kahann

Thanks for all your support. I agree this relates to mutual cooperation between the ED and the floors. It seems that we are required to be mindful of what is going on in the ED but it never makes any difference to the ED what is happening on the floors, we are expected just to cope. I have had a pt. expire unexpectedly just after shift change while I was handling an admission. The "should ofs" and "could ofs" can haunt you for a long time. Though teamwork is great on nights, at shift start everybody is handling their own patients and that extra set of hands you need to pass a med to your assigned patients, or track down the 8pm and 10pm meds your new admit hasn't taken before coming to the ED are not available. Nice to see we are all in the same boat on this one. And though we are expected to give 24 hour care, it would be nice if I felt I gave all of my patients (including my new admits) the best care I could for every hour of my shift.

I am interested in knowing if other facilities have a policy of holding admissions at shift change. I work 3rd shift and a shift change admission is difficult at best. I try to weigh the benefits for the patient on having them settled on the floor as early as possible against rounding on my patients, passing midnight meds, and putting out "fires" after a busy 2nd shift. I feel if I can get enough time to pass meds and peek in on my patients ( will play catch-up on assessments as the night progresses), I can spend more time with a new admission and get them settled with less interruptions. We are considering proposing this to our administration and would like to know whether this works at other facilities.

Guess I am pretty lucky. During Nurses Week the hospital I work for does something each day for the nurses. Sunday we had sundaes, Monday, Nursing mgmt came in and relieved each nurse for a 15 min break (mine was at 3am) and served cookies. Tuesday we each got a rose and a mass was said in our honor. Weds we had dinner and a presentation on nursing. Thursday we were served high tea and Friday we will have burgers, hot dogs, and popcorn. Management does this for each shift I have also received totes, umbrellas, and fanny packs. Nurses Week has always been a treat for me!

I work mainly 11p-7a and have had a day shift charge nurse tell me "I don't know why you get all the money, days does all the work". Best reply: You can work night shift too--come see what it's like to carry 8-10 med/surg patients a night, deal with cranky docs on the phone, have to be 1:1 with your dementia patients, and pass meds and monitor multiple post ops with PCA's and PCEA's. Our night crew thrives on teamwork, we have to work together because there are so few of us. I wouldn't have it any other way.