What is a typical night shift like in LTC

Forever Sunshine, ASN, RN · Aug 17, 2010

Hi All!
I am a new grad (ASN) who finally got a job opportunity at a LTC/SNF facility. The shift is from 10p-6:30a.
Since the residents will all presumably be sleeping, I was wondering what a typical night shift would look like. I will be grateful for this job since they are hard to come by for new grads, but am concerned about losing some of my skills.
Any thoughts appreciated!

Night shift is great to learn and your CNA's can either make or break your night. But the only resource is the RN supervisor as usually you are the only LPN on the unit.

Not all patients sleep. Get that thought out of your head right now. We usually have at least 2 residents who are awake the entire night and thats on a good night. The other night I volunteered to stay past my shift because there was no coverage. By 3:30am when I left.. there were about 5 residents wide awake. The ones who do sleep.. wake up and want PRN meds or need to go to the bathroom.

6am medpass needs to be started no later than 4:30am( I am not kidding you on this...earlier if your facility has alot of meds due at that time). As residents wake up they want something for pain, nausea, gas etc. Its better to be ahead of schedule on the meds and go back to the charting if you finish early.

hopefulwhoop · Aug 17, 2010

Yes, not all patients sleep at night. You will be doing a lot of charting. Also, be prepared for patients who want pain meds in the middle of the night. In the wee hours of the night, I usually chart and give PRN pain meds.

Zergasaurus · Aug 17, 2010

Night shift is great to learn and your CNA's can either make or break your night. But the only resource is the RN supervisor as usually you are the only LPN on the unit.
Not all patients sleep. Get that thought out of your head right now. We usually have at least 2 residents who are awake the entire night and thats on a good night. The other night I volunteered to stay past my shift because there was no coverage. By 3:30am when I left.. there were about 5 residents wide awake. The ones who do sleep.. wake up and want PRN meds or need to go to the bathroom.
6am medpass needs to be started no later than 4:30am( I am not kidding you on this...earlier if your facility has alot of meds due at that time). As residents wake up they want something for pain, nausea, gas etc. Its better to be ahead of schedule on the meds and go back to the charting if you finish early.

Thank you for the information! One of the things I wondered about was when to start the med pass. I assumed there would be IV therapies and tube feedings I would be responsible for, but was curious about other things I had not thought of. You are so right about the importance of CNA's and before I accept this position, I will be questioning them carefully about the night-time staffing.

I am actually a new RN graduate, sorry if that was confusing in my post.

Angel,LVNStudent · Aug 17, 2010

Night shift is great to learn and your CNA's can either make or break your night. But the only resource is the RN supervisor as usually you are the only LPN on the unit.
Not all patients sleep. Get that thought out of your head right now. We usually have at least 2 residents who are awake the entire night and thats on a good night. The other night I volunteered to stay past my shift because there was no coverage. By 3:30am when I left.. there were about 5 residents wide awake. The ones who do sleep.. wake up and want PRN meds or need to go to the bathroom.
6am medpass needs to be started no later than 4:30am( I am not kidding you on this...earlier if your facility has alot of meds due at that time). As residents wake up they want something for pain, nausea, gas etc. Its better to be ahead of schedule on the meds and go back to the charting if you finish early.

This is a great description of LTC. I didnt want to go into this job, but it sounds interesting

Suncat12 · Aug 17, 2010

I worked nights in a SNF for a while as a CNA. It can be quite busy. You might think the residents sleep at night, but many of them do not. There are frequent calls for BRP, meds, can't sleep, etc. As a CNA, I spent most of the night taking residents to the restroom and checking, changing, and repositioning those who could not do these things themselves. It's a busy time with some down times. There are usually other responsibilities that the night shift is assigned to do.

pedsrnjc · Aug 17, 2010

LTC is generally rough, but just from my own experience, nights are WAY easier than dayshift. Good luck.

dorrybnursing · Aug 17, 2010

Hi All!
I am a new grad (ASN) who finally got a job opportunity at a LTC/SNF facility. The shift is from 10p-6:30a.
Since the residents will all presumably be sleeping, I was wondering what a typical night shift would look like. I will be grateful for this job since they are hard to come by for new grads, but am concerned about losing some of my skills.
Any thoughts appreciated!

Night shift is busier than you think, but the pace is much slower than the day shift. This gives you time to develop your skills without being rushed. We do lots of charting, process the pharmacy delivery,night shift changes out the tube feeders tubing, we collect all the UAs on night shift, and we recheck all the previous days orders. I agree about starting at 4:30 to get everything done. Another interesting thing about night shift are your residents that insist upon jumping in the floor at night you really have to stay on top of this.

Forever Sunshine, ASN, RN · Aug 17, 2010

we recheck all the previous days orders.

Which can take anywhere from a half hour at best or 9 hours at worst.

jerenemarie · Aug 18, 2010

People are generally sicker at night, gives nurses the opportunity to give more personalized care! And sad to say, more people die at night (NOT just in LTC but in all types of facilities) so this is a time for nurses to really brush up on their end of life issues, pain control, etc & to be able to work closer with family members. Staff on night shift are known to work close, to depend on each other, to trust each other...if you get a good crew to work with, it makes the nights so much better! Nights in LTC care also teaches nurses to be more independent with their assessment skills, supervisory skills & people skills!

PatMac10,RN, RN · Aug 18, 2010

I never new LTC med passes could take so long, but it really makes sense once you think about it. Thanks for the information.

iamnomad · Aug 18, 2010

I worked both day and night shifts before when our facility was short of staff. Night shifts are generally slower than the day shift. Call lights are minimal and most of it is because they want to go to the bathroom or asking for PRN meds. Filing of paper works are usually done on night shifts, so as chart reviews, medication reorder, collection of specimens for lab, restocking of supplies, and changing of catheters.

Med pass is earlier during the shift, then after that the treatments, then the above-mentioned works.

work-wise, I'd rather work night shifts. It's not easy, but it's not as busy and sometimes not as chaotic as the day shift. Physically, it's not as exhausting. And on times when it seems so quiet, I can actually read my books, or read some medical references like drug handbook, lab test, etc.

And the best thing about night shifts, is you can actually sit with your resident (those who are still awake), talk to them, know them better, identify their concerns, and just being there to make them feel that they have someone who cares for them - things you sometimes can't do on day shifts because of constant distractions.