Working 3rd shift as a CNA

caliotter3 · May 22, 2010

Third shift is the easiest shift in terms of physical labor, but you have to stay awake (unless allowed to nap on your breaks). When you arrive, you find out your assignment and make a first round checking all rooms to make sure residents are ok, windows, doors locked or other safety matters, and one of you will get the list of vital signs to be taken and start doing that. If any of the residents need to be changed because they are wet, you do that. Then after that first round, your partner and you decide how you will answer call lights. Answering call lights goes on all night in between your incontenance rounds done every two hours. Your last rounds includes taking around washcloths and a basin of hot water for the residents to freshen their hands and faces before the breakfast trays come out. During the night the nurse might ask you to do vitals more frequently on somebody who is sick or to keep an eye on someone else for some other reason. That is about the gist of it. There can be a lot of sitting around time and also time to do extra tasks like wheelchair cleaning, cleaning the utility rooms, etc. We used to have pretty nice feasts at lunch time when people would share their food. That contributes to weight gain when you work nights. Biggest advantage of working days is you get to sleep at night.

CoffeemateCNA · May 22, 2010

It's difficult, though not impossible, to be hired directly to day shift. There are usually LISTS of people waiting to be transferred to it.

For a new CNA, evening shift is probably the best. It's more laid back than day shift, yet you still have a somewhat more reasonable number of people to take care of than if you were working nights.

With night shift, even though it's frequently the easiest to be hired to (because few people really want it), you will have way more people to take care of. This isn't necessarily the best if you only have limited experience.

And don't believe anyone if they tell you night shift is easy and people never do anything. Nights brings its own set of challenges. :)

dharmawalk · May 22, 2010

I am starting to look for work as a CNA and I am really hoping to get a 3rd shift position. I was wondering if anyone had any information or advice for someone going into 3rd shift. I don't really know what it's like working 3rds as a CNA (I know about 1st and 2nd from clinicals). Also, what is a good shift to start on? I know in a lot of areas 1st shift is coveted and it's hard to get hired for that shift. Is that the same for CNA work? I really don't want 1st shift but I am curious.

I loved working 3rd shift, but my family hated it. It would seem that it is little different to work while they are sleeping, and sleep while they are working but the real difference becomes evident when the weekends roll around and your family want to BBQ or other types of family things.

I was a full time student and I had best success with Eve classes, Night shift, Day sleep.

A few things about Night shift. Night shift nurses are sometimes on the night shift because of personnel problems. Don't jump on me nurses.. I am not saying ALL. But I worked with many nurses who couldn't/shouldn't/wouldn't work with normal humans during the daylight hours, and when you are on the night shift it is difficult to document abusive behavior from nurses because there isn't anyone around.

Once you get on "that list" of the night shift you will have to wait a long time to change shifts if you decide it isn't working for you, and whenever they lose people on the night shift you will likely be tapped to cover if you stay within the same company.

My favorite shift is Eve/Swing or 2nd shift. Other than the fact that the food is always cold and you have just as many showers as the day shift with half the staff, if you are in this job because you enjoy the residents Eve is really a great shift because it is less hectic and you have more time to spend with your residents. There are also far less nurses about on the Eve shift than the Day shift.

Dresdenchick · May 22, 2010

I am a night person, I usually stay up all night and sleep all day anyway, that's why I would prefer nights. Also it means that I can go to school during the day.

NM nurse to be · May 22, 2010

I have to disagree with Caliotter3 in that 3rd shift is not less in terms of physical labor. At my facility, I have found the reverse to be true. You typically have more residents on your section than during day/eve shifts. And you will be doing ALL changes, bed changes, whatever on your section, not just the 15 or so people you have during the day. If you have an evening crew that likes to scrape the barrel, you will have extra work catching up from them.

Hint here... if you are the newby and new to CNA work, they will (most likely) test you a LOT to start with. You will get left with whatever the previous shift didn't want to do, no supplies, rooms not picked up, stuff like that. It is really unfortunate that it happens but it does. I finally dealt with that situation by going room to room and checking butts for wetness/rooms clean before I took the floor. THey didn't like me much for awhile but did get back on the ball because they didn't want to have to stay late to fix it.

I like night shift best, especially when I was new. There is no way I couldd have kept up on days and not gotten fired in the beginning. I just didn't have the skills or any speed and would not have lasted long. So that might be a help for you to be on nights, especially while you are new. The first few months WILL be rough. You will go home hating it for awhile but it does get better. It is a hard job but worth it when you are comfortable with your skills and the residents. Good luck!

