I’m a baby nurse (new grad) going into day 3 of orientation with my preceptor. She mentioned that she lives close (within 5 mins) to the hospital so she usually gets there early [at a time that places her 40 minutes earlier than the start of her shift] so that she can get her day started ahead of clocking in. When our shift was coming to an end, I hadn’t looked at the time so I thought it was time to go because I saw night shift staff all over... but no, we had at least 45 minutes to even give handoff. One person (still in her coat, who I realized was a nurse) was even there more than an hour before shift start. So I realized this was a majority thing.
But why? Is this a common trend? When my professors in nursing school mentioned this, most scoffed at the idea of working for free. Yes I’m a new nurse but I’m not fresh out of school entering the workforce for the first time. It just feels weird that the notion is - in order to be successful and get home on time we have to work off the clock. I do understand being there in time to get settled (lunch purse away lol, snack eaten, coffee refill, non-patient chit chat, etc.) and getting your ducks in a row, mentally, to begin your shift. I’m not really an early riser but I do get in early enough to be on the unit at an appropriate time. I just feel like I can’t compete with the nurse who’s there an hour early. It’s like I’ll look ill-prepared being on the unit only 15 minutes prior to starting.
I just figure - I’m here for 12 hours and of course I’m still learning time management as an RN but gooooodness! Isn’t half of a day enough?? And if not, why? Do you do this? Is it so that you are able to be ahead or question the nurse who’s giving you report? Is it a reflection of management that it’s allowed or even required in order to feel comfortable with your patients?
I hope this doesn’t come off as offensive or snooty but I am really curious and kinda nervous at the same time.
At my previous job; nurses would come in early to start looking over the assignment, maybe up to 30 minutes. No one really prior to that, which, the assignment wasn't usually done till 15 minutes before shift change anyway so sometimes even coming in that early wasn't helpful.
I learned from most of the nurses; just know what questions to ask that way you don't need to be there early to research. I think a lot of it came from "What if something happens at the start of shift", because at the start, you really don't know anything but a brief summary and basically are relying on what the previous shift told you assuming you got a decent report. Report was pretty standard; our "report papers" were just the patient's information and PMH. Nothing else. Each nurse had their own report paper and took their own report. And also handed off their own report. It was amazing the things that would get lost, or forgotten. So knowing what information is important and making sure you get it is vital to starting your shift off right. That way, in 10 minutes if something happens... you can accurately respond and be able to answer questions.
At this place also; med passes started at 8pm. You have ZERO time to get report, meet the patients, and then look up anything prior to it being time to start meds.
Where I am now, almost no one comes in early. The difference is, this place uses SBAR report papers that are passed on from nurse to nurse. Med pass also starts at 9pm; so by the time you're done with report, done with bedside rounding, and everything else you actually have time to look up notes, meds, vitals and everything else for the patient. Assuming something bad happens right after shift change; the SBAR literally contains a brief summary of the patient's care since their arrival, so fewer things get left out, or lost in report, which helps immensely.
You kind of just have to find your own niche. And what works for you will evolve, especially as you become more comfortable with being a nurse, and not simply being a new grad.
I'm not going to fault them if that's what they feel they need to do to have a successful shift. But IMO, it points to lack of support from leadership. I would wonder what is going on that the nurses feel so overwhelmed that they have to come in 45 minutes early and work off the clock in order to be successful.
Thanks Klone, tried to write the same thing last night and my phone died.
I would be worried if they were to sustain an injury e.g. needlestick or back injury would they be covered by insurance? I had one staff member do this frequently and if I had been FC that morning the afternoon allocation may not of been made up yet. He would loiter at the desk asking for it to the point we had a formal chat about appropriate behaviours. Turns out he had severe anxiety about work and no love for nursing. He is now a pastry chef!
I would LOVE to quit nursing and become a pastry chef. ❤️
I worked in hospitality through high school and uni. Chefs have shocking hours, in for 5AM for breakfast, leave, back for lunch or dinner service. Work every weekend.
Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.
