Zoomer

I've been doing nights for 14 years now and I love the shift, but I too get sleepy around 4 am. I will get up and walk around or bathe my patient or chat. I also drink coffee but try to avoid that after 4 am. I usually do worse if I work 3 in a row so I don't do that often. Ithink the sleep debt builds up since I only get about 5 1/2 to 6 hours of sleep a day. I have recently started having problems staying asleep after 11 am. I tried the OTC sleep stuff but since most of it contains Benedryl it doesn't work for me. Antihistamines make me restless instead of drowsy. Now I take Ambien. Usually 2.5mg works fine to keep me asleep. The worse part was when I would get sleepy driving home. Now that I work within 30 minutes from home it is better but there were many times when I worked an hour from home that I had to pull over. Very scary. How does everyone feel about taking naps at work? I think if it is your break that the hospital is not paying you for then if you go to the lounge for 30 minutes for a nap if needed it should be okay. My only problem with this is the many staff members I work with who will do this for longer than their break time or who take their 45 minute dinner and their 45 minute nap. Anyway the hospital policy is no sleeping period. At one hospital where I worked if the supervisor caught you sleeping they could make you go to the ER for a drug test and to determine if you are fit for duty. They usually only did this for chronic offenders. I have heard of employees who were fired for sleeping at the desk.

A great reminder of why I became a nurse! What a difference you made in all those peoples life! Great for you! :)

I've been working nights for 14 years now. I swore once the kids were older I'd go back to normal hours but like nights so much better than days. There are many advantages to nights---better pay---less administration around---less people around in general--- you don't have to serve any meals---you learn to become much more independent---seems like there is better teamwork. Disadvantages---not enough sleep---having to wake up cranky docs---never having any hospital functions or inservices on your shift (don't you wish the administation had to come in at 0100 for a mandatory inservice?), How do you get through it as a new grad? Lots of coffee :)

You know how recently there is a big push to make sure all patients are on DVT prophalaxis? Well, one night I asked the doctor to order some lovenox or heparin for his patient to prevent DVT and he looked at me strangely. Feeling like quite the patient advocate I started on a speil about how important it was to be sure the bed bound patients didn't get clots. Then I remembered..... The patient had no legs!! :rotfl:

I saw on episode of ER where the cell phone set off a patients AICD. You know if it was on ER it must be true... :)

I work nights and we have a tech about 50% of the time and while it's great help for us they are counted in the hours per patient day the same as a nurse. The hppd is calculated as the number of nurses, techs included x 12 hours and divided by the number of patients. So if I have 4 nurses and a tech and 10 patients my hhpd is 6; however, this means 2 nurses are taking 3 patients. If we are over the hppd and I have an agency nurse then I am expected to send one home so more nurses end up taking 3 patients. You can see how I would rather not have a tech. I think techs in the unit are nice if you don't "count" them and if you can be sure they are accountable for their care. At night our tech will help to bathe the vented patients. After she is done with that she tends to disappear. Good luck.

I usually go by systems. Start with patient name age diagnosis allergies code status and pmh. Then just a quick system review. I also include the doctors including the consults. I hate when you are giving report and the person you are talking to doesn't listen to you or starts talking to other people in the room. I got fed up one time with one nurse who frequently looks as if she could care less what you are saying. She started talking to someone else when I was in the middle of a sentence so I got up and left telling her if she had any questions just look at the chart.

I work the 7p-7a shift in critical care. On friday night we were pretty short staffed with several nurses having to "triple" (take 3 patients). I was in charge and had my own assignment which is something the nurse manager has told us wouldn't happen. We are supposed to be out of staffing in order to help throughout the unit and make assignments etc... At the beginning of the shift we had 5 patients that were tele overflow patients and it is common that if a nurse has a tele patient then he/she can take 3 patients. However due to the fact that we had to make beds for critical patients we moved 3 of those patients out and then had some very sick patients. Durring the shift we got 5 new critical patients. The nurses I worked with were great and we worked very hard. The nursing supervisor told me at the beginning of the shift that the day shift for Saturday was very short, only 5 nurses at that point for the 20 patients we ended up with. Well, the supervisor called and begged and was able to come up with 3 more nurses although 2 of them could only work 8 hours. She called the nurse manager to inform her of the very bad staffing and asked her for input. And this is the part that made me so mad. My nurse manager told her, " That is not so bad they can handle it. I was there until 11 last night the patient assignment is manageable" Now the manager was apparently in the hospital meeting with one of the other staff members but not once did she come out to the floor. I didn't even know she was still in the building. What gets me so angry is that she didn't know a single thing about the 5 new patient we got or how sick they were. She didn't even call me to ask if I thought the assignment for days was manageable. At the time the supervisor told me about her comments I was trying to help a nurse with a patient whose heart rate was 200, at the same time I was trying to answer a doctors questions about his patient and deal with my own patients. I tried paging my manager but she never answered me. I am still steamed over this. This woman has been our manager for less than a year and has been heard to say "this is not a real ICU". What should I do now? I am tempted to complain our nursing VP about this. Or should I just talk to the manager to let her know how upset I am?

