Lessons from the Night Shift

I did it! Two nights in a row and I lived to tell the tale!

Of course I slept for a solid 9 hours Sunday and another 10 that night. But I did it. 🙂

It actually wasn’t nearly as unbearable as I was dreading. Just as during the day, you’re so darn busy that you don’t even realize it’s the middle of the night. It’s just a matter of training your body to sleep when everyone else is awake and be awake when everyone else is asleep. And now I have seen firsthand why patients don’t get any sleep in the hospital – cuz we won’t leave them the hell alone.

I did make some interesting observations from my first two nights. Here’s a quick run-down:

  • Night shift is a much better place to learn how to do your job than day shift. There are far fewer people to wrestle over the chart with, and it is far easier to learn the processes and paperwork involved at 4 a.m., when it is just a nursing team on the floor. The interdisciplinary aspect is of course critical, but I’m finding that it’s easier for me to learn how to do my part when it’s quiet. Plus several of our resource nurses pointed out that you really develop your clinical judgment skills on night shift – you learn what you can handle on your own,when to call for help, and when it really is important to call the doctor out of bed. 🙂
  • Ask for help when you feel overwhelmed. Actually, anticipate when you might feel overwhelmed and ask for help BEFORE then. On my second night, we took two patients and an empty room, which meant we would get any overnight admits. My preceptor had me take the lead on all of it. I was doing fine until 0330, when we found out we were getting an admit from the ED, at the same time that one of my patients started having chest pain and the other yanked on his IV line and sent one pump flying across the room. Nursing is nothing if not the definition of “sh*t hitting the fan”. 🙂 Luckily the other nurses came to my rescue, but my preceptor pointed out that it was a great lesson in learning how to delegate and ask for help. Two things I have yet to figure out, apparently.
  • I have developed quite the thick skin. My preceptor was not exactly the warm and fuzzy type, and there were several instances when I could tell he was irritated with me (sometimes unjustifiably so, because obviously I am still learning the ropes and had no idea I needed to fill out that damn form). Two years ago I probably would have been in tears throughout the shift. But I sucked it up and did my job and just kept reminding myself to have patience with myself. If someone else is a jerk to me because I’m a newbie, that’s on them!
  • We have a looooooong way to go in implementing evidence-based care at the bedside. The unit has a Performance Improvement RN whose sole job is to help us do this, but my preceptor thought the whole thing was a waste of time and rolled his eyes. And when he shared the news that a former critical care nurse just got a job overseeing performance improvement at the system level, he rolled his eyes again and said, “She’s just a mover and shaker.” Apparently the gap between non-bedside and bedside nurses is very much alive. It was the first time since I started nursing school that I did not share that I was continuing my own education. I didn’t feel like having eyes rolled at me.
  • Male nurses gossip and talk behind each other’s backs too. 😉 There are quite a few male RNs and CNAs in critical care and you would not believe some of the stuff I heard come out of their mouths this weekend. It’s not just women who can be catty, thankyouverymuch.
  • You MUST sleep during the day if you are to function at night. Find the tricks that work for you and go with it. My winning combination seems to be blackout curtains + 3 mg melatonin + the white noise app on my phone set to rolling waves and rain – so soothing! I’ve been sleeping like a baby.

Going back for more tonight and Wednesday. My preceptor for this week was the resource nurse over the weekend and she helped me with my admit on Saturday. She was wonderful, so I am really looking forward to tonight!

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