A day in the life of a night shift nurse

January 14, 2017

I took a little inspiration from one of my favorite bloggers, Franziska, for my version of Day in the Life.

I love reading posts where bloggers share what really happens in their life, so I thought this would be really neat to share. I had some trouble taking photos, because of patient's confidentiality and hospital safety, but I think you get the idea. I also think it would be fun to now contrast it with my shift on days. 

This is what my work was like on December 31st- January 1st. Let's jump right in!

1200-1700: I am sleeping in preparation for tonight's shift.
1700-1830: Getting dressed, eating dinner, preparing my late night meal, and driving to work.

1825: Just arrive at the hospital. Even though I do not officially clock in until 1900, I like to get to the hospital early so I can look up my patients and plan out my shift. I focus on writing down any pending labs or collections, medications, and what the patient came in for and how we can get them home. Items such as PMH, fall risk, activity order, and diet I can receive during shift report.

1858: I clock in for work and call the day nurse taking care of my patients on vocera so that I can get my report finished and start my shift.

1930: Typically by this time I am finished with my report and grab a vitals machine and make my rounds on my patient. I try and grab everyone's vitals by 2000.

2000: All staff on the unit attends our safety huddle. Our safety huddle consists of going over any important messages or changes to our units, talking to the charge nurse about our patient load, and letting any other staff members know if we need help. It typically lasts 15-20 minutes. Directly following the huddle, I will round on all my patients and ask if they are having pain. Then, I will start passing medications and perform a head to toe assessment. 

2131: Since I only had three patients at the beginning of this shift, I was able to pass medications and perform all my head to toes early. I had a brief moment to sit down and chart my assessments. I try to chart in the moment in my patient's room, but sometimes I have time-critical medications to pass or have to leave a room to answer a phone call. 

2158: My break was short lived when a patient either asked for some pain medications or I had a 2200 antibiotic to give. Either way, nurses are constantly on their feet. Additionally, I have to round on all my patients at this hour, so I am up anyways!

2300: I was not able to get a good picture, but my three patient load was short lived. I found out I was getting an admit from a SNF with abdominal pain, nausea, vomiting, and altered LOC. Admissions can be difficult because 9/10 times you have to call the doctors to get orders. Plus, all new admits require the nurse to complete a patient profile, medication rec, and a two nurse skin check. The adult patient profile goes over past medical history, family history of important illness such as diabetes or heart disease, assess for signs of abuse or depression, and any concerns about being admitted to the hospital. We also inform the patient how pain management is done at the hospital, the importance of safety and calling, unit orientation and room orientation, and other education pieces. 

2359: Because it is New Year's Eve...the staff sneaks away to an empty room to ring in the New Year together! We all toasted with sparkling apple cider and said happy new year before the call lights started ringing again. 

0000: Even though it is a holiday, the hospital never shuts down! My new admit had a few wounds, so after finally completeing the profile and getting her medications and orders in place, I was able to take my photos and print them for her chart. Oh how new admits can be fun! 

0100: All our aides take their lunch during this time, so all the nurses are running around helping patients to the bathroom or getting them water or warm blankets in between medicating patients and staying on top of documentation.

0200: One strange thing about working nights, is how empty the hallways are even though you feel like you are constantly running back and forth between rooms medicating every patient for this and that. Since the aides are back from lunch, once the nurses make their 0200 rounds, we sneak away for our own meal. We were very lucky to have the hospital spoil us and provide a lovely New Year's meal! 

0300: Not much typically happens at this hour. It is the calm before the storm and also the time to run to the bathroom if you can. 

0400: Back to making my rounds and keeping on top of my documentation. The most challenging part about this hour is that you are only a few hours away from ending your shift, but are starting to have trouble staying awake. I try and keep myself moving to combat feeling tired, so this night I went and cleaned up our tube system. I sent a few empty tubes down, replaced medications into their appropriate spots, and placed EKG strips into patient's charts.

0500: Only two more hours to go and the lights are back on in the hospital. Our aides take vitals from 0430-0500, so typically this hour I am handing out a lot of pain medications or assisting individuals to the bathroom. 

0600: I finished rounding on my patients, covering any individuals with insulin, medicating for pain, and making sure all bathroom breaks are taken. By 0658, the day nurses are calling us on vocera to receive report. 

0730: I can officially clock out of work if I have finished charting and delivering report to the day nurse! I have been very lucky to get all of my documentation completed during the night so that I can get out on time. Since there is daylight out, I wear my sunglasses all the way from inside the hospital to inside my house so that I can hopefully get a good "days" sleep. 

Hope you enjoyed these snapshots into one of my shifts!

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