Night Shift vs Day Shift (Part 2)

Night shift vs day shift nursing Part 2

Welcome back to the nursing school week by week podcast. I’m your host, Melanie, and I apologize for how my voice sounds, I am getting over a cold, but I just did one of those netti-pot saline rinses, so let’s do this. Alright, today we are continuing our conversation on the pros and cons of working the night shift vs the day shift as a new nurse.  So, let’s just jump right into it. 

First up, on the day shift, there are more meds to give. So, that can be good if you’re trying to practice your skills, but bad just because it’s more work and it’s going to take longer to do each of your med passes. Especially that first morning med pass. That’s when the patients are getting the bulk of their medications. And you can have the full gamut of pills, IV bag meds, IV push meds, plus topical medications, all in one med pass, for one patient in the morning. So if you’re doing that for 5 or 6 patients, for one med pass, that can take up a lot of your time and can be stressful to feel like you have to rush rush rush to get it done. And there were times, only on day shift, when I started my shift at 7am and it was 9:30-10am and I was being called away to do something else, and I’m like, “I can’t. I still am not done with my morning med pass. You know, my meds are an hour and a half late.” And that’s not ok, but I was just so busy that that’s what the situation was honestly. And that was very stressful to me because I don’t wanna be late on my med pass. I want to give my patients their meds when they’re due because that’s what’s best for my patients. So it’s very stressful when you feel like you’re just one person, but you’re being given the workload of three people. Especially when you’re a new nurse. You know, maybe a seasoned nurse would not have been late giving those meds, but as a new nurse, that was just my reality. And that was very stressful. But yeah, on night shift, you typically have a lot less meds to give. And if you’re in clinicals, you can look this up in your patient’s orders, if you get a chance, just compare what medications they’re getting during the day (especially that first morning med pass) versus what they’re getting at night. And it’s almost always a lot less at night. 

Another difference is that on day shift, you’re gonna deal with a lot more visits from family members. And usually more phone calls from family members. Wanting updates on how their loved one is doing and that can also be pretty stressful because for some reason, it’s Murphy’s Law, they tend to call right about 30 minutes, an hour into your shift, and there were so many times when I just wanted to say, “Look, I just got here. I haven’t even met your husband or your mom. I have no idea what to say to all of these questions that you have.” Um, but you just kinda have to do your best. Usually I would just leave them on hold for a minute while I quickly pulled up the chart and read the notes and then just tried to wing it and give them my best answer. And say something like, “The doctor would have more information about that. Can I take down your number and have the doctor call you back?” Or maybe I would say, “You know, I’m just starting my shift. Can you call me back in 2 hours, and I can give you a better answer.” But on night shift, you’re gonna have a lot less phone calls from family members and a lot less visitors. Sometimes you’ll have someone who wants to spend the night in the room if you have a big enough room for you to sleep there, and that’s fine, depending on your hospital’s policy. And sometimes family members can be a lot of help to you if they’re willing to help out with the care, like maybe they can go get the water, or they can maybe help you turn the patient to change them, or something. Sometimes they can be helpful, but a lot of times, it’s just kind of more questions, and as a new nurse you feel like it’s just another set of eyes that are watching your every move. So there’s a lot less of that on night shift. 

Another thing to think about is that you’re gonna deal with a lot more admissions and discharges on day shift. Especially discharges. And when you’re discharging patients, that’s a whole thing. You have to make sure that they have a ride; that someone’s coming to pick them up. You have to make sure if they’re in pain, that you medicate them ahead of time, because you can’t discharge them too soon after giving them pain medications. You have to make sure the doctor has visited them one last time and signed off on it, and you have to print off all of their paperwork. You have to kind of highlight the important things and go over it with them, give them any education that they need. Have them sign the paperwork saying that they received this information. You have to make sure to remove any IVs that they have. Make sure they have all the supplies they need to go home with. You might have to help them get out of their gown and into their street clothes. There’s a lot that goes into a discharge. Sometimes they refuse to leave. Sometimes they say they’re not ready. And you might have to get the doctor involved or the case worker. One time I said, “OK, you can stay here, but it’s going to be the most expensive hotel stay you’ve ever had because insurance is not going to cover it because the doctor has said that it’s no longer medically necessary for you to be here.” And so they did finally leave, but it was this whole thing, and it took a lot of my time away from my other 4 patients. Sometimes discharges go smoothly, other times they don’t. So that’s something that you don’t really have to deal with as much on night shift. Cause it’s pretty rare that someone will discharge from the hospital to go home after 7pm. 

Alright, one con for night shift is that you are trying to do a lot of your skills and a lot of your patient care with the lights off or very dim in the room. Because usually when you go into the room, the patient is sleeping or trying to rest, and you don’t really want to interrupt that. They need their rest to heal their bodies. But you do need enough like to function and see what you’re trying to do. So that can be difficult and sometimes the patient might get a little upset cause you’re flipping on the lights. They might get disoriented cause they’re not used to having the lights turned on in the middle of the night. But that was definitely an adjustment for me coming from day shift to night shift. Just trying to type on the keyboard by the glow of the computer screen. 

