A few months ago, I wrote a post entitled, "A Day in the Life" which attempted to show you what an average day on my floor looked like. Now I've been on night shift for over 2 months and I think it's time for this post.
05:00-05:30pm- Caroline wakes up and gets ready for the day. I've found that I usually eat breakfast foods at this time.
06:00pm- Head out the door with a hot drink in hand
06:30-40- arrive on unit, get all supplies for the day, get assignment and start looking up patients
07:00-07:30- Get report on patients from other nurses
07:30-8:00ish- Do full assessments on patients and determine any immediate needs for that night (If I do this now, that prevents me from having to call doctors at 1 in the morning.)
8:00-9:00ish- Give night medications
9:00- Start charting and filling out patient sheets. My unit has report sheets that has a lot of patient information on it for report. Night shift gets to rewrite them with all of the updated information. I actually really like doing this even though it's a lot of work because I have to look through all of the orders, notes, and results in detail to know what's going on with the patient. I get to look at the whole picture and see the big plan for the patient.
And that's where the consistency stops. Ha. Here's the lovely thing about my unit. Most of our patients end up going home in the afternoon which means that when I come onto the floor, there are either a whole bunch of patients who just got there or a lot of empty beds. The night shift usually ends up admitting a lot of patients right off the bat which can throw off your entire night. If I get an admission when I walk in, I'm running behind until midnight when I can catch up. If I'm lucky, I end up getting an admission later in the night so that I have time to do a majority of my tasks before the admission comes. Unfortunately, most nights I have to walk in to work ready to hit the ground running as new patients come in. I prefer late night admissions, but the downside to that is I might have to call a doctor at 2:00 in the morning for admission orders and no one likes that...
At 11:00 I start the next assessments and chart them.
When I'm done with that, I write the progress notes on the patient and sign off on their heart monitor strips.
Usually around 1-1:30am, I eat my 'lunch' at my computer while reading through patient notes. If I have good patients, I can end up not doing a whole lot at this point. I don't want to wake my patients up, so it has the potential to be quiet. That being said, there is rarely a night where my patients are all asleep and behaving. Here are some of the things that can take up time:
-Answering the call light for insomniacs who are so bored that they end up riding the call light all night asking for things because they can't sleep
-Taking people to the bathroom
-Making sure my confused patients don't jump out of bed and fall
-Helping other nurses with admissions
-Turning bedridden patients and cleaning them up
-Getting people fresh water/late night snacks
-Changing wound dressings
-Inserting new IVs
-Replacing batteries and electrodes on the heart monitors
-Sneaking around in the dark trying not to wake anyone up
-Various other nursing tasks that can't really be predicted
3am- I have another assessment
5:30am- morning medications
6:00- If there's anything that I wanted to ask a doctor that wasn't urgent, I call around 6.
6:30- Morning labs come back and I call doctors with any critical results for orders
7:00-7:30- Give report to next nurses
Here's the thing. Most patients wake up between 6 and 7. At this point, everyone needs to go to the bathroom, everyone wants their breakfast, everybody's family starts calling, everyone suddenly needs their pain medication, and someone ends up ripping their IV out. Sometimes it feels like I've been in control all night but when the day shift comes, my patients are all a mess. I hate that feeling, but it's kind of out of my control.
7:30- drive home
8:00- eat 'dinner', shower, pack lunch for next night, take a few minutes to breathe, fall asleep.
Hope this helps!
-C-
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