I've been looking all over the place for blog posts about night shifts on med surg floors because I'm considering switching to nights. Days are just too busy and stressful. I know nights can be stressful too, but from what I've heard from the night shift nurses on my floor it's A LOT better on nights. Here's hoping!
My day shift (without any discharges or admissions...LMAO. Days like this are RARE.)
0500- Wake up and prepare for work.
0610- Out the door and driving to work
0645-Arrive at work, clock in, unpack and start getting report
00645-0730- Roughly I should be done with report (really depends on the night nurse and the amount of stuff to report).
0730-0735 I organize all my paper work (report sheets, braden scales, skin assessments etc) Check charts to assure that no new orders were written while I was in report. Docs round really early.
0735-0800- Assess all my patients to make sure that they are IN FACT alive and don't need anything (I. pain meds, help to the bathroom etc)
0800-1030- Med passes. Sometimes I'm done early if patients don't have many meds. Chart assessments and anything pertinent that happened.
1035 Check charts again. Help with blood sugars. Pain meds are given if needed.
1130-Give insulins if anyone on my team is diabetic. Gotta wait for lunch trays which come early some days.
1200- Chart again. Check on patients. Check charts again.
1330- Give 1400 meds if not given.
1530- Check blood sugars
1600- Give meds.
1800- Hopefully start working on report materials and prepare for report.
1900- Give report. Do anything I didn't have time to do before 7pm. Clock out hopefully before 2000...
This is a GOOD day. I've only had 3 days like this in the 8 months I've been working. You can usually throw in stat lab orders. This doesn't throw me off unless the patient has a PICC and I have to stop what I'm doing to draw the blood because the lab techs aren't allowed to draw blood from PICCs...I still don't know why this is. Physical therapy rounds around 9-11am so you have to wait for them to finish so you can pass meds if you're running behind.
Patients leave for test all day long. Thought you'd get those 1000 meds in at 10. Hahaha. Patient's going down for a CT. He'll be back at 1030. Think you'll be able to get those meds to him at 1030. Hahaha. No, another patient is complaining of SOB and you have to get in touch with the physician, monitor their O2 sat, get respiratory to come see them and write some verbal orders because the doctor is stuck in a trauma in ED and can't come up right now.
Case management (bless their hearts) likes to toss discharges/transfers on you at random times. I've been told a patient is being transferred as late as 1 hour before the ambulance service showed up. You'd think that would be enough time to call report to the receiving facility, take out IV, foleys, PICC lines if they aren't going with them before the ambulance gets there but not so when you have five other patients calling for pain meds, beeping pumps and a 100 other things. Some times report gets called after the patient leaves the unit...I know. I'm bad, but I honestly didn't have 10 minutes to sit down, organize report material, find the chart (which is being copied by the way...and the CM neglected to tell you and instead let you run around like a crazy person searching for it for a half hour.)
Blood orders may be written too so you have to go get that started. God forbid the blood order is written at 4pm and you can't get the type and cross done and blood hung by shift change...All hell will break loose.
Toss in $#%%&^* family members complaining that the patient in room 123 called for a stool softener 30 minutes ago and the patient in 456 called for pain meds 5 minutes ago and is now requesting to see the manager because the nurse hasn't come yet and you're in for a LONG day.
And if you get an admission thrown in there somewhere you better hope the patient is either an ICU roll out or an admit from the ED which had an admission nurse because if not you're stuck filling out admission paperwork, setting up IV pumps, getting all of their admission requirements done (SCD, O2, ted hose, trapeze for ortho patients etc). If the patient comes up alone you can get all of their needs met pretty easily, but if they come up with a demanding family member be prepared to spend 15 minutes answering 150000 questions about a patient who only just rolled up on the floor and who you know absolutely nothing about aside from what you got in report.
I'm lucky to make it out at 9pm on days like this. The latest I've stayed was 1030 to catch up on charting and chart checks.
I like my job on those 'good days' and I despise it on those bad, but hey...what can I say. It's nursing. No one said it would be easy!
Me
