What's night shift like in pediatrics?

KelRN215, BSN, RN · Oct 19, 2017

In theory, there are fewer family members but not always. Your patient could have an infant sibling that the mother is breastfeeding and then that baby gets to stay, too.

On days, there are more staff around- entire teams of physicians rounding, PT, OT, speech therapy, Social Work, Child Life, Management, etc. At night, it's the nurses and Residents only on most floors. If the ICU, Respiratory is probably there too.

I preferred nights when I worked inpatient.

GetBackToClassRN · Oct 20, 2017

I would say that it highly depends on the setting. If you will be in a fully functional free standing children's hospital, each type of floor will vary based on its specialty. My primary area in the children's hospital setting for 11 years was hematology/oncology. That unit was very busy at nights as we administered the majority of chemotherapy at night. Also, it is true that a lot of pain and nausea symptoms worsen at night when things calm down and the kids aren't as distracted or possibly because they pushed themselves to do too much during the day.

When I did float to other units, they were overall more calm at night.

There are definite pluses to working nights, but it is a bit heartbreaking to see how many kids are left without a family member to advocate for them and give them individual care.

KelRN215, BSN, RN · Oct 22, 2017

I would say that it highly depends on the setting. If you will be in a fully functional free standing children's hospital, each type of floor will vary based on its specialty. My primary area in the children's hospital setting for 11 years was hematology/oncology. That unit was very busy at nights as we administered the majority of chemotherapy at night. Also, it is true that a lot of pain and nausea symptoms worsen at night when things calm down and the kids aren't as distracted or possibly because they pushed themselves to do too much during the day.
When I did float to other units, they were overall more calm at night.
There are definite pluses to working nights, but it is a bit heartbreaking to see how many kids are left without a family member to advocate for them and give them individual care.

My floor was Neurology, Neurosurgery, Neuro-Onc. Nights in general were less busy than days but nothing was as "I want to poke my eyes out boring" as the night that I got floated to a general surgery floor and was given an assignment of a few Urology kids who needed nothing more than some IV toradol and valium and to have Foleys emptied. On my floor, we had to wake the kids up for neuro checks, sometimes as frequently as 2hr depending on their acuity, chemo kids could be getting blood transfusions or electrolyte boluses on the night shift, kids could be seizing, shunts could be malfunctioning, etc. Sometimes it was so busy that it was after 4am VS/neuro checks that we realized none of us ate dinner. Sometimes it was the opposite and we watched movies in the back room and complained about management all night .

sergel02, BSN · Oct 24, 2017

In theory, there are fewer family members but not always. Your patient could have an infant sibling that the mother is breastfeeding and then that baby gets to stay, too.
On days, there are more staff around- entire teams of physicians rounding, PT, OT, speech therapy, Social Work, Child Life, Management, etc. At night, it's the nurses and Residents only on most floors. If the ICU, Respiratory is probably there too.
I preferred nights when I worked inpatient.

Something I'm enjoying about nights is having less people pull you in a million directions. On the other hand, it's hard because you have fewer resources. IV therapy leaves out hospital at 10 so if an IV infiltrates or something, you're on your own. Well you could call Rapid Response but there are only a couple of them at nights.

I would say that it highly depends on the setting. If you will be in a fully functional free standing children's hospital, each type of floor will vary based on its specialty. My primary area in the children's hospital setting for 11 years was hematology/oncology. That unit was very busy at nights as we administered the majority of chemotherapy at night. Also, it is true that a lot of pain and nausea symptoms worsen at night when things calm down and the kids aren't as distracted or possibly because they pushed themselves to do too much during the day.
When I did float to other units, they were overall more calm at night.
There are definite pluses to working nights, but it is a bit heartbreaking to see how many kids are left without a family member to advocate for them and give them individual care.

Our peds unit is med/surg and heme/onc, so I guess there is a bit of variety when it comes to it and how nights are.

Kids seem like they sleep earlier than adults do, but I dunno how that translates into the hospital.

cel589 · Oct 25, 2017

I agree that it definitely varies by floor/setting. My floor is primarily babies / young children usually under 2. So having a 4 patient assignment with babies is pretty similar to day shift in that they still have to wake every 3 hours to feed, change diaper, vitals q4h, IVF, up to q1h assessments for certain illnesses, meds, etc. Meds are usually q6h or q8h around the clock so just as many as dayshift. I will say though even if I'm personally doing the same interventions as dayshift it tends to be a quieter, slower shift (on a normal night with none of my patients acting up) due to the fact that its night and it's quiet, parents are sleeping, there aren't constant visitors like dayshift (PT, OT, Speech, Consults), there aren't road trips (OR, IR, Radiology, Swallow studies, endoscopies), and there generally aren't changes in plan of care throughout the night unless it's an acute issue. For me, a typical night is much calmer because of this but definitely still steady with things to do every hour. Also, babies and kids love to keep you on your toes and crump in the middle of the night!

emily34812 · Oct 26, 2017

I'm just a tech but the workflow is totally different where i work. We also get more admits at night versus days but we also generally don't deal with discharges

annabash_rn · Dec 8, 2017

I recently started working in a pediatric hospital on a med surg floor. Night shift is generally slower than day shift bc we don't have as many discharges, but we still get a ton of admissions. 7-11p is generally super busy but after midnight vitals/med pass/assessments it usually calms down. Sometimes there are less family members at night, but not always. I do feel you get a little more one on one time with your patients during night shift because it is slower than days and there are no (or fewer) PT/OT/management/whoever blowing up your phone all day.

sergel02, BSN · Jan 12, 2018

I recently started working in a pediatric hospital on a med surg floor. Night shift is generally slower than day shift bc we don't have as many discharges, but we still get a ton of admissions. 7-11p is generally super busy but after midnight vitals/med pass/assessments it usually calms down. Sometimes there are less family members at night, but not always. I do feel you get a little more one on one time with your patients during night shift because it is slower than days and there are no (or fewer) PT/OT/management/whoever blowing up your phone all day.

That 7 to 11 time is definitely relatable on adults so that's nice. It's like we have vitals, evening meds, and assessments to do and chart and that doesn't include anything extra like pain meds or blood cultures, or calling lab or pharmacy to clarify things, or admissions. After 11 it tends to slow down sometimes on my unit though there is chemo to give in the middle of the night.