switching from nights to days - differences

[pinkiepie_RN]

I've been a nurse for about a year on a 26 bed adult unit. I've been really getting restless on nights and yeah the messed up sleep schedule is getting to me. The busiest time for me on nights is getting everyone medicated between 2100 and 2200 and dealing with crises. After that, people tend to go to bed and while some patients are up all night, most sleep or at least stay in their rooms. The work I do between 12m and 0700 consists of admissions, LDS paperwork if necessary, calling docs for admission orders if necessary, chart order checks and preparing my report for day shift.

I know that it's a faster pace on days, what with rounding with the doctors, groups going on all the time, and most of the patients out of their beds. Is there anything I can do to mentally prepare myself for the transition or is it really just sink or swim?

[fancyhen]

It's great to ask for advice BEFORE you start something new. I've been a psych nurse for over 20 years (adults, kids, teens, inpatient and outpatient) and worked all the shifts. No matter what kind of nursing, you always have some issues with "that shift never...".

Day shift will be very different. You won't have much free time to review charts and your time will be very full. Sometimes you'll wish you were back on nights. LOL. Be familiar with your facility's basic schedule, team meetings, med times and patient schedule. Remember to think before you automatically tell a patient something that might be against the rules. A big difference will be dealing with ALL the patients for 8 or 12 hours instead of just a few. Then there are the physicians, social workers, dietary workers, laundry, deliveries, phone calls, visitors, etc etc etc. I never understood why day shift makes less money but has to handle a lot more issues. Organization is the key.

I've always found it convenient to keep a pad of paper close by and make brief notes to myself as the day progresses. (phone messages, things to do, etc). It helps keep you straight and organized. Feels great to cross things off your list too.

I've always prided myself on doing what I say I'll do. The patients might not always like my answers, but if I tell them something....I follow through. My little note pad is a major player in helping me do that. I'm always honest and I keep my word.

Good luck with the change. Night shift can cause lots of problems with your personal life but a top-notch night shift nurse makes the day shift go much more smoothly. So thanks for your time working nights and good luck with days. You'll do great because you care.

[Yosemite, RN, ASN, EMT-I]

Day shift:

Pros: More staff to help with medical and/or psychiatric emergencies. (Usually) slightly less admissions. Administration usually there if you have questions/concerns. You may have a better chance to attend a staff meeting without overtime. Possibly an extra staff member or so. Clients who are loud/disruptive have less of a chance inciting "situations" as less clients are trying to sleep. Psychiatrists usually on-site. Usually there is a unit secretary (or what ever your facility calls that position). You don't "loose a day" off due to having to recover from/prepare for the night shift. More quality sleep. You get to spend more time with your family/significant other. Don't have to deal with grumpy physicians when you have to call for orders (well, at least you dodn't have to wake them up... unless its a Saturday, Sunday or holiday).

Cons: Barely (if at all) controlled chaos. Definately many more discharges. Administration is there to criticize but offer no actual help. Mandatory overtime for staff meetings. More clients awake during the days. No shift differential/more work for less pay. You have to interview and chart on more clients. MANY more physician orders. The phones! The phones! They NEVER stop ringing! The Unit Secretary is run ragged and seems to never be available WHEN THE PHONES ARE RINGING OFF THE HOOK!

All in all... I miss the night shift. Unfortunately (or fortunately depending on your outlook), I want to stay married, so I get up in the mornings now and come home to my loving wife in the evening stressed out as all get out!

[Jules A, MSN]

I try to never do day shift during the week because of all the extra people bogging down the nurses station, taking the charts, offering their sage advice etc. It is chaos with the phones, groups, treatment teams etc. It is also about $5 an hour less! Weekend days are cool but for the most part I love my nights. I can spend evening time with my patients in a more low key atmosphere, then they go to bed so I can get to the massive paperwork that is nursing today. In considering the history you have shared here I would say the day shift will be great for your physical health and hopefully your stress levels won't go through the ceiling by the increased pace. Definitely do a share shift or two first especially on a Monday morning. Good luck.

[jlbic]

I worked nights for over 2 years. I will say for the most part, it is less chaotic than day shift. But I also had some pretty chaotic night shifts. When things go bad at night, there aren't many resources around and thats what sucks the most.

When a pt goes bad on days, there is like a million people there. Your whole routine changes when you go to days. You have a lot more meds to pass. You have breakfast lunch and dinner for patients. You have to get most patients out of bed TID. You have doctors and tons of orders, tests, surgeries, procedures, discharges, admissions,etc. I think you learn more skills on day shift, so that's a plus. But I would say that day shift goes by a lot faster than nights, you are too busy to really look at the clock. Oh, and sleeping at night and being on a "normal" sleep schedule is so very wonderful.....and a lot healthier for you. But, you get paid less to do more work.

So as you can see, there are pros and cons. Just figure out what things are more important to you.

[bluecatfarm]

After 2 years of working nights, I am finally getting off. My health was suffering, my relationships deteriorating, my concentration subpar. I either never slept or slept too much. I always felt out of sync w/ everything, sleepwalking through my days, no motivation. I became more and more depressed until I couldn't even get out of bed except to go to work--the only place things seemed normal.

I will miss the night shift, because, although I hated the hours, I loved the work. Less chaos, more time w/ patients and their charts, quiet times, and more money! But enough was enough. I just didn't have what it takes. Everyone is different and some it seems can adapt better.

Now I am going back on days where I will get paid less and work harder, and I couldn't be happier. I feel as though I am getting my life back.

My 2 cents. :)