#nightshiftnurse

Just some background- I work on a 36 bed Med/Surg and Oncology Unit, we have a 6:1 - patient:RN ratio. It is fast paced, even on the night shift which is 1845-0730 or later. I have been an RN for a year now and I was a tech on this same floor. I have learned SO much that Nursing school never taught me, and things clicked in my brain that didn’t click while I was still in school.

It’s been an amazing year and now I am training new grad RN’s on orientation to our floor! I have done orientation with a few that are experienced, but just new to us, and with a few that trained with someone else for most of their orientation before they came to me.

Now, I am training brand spanking new grad RN’s and I am so excited about this! I really like helping ppl connect the dots and helping them to feel welcome and making sure they never feel stupid or bullied. No new grad will leave the floor and cry in the their car if they are on orientation with me. I had an amazing RN for orientation and she and I became close friends outside of work, I had such a wonderful experience as a new grad.

Questions I am always asked by RN’s new to night shift:

1. How do you make it work with life?

A: I PLAN! I plan ahead as much as possible, and I schedule life around work.

2. How do you sleep?

A: When I am not working I sleep on a regular schedule. On the day of the first night shift back I get up in the morning and do whatever until the afternoon, when I try to get in a couple hour nap. Then, when I get off work I try to be in bed by 0930 at the latest (if possible) but absolutely no later than 10. I get up between 1530-1700 and head out by 1800.

3. How do you eat?

A: I am still trying to figure out the best way to schedule this, but recently I have been doing a couple small lower carb snacks earlier in the shift, and then fast until about 0400 and have another healthy snack. I was doing a “lunch” meal at midnight for a long time, but I don’t think it works well with my metabolism.

4. How do you manage with pets and/or children?

A: I have two dogs, one of which has chronic health issues. My younger brother comes to my house after he gets off work, and it is his “part time job.” He walks them and plays with them, and he is a presence at my home that keeps people clueless as to when someone is going to be at my home which is great for security purposes. I can trust him with my pets and my home. I know everyone isn’t fortunate enough to have family nearby for this, but I recommend finding someone you know you can trust to help with your pets and children. My pets are family, they are my babies, and they will never pay for the career I have chosen.

5. How do you workout and try to get or stay healthy?

A: This has taken some trial and error. Originally, I was trying to go to the gym after work in the morning, or before work when I woke up, but I cant maintain that long term. Now I focus on getting there when I am not working, and fitting it in as much as I can, while still allowing recovery time.

I have found that EVERYONE does something a little different! What works for some doesn’t work for all and working night shift takes a lot of planning, at least for me.

I WOULD LOVE TO HEAR WHAT OTHER NIGHT SHIFT NURSES DO TO MAKE IT WORK!

The frequent flyer.

The one who goes home after a stay in the hospital, only to return to the hospital after a period of time. Some of them return because they are just lonely. They live alone and have a hard time doing the normal activities of daily living. Some of them return, because they cannot or are unwilling to follow the instructions for care at home. The illnesses they have become overwhelming even for some with help at home to try.

At every hospital, there are patients who know all of the staff because of many stays over a period of time.

George was one of those patients.

End stage chronic obstructive pulmonary disease (COPD); a chronic or long term disease that causes inflammation in the airways and usually a result of smoking. It can be debilitating and result in the need for continuous oxygen use and sometimes severe enough to require several respiratory medications. A patient with long-term COPD has a hard time getting air out of the lungs, rather than into the lungs, and it can frequently lead to recurrent respiratory infections including pneumonia.

George was in the hospital at least three times this year (and it's only February) for pneumonia and problems related to his COPD.

He was funny. He loved to laugh and had a sense of humor that either made you laugh or annoyed you. I thought he was hysterical most days and would usually preface our shifts together with comments about when he was going to start getting his mail delivered to his room. It didn't matter how many shifts a week I cared for him, he laughed every time I said something about his mail.

George was also a bit particular about what he wanted and was not able to do much for himself. He would get extremely short of breath with any activity and was reliant on oxygen almost continuously. George was also a fan of eating ice chips. While this activity is common in some folks, George was notorious for how much ice he needed during a shift. Of course, this also led to needing assistance keeping urinals empty frequently as well.

About every 2 hours, George would need a fresh container of ice and his urinal empty. If you did one and not the other, it wouldn't be long before he was on the call light to remind you to come back to his room and take care of whatever he needed.

George also didn't sleep. Whether a chronic problem with insomnia or a side effect of the steroids he was taking to help with his lungs, he was awake almost all of the time. There was a lot of time during night shifts where George was the only patient awake.

George was talking about hospice. He was tired.

The last night I was able to care for George, you could see how tired he was... you could tell his laugh wasn't as boisterous as it has been in a few weeks.

George wanted to get up out of the bed. Using a mechanical lift, we put him where he wanted to be and he said he wanted to sit a while.

I checked on him 10 minutes later and he was no longer breathing.

I was glad I was there to be with George on this last night. I was sad to share it and heartbroken to have to tell his George Jr. that he was gone.