Alright, another definite con for night shift is trying to stay awake during that whole shift. The first few shifts I did on night shift, I was like, “Yeah, no problem. I got this.” But I think that was because it was all new and exciting. I feel like the longer you spend on night shift, the more difficult it is to stay awake. And that ties in with trying to keep a healthy sleep schedule while on night shift and how difficult that can be, and that definitely bleeds over into how hard it is to stay awake on night shift. If you’re not getting enough sleep during the day then it’s gonna be really hard to stay awake at night. And sometimes even if I did get enough sleep it was still hard; it’s just something about it being nighttime, even if you’re not next to a window, your body still knows that it’s night time and it still feels like it should be sleeping right now. But each person has their own things they do to stay awake. Um, one of my coworkers, you would see her just walking around the unit. Walking walking walking from about 3 to 4am, every shift. She would just be walking around. Cause that’s what she had to do. If she sat down, she was gonna fall asleep. She knew that about herself, so she just walked and walked to keep herself awake. A lot of the nurses will have a coffee at about 3am. You also do things to keep yourself warm because your body kinda goes into sleep mode, and when you’re asleep, your body temperature decreases. And it will do that even if you’re awake on the night shift. So you start to feel very cold around 2 or 3 am. And you’ll see a lot of nurses covering up with blankets or drinking that hot coffee, or even (ha ha) - One of the nurses and I used to put on the yellow PPE gowns just to keep ourselves warm if we didn’t have a blanket or something else to use. So you kinda find what works for you to keep yourself warm and awake on night shift.

Another thing to think about is that drive home after your night shift, and how difficult it can be to stay awake especially if you have a longer commute from the hospital to home. For me, I had about a 45 minute drive to get home when I got off of work. And that was a little rough. Especially the first couple of times before I figured out what worked. For me, the best thing to keep me awake was coffee and Crime Junkies. I don’t know if you guys are into true crime at all? I’m usually not, I usually don’t watch scary movies. I’m not a thrill seeker in that way. Scary movies give me nightmares, and then I’m just mad at myself for watching them. Um, but in order to keep myself awake on the drive home, I would play Crime Junkies and drink a coffee. Which may not be the best, because then when you get home you might be wired from the coffee. Coffee doesn’t really effect that much, so I was still able to sleep a couple hours after I got home. That might not work for you. For you, it might be something else. It might be singing all the way home in the car, or I don’t know, or listening to some other podcast that keeps your attention and keeps you awake until you get home. That’s definitely something to think about and can be a serious safety issue if you’re working night shifts. Just how are you going to stay awake on your commute home?

Alright, and then the last thing that I have that I want to talk about is a definite con for night shift nurses, and this is how you feel like you lose a day of the week. A day of your life. A day of your life is just gone every week. Just because, nurses whether you’re day shift or night shift, if we’re working full time, we like to schedule our shifts 3 days in a row, so that you have that continuity of care. You have as much as possible, the same patients for those three days. And that makes everything a little easier, right? You get to know those patients, and you get to know what procedures you’re doing on them. If they have a wound dressing on their left leg, you get to know exactly how to change that dressing quickly in a way that the patient is comfortalbe with, and you’re kind of doing the same things over and over again, which makes anything easier. But if you’re working night shift, and let’s say you work Friday night, Saturday night, Sunday night. And then you have the next four days off. Most nurses will try to get back onto a day time schedule for those 4 days that they have off. Because maybe they have kids, or A LIFE. And they would like to see the sunshine occasionally. So most nurses will try to switch and get back on a daytime schedule for that Monday, tuesday, wednesday, thursday. And there are a couple of different ways to do that. Some nurses will try to stay up for most of the day on that first day that they have off, and then go to bed early that night to get back onto a day schedule. Um, what I usually did was, I would come home and sleep for like 5 hours and then get up and try to stay up until about 11pm, and then go to sleep. But either way, whether you’re forcing yourself to stay up on that first day off, or you’re sleeping, either way you’re gonna miss pretty much a day. Cause you’re either gonna be a Zombie and just be sitting in front of the tv, probably stuffing your face with unhealthy food because you are exhausted, or you’re going to be sleeping for half the day, and then just wake up and be like, “whoa, where am I, what day is it, I have no idea what’s going on.” Either way you’re gonna feel like you lose that first day after your 3 day shift, and you’re not really feeling normal until at least that second day. So that’s something to think about because yes, you do get paid more to work the night shift. But if you’re losing a day of your life every week, is it really worth it to get paid more. If you calculate that out per hour, are you really getting paid more? So for me, the greatest benefit of working night shift was not really the money, but it was more the lower stress. For me, I will take less money to have less stress in my life. But I only did it for a short period of time. So if you’re looking at working the night shift for a long period of time, then you have to take more of those health risks into account. So I know, I just gave you a lot to think about, and no, I don’t have a clear winner. I mean, I can’t say, “For you in your situation, day shift is better, or night shift is better.” Cause I don’t your situation. That’s up to you. You have to look at your life, what your kids schedule looks like, if you have kids. Are you a thrill seeker, is your main goal to get proficient in your skills as fast as possible? Or, would you rather take it a little slower, you know, you’re a new nurse. You’re in this for the long run. You don’t wanna burn out. So maybe you wanna do night shift for a while. Those are all questions that you’re really gonna need to sit down and make your own pros and cons list based on your own lifestyle. But I hope that I’ve given you a lot to think about, maybe something that you hadn’t really considered before. So you can weigh all the pros and cons and, yeah, I hope everyone is doing well in nursing school if you’ve started already. If you haven’t, I hope you are studying hard in your prereqs and getting excited about starting. 

Alright you guys, have a great week, and I will talk to you again next time.