This is a letter I've been mentally writing for the last few years. Almost 2 years ago, I transitioned from a night shift nurse to a day shift nurse and it has been a huge blessing! I'm so thankful for my normal sleep schedule, not having to spend my days off catching up on sleep and feeling like I'm on autopilot all the time. I also love that I can interact with patients' families and the different disciplines who are present during the day time who are never really seen at night (i.e. PT, OT, ST, Case Managers, doctors, etc). However, there are a few things about being a night shift nurse that I always wanted to remember and that I wanted to constantly remind my day shift self of. I've been trying to find the right time to write this post to myself (and on behalf of my fellow night shift nurse colleagues) and I feel like now is a good time. I have enough experience as both a night shift (1.5 years) and day shift (almost 2 years) nurse so hopefully I can continue to remind myself of these mental notes I took for myself and learn to be a better day shift nurse for the sake of my night shifters. :)
{As a disclaimer - this is not directed to any of my day shift crew, whom I love and who have grown to become my closest friends. These are just things I wanted to tell myself as a day shift nurse from the things I learned/experienced}
Dear "day-shift Sharon",
Congrats on getting your day shift position, finally! I know you've waited a long time for it. I know that the pace of day shift is different and the culture/people of day shift will be much different than night - but here are a few things I never want you to forget about being a night shift nurse:
1. We night shifters are generally pretty tired people. We don't get as much sleep during the day - you know, our bodies weren't meant to be kept up against our circadian rhythm and life is not accommodating to us night shift folk. Some days, I barely get more than an hour of sleep because there is gardening happening outside, or there is a scheduled fire alarm at 2pm or there might be a bomb squad clearing out your apartment complex - making you wait 4 hours in your car before being able to get to bed in between night shifts (true story, this happened to me!) Also, the sleep quality during the day is super hit or miss. Sometimes you wake up feeling fantastic. Other times you feel like you've been hit by a bus. So, be nice!
2. Give me a break if I wasn't able to give your 6 AM Synthroid or do your pre-breakfast accucheck. Sometimes it just gets super busy and you have to prioritize other things during that hour (i.e. doing an emergent I/O cath for someone you found out at 6:20 am that they were retaining 2-liters of urine in their bladder - true story). Sometimes, I just forget because the night was crazy and I had other stuff on my mind. Please don't act like the world will end because they missed their Synthroid. I promise the patient will be okay.
3. Don't roll your eyes at me when I say I had a busy night. I know that day shift people think that night shift nurses just take short naps and paint their nails and drink coffee and gossip at the nurses station. This is so not true. Patients (especially neuro patients with a history of dementia, Alzheimers, sun-downers) do not sleep at night. Most of the time, we are chasing them down, trying to keep them in bed, re-inserting the 10th IV they put out and having to call surgeons in the middle of the night because they pulled their drains. It's busy at night, too!
4. For pete's sake, please get your foley and restraint orders renewed. This is 100% harder to do during the night because the on-call hospitalists usually have a very limited idea about why your patient is here and what the scenario was regarding their foley or restraint. Have they been trying to bladder train to remove the foley because its the 20th day its been in? Are they trying to limit the use of restraints to help patients get into certain nursing facilities? If you get super busy and forget, I totally understand.. but please try if you can!
5. On that note, please don't be upset or disappointed at me because I didn't get an order for the patient to go off monitor for their morning CT/MRI. It only takes 2 seconds to call the patient's own attending and getting the clearance instead of spending 10 minutes explaining to the on-call hospitalist about the patient's cardiac history and telemetry status for the last 12 hours. If the patient has been sinus without any ectopy and it's an easy call, I'll do it! but please don't be disappointed if I choose to let you do it.
6. Teach me what you learn throughout the day. There are so many more resources during the day shift and you are going to be able to learn so much about everything! When the doctors tell you about the patient's plan of care, or why they choose certain medications/procedures over others - please tell me too! When the case managers explain things about acute-to-acute transfers or what qualifies someone to get into an acute rehab facility - teach me, too! Don't leave me out!
7. If there are any changes that happen throughout the day- please let me know! For example - if the patient was cleared by physical therapy to ambulate to the bathroom - please change the order so it reflects that or at least let me know! Don't make me be the bad nurse who keeps the patient in bed and makes them use a bedpan because she didn't know!
8. We're often under-appreciated. You guys get the cool pens from the ambulance companies, fresh fruit trays/edible arrangements, pizza, cakes, cookies, etc. They even cater lunch for you guys sometimes for medication inservices (what?!) Also, people tend to remember the staff who worked with them while they were awake rather than the ones who took care of them while they were sleeping, or half-asleep. They also don't really love our little visits to their room when we have to do q4hr neuro checks at 4 AM. Regardless, we work hard and we love our patients the same. Appreciate us, too!
9. I eat a lot of ice chips and drink a lot of coffee - even on the days that are busy. I'm just so sleepy sometimes! So, if I'm not able to read through all the h&p documents, progress notes, surgical notes etc and don't really know every single thing about the patient - be understanding. Sometimes reading those documents while being super sleepy is like trying to write Chinese with your eyes. with glue painted in between my eyelids. It's no easy feat, trust me.
10. Remember that we're a team and that it's a 24 hour job. I know there are some days that I'm unable to do a lot of things during my shift and it messes up your routine and makes for a busy start. Please forgive! I promise I tried my best. If I'm unable to finish the surgical check list, or give a few meds, or sign a few consents, or insert a new IV in lieu of an expiring one - please be gracious to me. There will be shifts where I'll have to do the same for you...and that's okay. We're all on the same team and ultimately our goal is to provide the best care for our patients. So let's work together and help each other out. Let's not make mountains out of molehills. It's a 24 hour job. Chillax. I promise I'll return the favor some day.
Sincerely yours,
Night shift Sharon.
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