Ev1987 · May 22, 2010

I enjoy working the night shift. I think the atmosphere is more mellow and laid-back than the day shifts. But I ALWAYS appreciate the hard-work that comes from the previous shifts. They have tons of people to wash, dress and feed. Day shift deals with family members and state inspections. I think that they are the backbone that keeps the facility going. :bowingpur As a new cna, I think day shifts are important to get familiar with because you experience the system, fast pace and job duties that come with working at that particuliar time. I am also a night owl, and 3rd shift is best for me leaning towards school. I strongly doubt I could last working 1st shift permanently beacuse of the added pressure and stress that come with that workload.

eveningsky339, LPN · May 23, 2010

At my shift, 1st Shift was the least popular. Not that popularity really mattered in terms of staffing, as hiring new CNAs was like looking for a needle in a haystack. :uhoh3:

I started out as a student CNA doing nights. I ended up giving that position up because while I enjoyed the shift, it took a toll on my body and my family life, and I developed a sort of isolation syndrome from being on a different schedule than the rest of the world.

Afterwards, I worked per diem on all shifts. After only a handful of day shifts I decided no more, the hours were good but they were understaffed and not very nice. I found a nice little niche in evenings, but I hated having the morning off then getting in the mindset to go to work. I occasionally went back to nights, and discovered a newfound respect for how laid-back it was and the coveted sit-down time (though some nights were so busy that this didn't happen).

turnforthenurse, MSN, NP · May 23, 2010

I used to work third shift as a PCNA (patient care nursing assistant - basically a "glorified" NA minus the actual certification) and physically it's the easiest because you don't really have to deal with all of the baths and other AM care, unless you have patients that get night baths. I love the atmosphere on nights - it's quite and a lot more laid back, but it can be really hard trying to stay awake! I remember the first night I worked was ROUGH - even after coffee I found myself dozing off at 3am (I worked 7p-7:30a) and had to have my preceptor PCNA and the nurses try to keep me awake. Sometimes nights can be a little slow but other times a lot can be going on. I used to work on a tele floor so I did a lot of q4 vitals - at 1900, 2300 and 0300. Some were q8's (only at 2300) and I loved the q12's (only at 1900). I would do accuchecks at 2100 unless they were q6, then I would do them at 0000 and 0600. I turned patients q2h on the dot - I would usually keep them all on one side (for example I would turn all of the patients that needed to be turned on their left side, then 2 hours later put all of them on their back, then their right, then repeat...just makes it easier imo). did I/O's at 2200 and 0600 and also got weights at 0600. I also answered call lights and helped patients with basic needs.

Now I work as a nurse tech at a different hospital and occasionally I will work nights...but it's pretty much the same. As a tech I can do pretty much anything I have learned in school except for assess & pass meds...but of course with assessing there is always that "gray area" - for example, I might be doing a sterile dressing change and the nurse is not with me - but every time you do a dressing change you have to assess the wound! Basically what I described above is what I do at my tech job but some things are different...accuchecks are done at 2100 and 0600 (unless they're q6, then 0000 and 0600)...we just changed our I/O schedule to q8h instead of qshift so from 1500-2300 (but usually the other techs/aides that are working until 2300 do those) and then I would do the one from 2300-0700. If dressing changes need to be done, nurses will delegate that to me. I will also draw morning labs on patients. It just depends where you work, I guess. Usually on nights there is only 1 or 2 aides/techs...depending on your hospital you might have the whole entire floor. At my old job we could have up to 15 patients max (on day shift we can have up to 12). I alway found the nurses to be helpful, though - that makes such a huge difference!

daimere · May 28, 2010

This is how my 3rd shift is at my ltc:

11:00: clock in; start the bath water, ask the 2nd shifters how the hall is and all that.

11:10: start baths. These baths are all carelifts. If you don't have baths (all lifts are a two people job), you do vitals/make beds. Typically we only have 3 on a unit. If we have two for each all, one does one bath and the other pair does the other. And own vitals.

12:00-12:20: Start rounds. We do hall one first. Since we are always three, we do do both sides. That means rounds will last around 30 minutes to an hour.

1:00: Start 15 minute breaks. We have a ton of fall risks. So now, we are only allowed to do our breaks one at a time. During this time, we clean the bathrooms, change O2, sharp containers, do lift inspections, headcount, fill out BM bookwork, and any other things we gotta do.

2:00: Second round.

2:30: One person goes to break while others finish.

3:00: more breaks and finish anything that wasn't done.

4:00: empty cath bags, check heavy wetters and the ones that like to leap out of the beds. More breaks. If people are asking to get/continuously trying to get up, we get them up so they don't fall.

4:45: Hopefully all breaks are done. Hall one usually starts getting some of the carelifts up. Usually hall 2 has to wait till someone comes at 5:00.

5:00: Officially time to start getting people up. We work constantly dressing and getting people in chairs. I work on a total care unit. There are few one assists or independents. We need everyone up by 700. A lot of the time we don't get everyone up till 7:30 which is still acceptable because they are still passing trays at that time. After that hall one needs to turn the tube feeders and leave at 7:30.

Since we have so many fall risks, we have to stop at all times and go check the bed checks if we hear them. That means a lot of time hall 2 is behind. It's really stressful and hard at times. You're not moving as much throughout the night and then you are running at top speed for 2.5 hours. We have mandatory overtime and usually don't get breaks during shift change if you are MOTed.

I like doing nights. I wish there was more ideal staff because the residents would get better care.