[Mr_Dog]

I work the night shift (1900 - 0700) on the tele/neuro floor. We have a reputation as a difficult floor to work on, mostly due to the pace and sometimes because of our ratio (as high as 6:1 on days and 8-10 at night.) Also, we had (until about 4 months ago) a really bad Nurse Manager who almost faced an oughtright mutiny before he was fired. He liked to play people and shifts against one another, which had awful effects on morale. Our new NM is much better, and most things are greatly improved.

My biggest gripe is that there seems to be a good deal of trash talk from (some of) the day shift about things left undone from the overnight. Aside from the occasional missed med or central line blood draw, the things we leave are those that happen between 0500 and 0700, our busiest time of the 11-7 shift. The day shift gripes about IVs not being restarted (even if attempts were made), procedure consents not being signed, new (after 0630) admissions not being done. Anything they have to pick up from us seems to be fodder for the mill. During morning report the other day, I related that a pt had lost her IV access. The incoming nurse asked me "why do all these patients lose their IV's at 6 in the morning?" I asked her what she meant by that, and she said "Really, all of them at 6?" I was furious at the implication that we just leave things for them out of laziness! I was even told by my NM that "we keep working until 0700."; even though I can literally count on one hand the number of times I have left before 0730! I usually don't get out until after 0800. It is often said that we work in a 24 hour setting, but the day staff seems to think all the patients are sleeping and we don't have that much to do on nights! There have been shift swap offers, but so far no takers.

I am not claiming that we, the night crew, are perfect, or that we don't sometimes leave things that we shouldn't. We're not, and we do. What I wonder is this: Is this a typical situation, or is the attitude on my floor "broken"?

[cougarnurse]

Hey, Mr. Dog....I hear ya loud and clear! I 'only' work 8 hour shifts, and LTC at that. However, I have worked all 3 shifts at some time in the past 7 + years, and I know how each shift goes. On Midnights, there is one of me, and 4-5 aides, and I can tell ya, 6 am IS the witching hour. (Or maybe it is that 'unmentioned' time riiiiight before shift change.) Either way, things do happen then: Lab comes in, call offs, people tend to bump themselves getting up....day shift has to realize that things 'seem' to happen on the supposedly more slower shifts, and just when it is getting busy. Cheeze Louise!

'Cat'

[Dutchesslaura]

You are right! I don't work nights anymore but you are totally right. The IV's always come out just as the dayshift shows up. I now work in a clinic. No weekend, nights or holidays. Nice in my old age.

[nursesong]

Those staffing ratios sound plain dangerous. When nurses are stretched so thin on either shift there are things that are not going to get done. When you need to have a patient sign a consent for a proceedure they need proper education of the risks involved and they need an opportunity to choose what is best for them, that is the law, it is called informed consent. As long as nurses continue to work so stretched we will continue to be abused. I think we tend to turn on each other which is insanity. We need to work together and be heard by administration. They want good patient satisfaction scores, and they spend tons of money trying to reseaarch how to obtain them when we nurses all know it is about staffing ratios. Quality of care and patient outcomes are directly linked to staffing ratios. I worked at a hospital where a new PCU unit was established and they were staffing 5:1 on days and 6:1 at night. The nurses all held a meeting and protested and they were heard. Now they are staffed 4:1 on days and 5:1 at night based on the acuity of the patient. There is a nursing shortage and if we play our cards I believe only we can make change by standing up for ourselves. If a unit sticks together they cannot fire you all! Good luck to you for the sake of nursing and the patients

[nursekate]

Mr. Dog,

I too worked the 7P-7A shift in a busy ICU and telemetry floor, with the same ratios for years. We too had some of the issues you describe. You have a new NM, have an open discussion with both shifts to try to come up with a workable strategy. I know this is how we solved our similar problem. We had a nurse who was willing and able to come in one hour early 6A and she would leave at 6P. She became our transitional nurse between shifts. She hit the floor running, she started IV's, performed lab draws, set up orders, helped new grads,.... Because she was a seasoned nurse she felt comfortable filling gaps, and took on her own patient load at 7 AM with the rest of the staff. Her organizational skills were amazing, somehow she always started earlier and finsihed her care on time each workday. We found within a month the nursing morale was up, the request for unit transfers was down, and the patients and the docs were happier.

Good luck, NurseKate

[clemshady]

Guys........... and Gals, come on! You all sound like your on a witch hunt! As a night person I get the same crap too but realize what you walk into at 1900...... a bunch of frazzled, strung out, over stressed very tired people that want to go home. Now dont get me wrong, these are the same people that showed up at 0700 yesterday and "had" to get breakfast before report. Complained about all that needed to be done and wasnt and generally thinks the night shift does not work very hard. Kinda sounds like what the night shift thinks about the day shift at 1900....... hmmmmm me thinks I see a pattern here. Most night nurses have worked days from time to time and CHOOSE to work nights! It amazes me how the few day nurses that work an evening or night here or there seems to be a great deal less critical. I guess what Im saying is ....... why cant we all just get along!

clem

[cougarnurse]

Hey, we're just relieving stress here.... Better than having an ulcer, or choking the bejeebers outta someone, eh?

[clemshady]

LOL........ gotcha

clem

[cougarnurse]

Well, that is my take; I figure there are soooo many different personalities in the profession, ya gotta know who to ignore, etc.

[BigRedNurse]

I am a night nurse, and I feel yur pain! 0500 seems to come with a trumpet blast; I don't have to do lab draws unless I have a central line, but patients have to pee, bowel preps with incont. pts, and PRN meds and admits and calling docs because no PRN orders and "what time will my doctor be here?" and IV antibx and lab calling with criticals; It's funny that other shifts think that our patients are sleeping like babes when they just slept the 3-11 shift! I agree with the post "Can't we all just get along?"