Very well said!! I know in my facility the management is now saying that if you are a registered nurse you are expected to take leadership responsibilities and if you don't it will reflect on your evaluation. I am in charge frequently and it steams me that those nurses who never do charge are being paid the same as me. We get no extra compenstion for being in charge. I hope the managemnet sticks to what they are saying and starts giving less of an increase at evaluation time to those people who don't step up and take their turn. Also, if you take turns being in charge then everyone knows how hard it is to make certain decisions about assignments etc...

1. customer service. I once told a patient who complained about "the service" that she didn't have to leave a tip. 2. Not starting report on time. Also since we pick our own assignments in the ICU where I work some nurses come in early and expect report after they have picked out their choice assignment (usually the patients that were bathed by night shift are sedated on the vent, never the confused gomers) then I have to give report all over again when the rest of the nurses get there and realize what an unfair assignment it is 3. Lateness. Some nurses are always 5 minutes late then get ticked off when they get the "leftovers". Leave your frickin house 10 minutes earlier!!! 4. Nurses who don't answer call lights or who will sit and ignore IV's beeping or vent alarms because it's not their patient. I call it selective hearing. 5. Constant negativity. If this hospital is such a lousy place then why have you worked here for 20 years. 6. sharing all the negativity with the new nurse I am orienting. 7 Smokers who take 5 or 6 breaks a night. Believe me that 5 minutes you tell me you are going to be gone is actually 15 minutes and I don't appreciate haveing to cover for you every single time, and why is it half the staff expect to be able to leave at the same time? 8. Phone calls from "family" who get angry when you won't tell them all the details of their brother-in-laws illness. 9. People who don't think the visiting hours apply to them. 10. People who bring their 2 and 3 year old kids to visit and stay unitll well past the kids bedtime. Also let the kids roll all over the floors or drink out of grandmas cup. Not to mention running up and down the halls. I once had a visitor leave a 6 year old with grandma for several hours because she didn't have a baby sitter. No reason why grandma can't take care of junior just because she has had major abdominal surgery.

I work in a 20 bed ICU. At any given time we might have 4 or more tele overflow patients because the tele unit is always full. ( Why doctors feel these days that every patient has to be admitted to tele is another issue :angryfire ) I was wondering if any of you have the same problem. The problem is our nurse manager and the supervisors will staff us with less nurses because of this and we end up taking 3 or more patients a piece. We will be told to group all the tele patients together and give them to one nurse. This would mean the nurse would probably have 4 or 5 patients. You know there are not many ICU nurses who want to do this. Sometimes they will pull a tele nurse into the unit and then they get all pissy if they have to take 4 patients while the ICU nurse only have 1 or 2. Does any one else have this problem and how do you handle it?

I would ask if the hospital you are going to has a critical care course. My hospital had a very good core curriculum course and it was great. Although since you are just out of school and a lot of it would be review for you. I always advise new nurses to be sure to ask lots of questions and if you feel you are not ready at the end of orientation ask for more time. If you feel you and your preceptor are not a good fit ask for another. Just remember you are in charge of your orientation.

I am sure you will do a SUPER job. I came to the ICU after 13 years of med-surg. My organizational skills came in very handy. I remember thinking that the ICU nurses were all snobs when I was a med-surg nurse too. It's just a different world. What I like about ICU is the control and the ability to know exactly whats going on with the patient. I also think that the doctors respect you more which is probably wrong, but they do get to know you better when they spend so much time with you. Just remember to treat your former colleagues with respect as you do now. I often have to remember my med surg days when giving report to a floor nurse and have to stop myself from giving such a detailed report. I loved med surg for a long time because I liked the variety but patients are just too sick these days to be able to handle the nurse patient ratios. You have made a good decision. :)

i can relate. i had a wife get all mad at me one night complaining that we told her her husband only had a few hours and here he was still alive 2 days later and she would have to get her hair set again. also had a family member from out of town ask me if there was something i could do to help speed the dying process as his return ticket was non refundable and he wouldn't be able to go to the funeral if his father didn't die that day. i had a patient once who attempted suicide (eventually succeeded) by drinking a glass of drano. unfortunately a very slow painful death. anyway, it turned out he had a mistress and an illegitimate daughter that the legitimate family knew nothing about so they were given permission to visit after visiting hours so we could keep the 2 "families" seperate.