draw up insulin only to find there are no syringes in the cart, or try to gather supplies for a dressing change and realize that someone used the last Salijet and didn't replace it, NOC shift makes sure that never happens to them

Specializes in HH, Peds, Rehab, Clinical.

And since pharmacy was just here, it reminded me that on NOC's we count narc boxes when they come in and we also destroy all narcs that have been d/c'd, resident discharged, or passed away. That can take a huge chunk of time sometimes, trust me!

Specializes in Ortho/Spine, Telemetry, SNF/Rehab.

At my facilty, i spend the majority of my time making sure all treatments were done, and most of the time I'm finding they were not..So on top of chart checks, med pass, double checking anything that was missed on admission, answering call bells and the goofiest of requests on the middle of the night, I'm also doing treatments that were missed on first and second shift...among other things. We are always busy.

Specializes in LTC, Agency, HHC.

What do we do on nights? We complain about day and evening shift. They, like us, don't do anything! I've worked every shift out there....as well as a few 2p-6a because someone didn't show up. That $2 an hour more, is differential for staying up all night. Not very many people would work nights without an incentive, unless they want to. Some people like nocs.

Ask them what they do. Volunteer to pick up a shift or 2.

And stop complaining.

I'm 11-7 part time, I have approx. 20 pts. so I come in early to look up the MARS and TARS and fill in my personal chart for pts. med times and right out what tasks I need to complete. I get report which usually takes 30 minutes so by the time I start it's around 11:45 depending on if the 3-11 gives report on time. I have a midnight med pass, do vitals which is never fun when people want to sleep but we have to do it as well as checking any wounds, repositioning etc. My goal is to be done by 1:30-2:00. Then on to 24 hour chart checks and other misc. stuff such as crash cart checks and the 50 million interuptions by people in pain, can't sleep, fevers, breathing treatments, peg tube flushes, IV's, eye drops etc. Pharmacy normally drops off around 3 so we go through the meds and verify on the computer to make sure that they are correct. By that time (hopefully the night went through without any emergencies etc.) it is usually around 4:00 so we start checking the stuff we did, putting in the vitals, etc. and charting on the patients. Then comes the 6:00 med pass that we are allowed to start at 5:00 and that's when it's the big rush with any Heparin injections and give meds to just about every patient rushing to finish before the 7:00 shift comes in and finish any charting that we didn't have time to complete during the evening. No time for "lunch break" and our 15 minutes break usually involves wolfing something down while doing the chart checks. -That's just my experience but I'm a fairly new grad. I'm learning alot and like my co-workers but I just don't like the pt. ratio

On my particular unit, there are 33 residents and on nightshift, we currently have one LPN and one CNA for 12 hours. As the LPN, I'm responsible for med pass, any wound dressing changes left over from dayshift, some treatments that were already scheduled for nightshift, skilled charting (which we do both on paper and in a computer-double charting, anyone?), putting all of the labs for the next day into the computer, doing chart checks, refrigerator temperatures, controls for the glucometers, writing out our census for billing. At the end of the month, we're responsible for checking the MARs (we're still on paper. Yuck.) and doing the monthly summaries for the residents that aren't skilled.

I personally wouldn't want to work dayshift. I know that it's a lot of stress. But nightshift is too. At least there's a little more help on days. Also, if you have a resident that's going beserk with no prn on dayshift, there's usually a doctor to call. I have to wake up an oncall.

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