What is a Typical night shift like?

Clovery · Dec 23, 2013

I work days and it goes something like this: Get report, immediately start on morning meds. Do assessments during med pass. Hopefully finish meds on time at 10am, assist CNA with turning/incontinence care, do wound care treatments then if applicable. Possibly have time to chart assessments before lunch time med pass. Call or speak with physicians about any changes in condition, critical labs, etc. Assist with incontinence care/do wound care. Maybe have time to take lunch. Try to chart assessments without getting interrupted to do more incontinence care. The last 3 hours of the shift I'm passing 6pm meds, doing any wound care that's still left, starting IVs, changing central line dressings, etc. Trying to get as much done as possible and making sure the patients are clean before I hand off to night shift. Often I stay late because I never had time to chart my assessments because of the patients' needs.

Night shift isn't as busy as days. When I stay late, I notice they have no immediate need to rush into their med pass. They generally only have to communicate with the house doc unless there's a major issue. Night shift RNs do more patient care, full baths, etc. They're also responsible for hanging all the new tube feedings, changing IV tubing, etc. There are often things I just couldn't get to on day shift and I unfortunately have to pass to night like wound care, new IVs, etc. At the end of the day when I'm giving report, and I'm frazzled because I had a crazy day, the night nurses always tell me to switch to nights because it's so much more laidback.

It's definitely challenging working at an LTACH. I really love the work, and it's great that you can get to know your patients. Another bonus about nights is that everyone in administration/case management/PT/OT isn't coming onto the floor interrupting you regarding various issues. People say it can be more challenging on nights because you have less resources, but you can rely on your fellow nurses to help you. At least where I work, the work is too hard and we're all too busy to be petty and everyone is very nice and helpful.

newbieRN724 · Dec 23, 2013

Thanks for replying! It sounds like a busy shift but a nice change from long term care and rehab facilities.

AngelRN27 · Jan 15, 2014

Good Morning! I currently work night shift at a LTACH and I also started my career in LTC/SNF. Very big change, but if you're a quick study, critical thinker, a doer, and enjoy somewhat of a fast pace, you will do just fine. It helps immensely if you love to investigate and learn while on the job.

While it is true that the night shift is a little "less busy" than days, that is really only true in regards to MD correspondence and (as the last poster mentioned) the absence of administration on the floor. Not that there is anything to cover up, but anyone will tell you that just the pressure of having admin. around sort of makes the shift more tense, so I appreciate not seeing them much LOL.

The last poster also mentioned that one of the challenges on night shift is the lack of help and/or resources. Working nights in LTACH you have to be very creative and resourceful in solving problems as you will not have many people around to solve problems for you. Also, I'm not sure if this is just at my facility (although I've noticed this in a regular ICU as well) but most of the codes tend to be on nights. We also get more admissions on the night shift, believe it or not (that one is backed by national statistics, btw LOL).

Anyway, make sure you learn all you can, investigate where necessary, ask questions, and you'll do well!

newbieRN724 · Jan 17, 2014

Thank you! Coming from a LTC/SNF to LTACH what would you suggest I review?

AngelRN27 · Jan 19, 2014

I'm not sure that there is any one thing I could tell you to "review" to help... one of the biggest things you may need to get used to that we don't really work with much in LTC is lab values. You will get used to what is emergent and what is "okay," but you need to be aware of signs and symptoms associated with certain electrolyte imbalances or other abnormal labs. You also want to know what the usual treatment is. Apart from that (like most of nursing) you will do your learning on the job. It always helps to have a good foundation from nursing school, but that depends on a lot of factors, not just you as a student nurse. Plus, you can't really do that over LOL.

readytobeanurse · Apr 6, 2014

This is night shift like the 3-11 shift right? not 11pm to 7am. I am working this shift as a new grad starting monday.

newbieRN724 · Apr 13, 2014

I work 7p-7a