My last hospital unit refused to hand out the assignment sheet until 7 minutes before shift end/start. It made it basically useless to come in too early.
I go in an hour and 45 minutes before my shift but only because I just don’t want to deal with the horrible traffic and parking associated with my current job. I don’t clock in but I listen to music, have a cup of coffee and maybe clean up my cubby or play on AN. ? I clock in at 7 (0730 is my clock-in time) and work on mandatory ED, projects, work emails and review my clinic list for the day to make sure orders are in and any special needs have been addressed. Sometimes that 30 minutes isn’t enough. ?
We are forbidden to be in our EMR without being clocked in and they’d rather we weren’t in our work email either. I also don’t work for free.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
Well that sucks. The nurses where you work are willing to work for free and it seems it is the standard. Unions prevent this kind of nonsense. If you need to come in early to look at charts, then you should clock in for that. If you can't clock in for it, it should not need to happen.
You are in a bad position to change this because you are a new nurse. I will not encourage you to accept it though. It's not acceptable.
I will advise you not to compete with your coworkers. Think of then as your teammates, not your competitors.
I'm salaried now, but when I worked on the clock, I clocked in as soon as I came in the building. That's how it should be.
I don’t work for free. It’s insanity to go in 45 minutes before your shift. I wrote the night shift assignments on the board at 1858 last night.
Nobody needs to do that much research on a patient. It takes a few minutes to look up lab results and test results. You don’t need to know every, single, thing on a patient to be a nurse for them that shift. Report is to get info needed and if you feel you need any additional details you can take 10 minutes after report to look it up.
I would be very annoyed if night shift showed up at 1800 to take over the computers to look stuff up. I usually power chart from 1800-1900.
I think part of this may be a holdover from the days before we had EMRs. Back then researching your patients required searching through pages of documents if you could even find the chart. You couldn’t do it in 10 minutes.
Every unit has a different culture. Apparently where you are now working, this is a tactic nurses use to survive.
Coming in early to look up patients, leaving late to chart, missing lunch regularly are symptoms of a unit with a crushing workload, lack of ancillary staff, or low quality ancillary staff ( CNAs who are always in the cafeteria or on smoke break).
Do the best you can.
Absolutely hit the nail on the head. We had a major problem with our unit's CNAs. Constant refusal to do anything outside of vital signs and blood sugars (they had 10 patients to our 6). As you mentioned, nurses came in earlier and earlier, especially the newer ones. Clocking out at 7:45-8 was not uncommon either.
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TheLastUnicorn
40 Posts
At my previous job; nurses would come in early to start looking over the assignment, maybe up to 30 minutes. No one really prior to that, which, the assignment wasn't usually done till 15 minutes before shift change anyway so sometimes even coming in that early wasn't helpful.
I learned from most of the nurses; just know what questions to ask that way you don't need to be there early to research. I think a lot of it came from "What if something happens at the start of shift", because at the start, you really don't know anything but a brief summary and basically are relying on what the previous shift told you assuming you got a decent report. Report was pretty standard; our "report papers" were just the patient's information and PMH. Nothing else. Each nurse had their own report paper and took their own report. And also handed off their own report. It was amazing the things that would get lost, or forgotten. So knowing what information is important and making sure you get it is vital to starting your shift off right. That way, in 10 minutes if something happens... you can accurately respond and be able to answer questions.
At this place also; med passes started at 8pm. You have ZERO time to get report, meet the patients, and then look up anything prior to it being time to start meds.
Where I am now, almost no one comes in early. The difference is, this place uses SBAR report papers that are passed on from nurse to nurse. Med pass also starts at 9pm; so by the time you're done with report, done with bedside rounding, and everything else you actually have time to look up notes, meds, vitals and everything else for the patient. Assuming something bad happens right after shift change; the SBAR literally contains a brief summary of the patient's care since their arrival, so fewer things get left out, or lost in report, which helps immensely.
You kind of just have to find your own niche. And what works for you will evolve, especially as you become more comfortable with being a nurse, and not simply being a new grad.