Nights vs. Days

[nurseontheway]

Good morning everyone! It is true that working at night is less hectic than working during the day? I am not a new grad but am thinking about going to a hospital to get more skills under my belt. Unfortunately you have to get in on nights and a day shift may open in the future. There is an opening on a med/surg floor and IMC (intermediate care.) I know the patient ratio is less on IMC but the patients are sicker. I am trying to make a wise move and I will have to sign a two year contract since I do not have a year of acute experience even though I've been a nurse for a while.

[JadedCPN, BSN, RN]

Good morning everyone! It is true that working at night is less hectic than working during the day?

The short answer is, NO. Of course things vary from facility to facility and even floor to floor. However, in my experience it is a myth that night shift isn't hectic. There may be times where it is less hectic than day shift, but even then it can be hectic. There tend to be less nursing staff around, less providers around, and less ancillary staff so when things do go south you have less resources.

[nurseontheway]

That was my understanding too.

[Sassy-RN]

No! I've had way more horrible shifts on over nights then on Days.

Mostly because you don't have as many resources.

Also sweet little old people with dementia turn into gremlins after midnight!

[ShadowNurse]

Night shifts are definitely just as hectic.

[Cowboyardee]

In most places, the average night shift is less hectic than the average day shift. There are some exceptions - notably, units that go to a substantially lower nurse to patient ratio on nights, and also maybe units where the day shift is far more seasoned and experienced than the night shift staff and is better at putting out fires. Also, you should note that the worst night shifts are every bit as bad as the worst day shifts. But on average, day shift has more new orders, more tests, more decisions, more family and visitor issues, more adminstrative oversight, and more interruptions.

Ive worked both shifts in several different hospital systems over more than a decade. I've heard many nurses dispute that night shift is slower, but never anyone who's worked enough day shifts to know better.

[confusednurse10, BSN, RN]

This is slightly a myth. On night shift, you do not have to coordinate with PT/OT, patients going down for testing, discharges, etc (for the most part). Family members and management usually aren't present either. It's more just you and your patient, which is nice. However, things still get busy on nights- if patients are having problems during the day, those problems don't magically go away during the night. There are also less resources available (less nurses, doctors) if things go wrong. On the unit I work on, we work at a higher ratio than day shift- which can add stress. It really just depends on the night and the unit you work on!

[bd2rn]

It truly varies from place to place. On Med Surg, the shifts can have DIFFERENT factors that can make the shift hectic. It also depends on whether you like to have lots of people around you or if you'd rather do your own thing. Having lots of people around can be draining, IMO.

[NorCalKid]

I feel like day shift is faster paced with admits, discharges and procedures. But night shift can be just as hectic in it's own way. I am glad I started on nights, I'm also glad I no longer work nights.

[dennis8, ADN, BSN, CNA, RN]

I believe it depends on where you work. In California there are mandated patient to nurse ratios. It will always be 1:4 or 1:5 (depending if they are on telemetry) which is very nice. I worked both day and night shift in the hospital I am currently working in. I started nights, went to days for a couple months, then went back to nights. In my personal opinion, the difference was night and day (pun intended). During day time you have to deal with family (which can be the hardest thing you will deal with), physical therapy, administration, 10 doctors giving orders for one patient, a discharge, an admit, another discharge, another admit, and 3x a day accuchecks before each meal, and alot of other things that only happen when normal people are awake. At night, its usually busier at the beginning of shift and slowly dies down. Most patients that have discharge orders would be gone before shift change, or leave an hour or two after the shift starts. The nocturnal doctors will be in and out throughout the night. Most daily meds will be given during the daytime, which leaves fewer at night (for most patients). Admissions can come any time of the day, but at least at night you will typically have a bit more time to work on it. What I really hate about nights is trying to get a hold of certain doctors. Then again, this is based on my experience at my current workplace. Alot of things must be factored in such as your boss, your coworkers, your facility rules, and alot of other things that are workplace specific. Best of luck!

[Persephone Paige, ADN]

You know how kids get sicker at night? Well, that's always been my experience anyway. People sleep, heart rates drop, people die, etc... Both shifts present their own challenges. Days have orders coming in, non - stop. Dressing changes, discharges, admissions, physical therapy getting in my way when I need to hang an antibiotic, an so on. I still wouldn't want nights. More patients, less help, doctors in a foul mood when you have to wake them, etc... If you work days or nights, you are earning your keep. The only thing good about nights, imho are less doctors.

[ClaraRedheart, BSN, RN]

This is an older post... but I've worked both nights and days on the same unit. Here's what I've noticed.

On nights, you hit the ground running. People want to get their last walk in. You have one more patient than the day shifters have, so you still have to medicate and assess 6 patients within two hours. Not really possible to do a thorough job and chart in the room, so usually I assessed, then charted later when the lull came (assuming you have no gremlins). Ah, the lull... that's nice. You can catch up on charting, power walk around the hallway and get your steps in early, review charts.. that DOESN'T happen during the day. If you don't chart as you go, you're behind and will be hanging out for two hours after shift is over. Mornings also (usually) start out slower on days. You have time to get report, review your charts, then get started on med pass where you chart as you go. Just don't expect things to slow down, because many doctors will waltz through, sometimes multiple on one patient and place orders... more orders. Better not miss any in the onslaught or lab will be calling you or night shift will be asking why you missed that CBC that was due. You also have discharges, admits, transfers. Overall, I think days are a lot more busy, but I've never felt the need to come in early and review charts on days. Nights start faster, and you need to know whats going on BEFORE you hit the ground running or things could get dangerous real fast, so I always came in an hour early to look at charts. Probably depends on your unit what the differences are, but this is what I've observed on my unit.