Welcome to nights!
Here is my run down
1845- bedside report and chart check review (look for new orders written on days that may not have been addressed or faxed to pharm yet)
1915-2300 assessments, evening meds, pain assessment. I usually ask all of my questions and review their med schedule all night so they know to be expecting me in all night long. I also ask them if they want to be woken up when pain meds are due or if they want to call when they are ready. Some patients will sleep too long and wake up in horrible pain (deep sleepers) others will wake up with the first twinge. I normally recommend waking them up the first night or two after surgery, after that it is up to them. If there is anything they need or are concerned about, I want to know NOW so i can call the md before the wee hours.
2300-00 round to check for five 5 p's. Take away any food or drink for anyone npo for surgery in am. at 11pm I offer snacks to these people so they can rest without their tummy growling.
0000-200- my floor has a lot of drain removals at this time, extensive dressing changes, full chart reviews to ensure all orders were put in correctly and carried out
200-400- second round of drain removals on my floor (some docs order removal at 2, some order removal at 4) and dressing changes
400-600 morning rush, 5 p's and morning medications. I also use this time to ambulate patients who need to walk.
600- end of shift, make sure all iv fluids are full or changed and in date, make sure everyone is ok for pain med to last shift change, clean up room if necessary etc, dc foleys if ordered.
But the best laid plans don't usually work out. You need a "loose" plan like this as a general guide, but you will get admissions, have emergencies, have blood transfusions etc that will keep your schedule on edge all night.
Make a list of all your "must do's" and your "want to dos". Get the must dos done first and after you get into a good routine ( a few months or so after orientation) you will find yourself getting most of your want to dos done as well. In the beginning getting all your must dos done is trying. On my floor dressing changes are not timed but it makes sense to do them when taking out a drain. But If I cant get to it I cant get to it.