What is up with night shift??

Trauma Columnist · Feb 7, 2007

It is not a particular shift, it is an individual person and that is probably the best way to address it. Are they staffed adequately? Do they the education, supplies and ability to properly care for the patients? Your DON and educator need to address the concerns to the individuals, not the entire shift. Shift wars are not a fun entity, so if you start with the individuals, then you get some progress. Good luck.

BmtTXLVN · Feb 7, 2007

traumarus is right. i believe it is just an indiviual thing. im an lvn on night shift. we have for the most part wonderful aides, but there are those few that just wont do their job no matter what is said are done to them. talk with don and education personel to see if they can get some inservices going, if they still do not do their job maybe harsher measures will be taken by the don. keep your head high and give the best care you can give while your there and pray for the people that dont do their job. for oneday we will be in the need of that type of help ourselves.

nrse4evr · Feb 7, 2007

Unacceptable care is unacceptable care no matter which shift it occurs on.

Talk with the DON as has been previousy mentioned but also with the individual caregiver ( and I use that term loosely) about the kind of care he/she is providing. Make it non confrontational, but stress the point that the pt deserves better than to be left in a wet bed or to have to smell the stench of their own feces when that can't do anything about it. How would that person like to be treated in the same way!

nurseangel47 · Feb 8, 2007

I've always found third shifters to be rather sluggish when they arrive on the unit and have always been able to empathize since I use to be one myself way back when I was young enough to stay up all night! Some places allow slackers to sleep walk all night and do next to nothing...others won't tolerate it. One does it and gets away with it, the rest usually follow. Sorry...that's the way I've witnessed third shifters in most LTC facilities these past few years in my area....sad, but true. One nurse to 56 - 60 residents for the entire shift and not enough time to stay on the 3 CNAs backs to make sure they did right, I suppose....

shadchan · Feb 13, 2007

Thank you for the advice, everyone.

I said "night shift" in general because I am not the only one who complains about the 11-7 shift. I have heard grumbles from almost every corner.

I've spoken to my immediate supervisors and also the DSD about it (the DSD, twice; as there was another incident today of bedpans covered in dry fecal matter and clumped baby powder...ewww) so hopefully something gets done.

I can understand that they might be sluggish on an 11-7 shift, believe me, I would too. But, doing your job is doing your job...that is the perspective I come from. Maybe I am being a jerk about it, I don't know.

casi, ASN, RN · Feb 14, 2007

What kind of staffing do they have on night shift? Could it be that something comes up and they say 'oh I'll come back and clean that' and never get the chance?

Is it a chronic problem due to laziness or staffing?

shadchan · Feb 14, 2007

I have not noticed any staffing problems with night shift lately.

Some of the other CNAs I work with on 7-3 have complained that the night CNAs sleep on the empty beds though, and 7-3 has to fix the beds again in the morning. :icon_roll

casi, ASN, RN · Feb 14, 2007

Ouch so it's laziness. As a night shifter I know I sometimes have the nights where I look at dayshift and say "If I forgot anything I'm sorry last night was crazy" because contrary to popular belief residents rarely sleep all night. And there are always those nights where things keep popping up and there's only a limited number of staff to handle those things that keep popping up.

It normally drives me crazy when I hear "Well night shift left everything a mess and it's not like they busy all night!", but if staff is sleeping, that's a whole different story.

rn/writer, RN · Feb 14, 2007

Being a long-time night-shifter I will try not to get my defenses up. I have worked too many places where people from other shifts make all kinds of assumptions--until they have to work a night shift. Then they see the reality that nights has plenty to do. Part of the problem is that much of what night's does is invisible--until it isn't done. It's difficult to give due appreciation for things that only show up by omission. At any rate, every place I have ever worked, the night staff took their jobs seriously.

That said, I have heard plenty of horror stories from people whose word I trust. What you are describing is a problem involving both substandard individuals and poor management. Night shift is an easier shift to abuse, and you can run into a situation where various people have cut deals allowing each other to pull all kinds of shenanigans. No one says anything because pretty much everyone has something to hide. This system continues until someone new shows up, someone who won't play the "go along to get along" game. Then they are either harrassed and intimidated until they quit, or they finally squawk long enough and loud enough for management to take matters seriously.

If the powers that be are serious about running a decent facility, they need to start showing up at random times during the night to make certain that staff are awake and performing their duties. They need to find out if the last round is the only round or if residents are truly being turned and changed throughout the shift. They need to stop looking the other way just so they can say they have proper staffing on paper. And they need to start canning staff members who are lazy, who have attitude, and who have become overconfident that their jobs are safe no matter what kind of garbage they pull. If management can identify the pack leaders and get rid of them, the more malleable staff members can probably be reshaped into decent employees, but that won't happen unless the real troublemakers are booted.

All you can really do is report what you see. Document for your own benefit. Names, times, dates, tasks that were not done, excuses made, improper behavior caught (sleeping, watching TV, playing cards, etc.). If management takes no action when presented with this information, you will know to look for employment someplace else.

If your complaints are not taken seriously, you can also place anonymous calls to JCAHO, your state organization that governs LTC facilities, media outlets, and anyone else you can think of.

I wish you well.

pkiddlpn · Feb 14, 2007

I am an LPN & @ my facility we do what they call action rounds through out our shift. The nurse writes down what they find wrong such as trash is full or things that need picked up & so on and then when the aide corrects the errors the nurse will initial it showing it was corrected. Maybe if you don't have something like that at your place you could talk to a higher authority about trying it