(If you missed it, here’s Part One)
Now for the rest of the story of night shift nursing:
2AM to 5AM on night shift:
When it’s quiet or even moderately busy, here’s where the night starts feeling long, the yawning starts getting serious, and the ‘since I can’t sleep yet’ eating starts happening. I try not to have caffeine after 4 AM or so, because I want to sleep well when I get home, and also if I overdo the caffeine at this time of night, my stomach gets uneasy. But usually I feel in desperate need of a pick-me-up. Lately I’ve been drinking just a little black tea around that time. I will also often run an item personally to the nurses on the ‘other side’ of the OB department rather than using the ‘tube’ system, because a brisk walk is a nice pick-me-up at that time of night.
When taking care of moms in labor:
When the night is busy, even this part of the night can roar by. I especially like having a birth around 4-5 AM, because the busyness surrounding the birth carries you through the tiredest hours of night shift while still giving you time to wrap up loose ends of charting before the tail end of the shift. And usually if you have a mom who delivers between 4-5 AM, you (probably, usually, unless it is a hectic night) won’t get assigned another labor after she delivers.
I tend to use a lot of energy coaching moms near delivery. After that ‘whew, we did it!’ euphoria of a good birth, it can be hard to hand off that patient to her postpartum nurse and run back over to the labor side to do it all over again. Especially hard is to be equally energetic with the next momma, especially if you get her at 5 AM and know you probably won’t even get to be in on her birth. On busy nights it’s just a fact of life that we go from patient to patient. But when it happens near the end of my shift, I really have to pull the energy up out of my toes to give that next momma my best.
When taking care of moms on postpartum:
Often the postpartum side has a time of quiet between 2 and 5 AM, even when most of the rooms are full. The visitors are usually finally gone. (Side note: I am BLOWN AWAY at how many people will visit new moms at midnight or later, often trundling little children along with them. What can they be thinking??) By the wee hours of the morning, the moms are getting tired and they’ve gotten their pain meds and some of them even turn off their TV’s and actually get a little sleep, if their babies and visitors (grr) allow it. Nurses have a dab of time to eat lunch and get caught up on charting, and maybe even sometimes sit and chat for a few minutes before the pace picks up again and we need to do our 5AM lab draws and other end-of-shift things.
Since we don’t have a well-baby nursery per se, often there’s a baby or two behind the desk keeping us company while a momma or two tries to get a little rest. My daughters think I’m crazy, but I find almost all newborns to be completely adorable, so it is fun when I have time to give one a snuggle, or if the aides are busy, sometimes even a bath.
5-7 AM on night shift: Here’s where the night shift feels most brutal, and almost everyone wonders why they signed up for this gig. You’re so close to bed and yet so far away still. When it’s quiet, you’re exhausted, and when it’s busy you’re even more exhausted. Time does go quicker when you’re busy though.
One of the craziest times (I think) to have a delivery is between 6 and 7 AM. Some nurses are good at staying caught up with charting, but I tend to get behind on charting at the tail end of labor, because patient care feels all-consuming. So a 6-7 AM birth almost always leaves me still charting at 7:30-8 AM, and straggling home late. I almost always clock out late when there’s a ‘shift change’ baby.
On the postpartum side, you tend to have a teeny bit more control. I spend this time trying to be as organized as possible, finishing every scrap of charting, making sure my moms’ needs are fully met so I’m not scrambling trying to do things at 7. Also looking at the clock. And looking at the clock. And wondering why on earth I ever thought night shift was a good idea.
Around 6:50 AM the clickety-BEEP of the time clock gives our sleepy brains a reason to rejoice– the day shift staff is starting to clock in! It’s almost time to go to bed.
At shift change, as long as you aren’t in the middle of delivering a shift change baby, being on the labor side is nice. All you have to do is give report on one patient to one nurse and then you’re off, home to bed, sometimes even a few minutes early.
On the postpartum side, you usually have 3 or so mother-baby ‘couplets’, and very often your assignment of patients has been divided in a different way on day shift than on nights, meaning it’s common to give report to two or three different nurses. So there’s lots of waiting around to give report to various nurses during that final snails-pace half hour. Almost always giving report, and then introducing patients to the new staff, takes til 7:30, or sometimes longer.
Then finally, off I go, yawning my way toward home and the blissful thought of sleep. Driving home, I try to shut off the worries about what I might have forgotten to do– usually it’s charting-related, not patient care. But it is incredible how much charting there is. Once home, I usually don’t manage more than 20-30 minutes of awake time with my family before I trundle off to bed. Sleep. Bliss.
I’m fortunate that (thanks to a fan, room-darkening shades and a quiet family) I sleep pretty well during the day, usually til around 3 PM. By then the boys are just getting home from school and the girls have been done with homeschool for several hours. (Maybe I’ll share in another post what we’ve been doing to make homeschool doable on my work days.)
In the afternoon when I get up, I’m completely groggy. I make my way to the coffee pot and sit in my comfy chair in my sweats for an hour or so, and gradually wake up. By the time I’m actually awake, it’s already time to rassle up some dinner and get ready for work. Often I’ll order pizza, or do something super simple like fish sticks and tater tots. I don’t tend to have much energy to cook in between two work nights. Lemme tell you, night shift nurses EARN that hefty hourly shift differential.
But the good thing at this point in the week is that I only have one more shift to do before I make it to my next stretch of days off. AND (unlike before my first night shift of the week when I can never sleep) I spent this whole day sleeping. So once my coffee kicks in and I’ve come up with some type of food for everyone, I’m usually awake enough and energized enough to hit that second and final 12 hour shift with energy and enthusiasm.
There’s another bonus of two nights in a row: sometimes I get the patient I had the previous night. I usually enjoy caring for someone who I already know, and who already knows me. In fact, even if I don’t get assigned the previous night’s patient, I will often zip over to her room and say hi to her sometime during the shift. And sometimes, of course, instead of getting the happy grateful type of patient, you can be assigned a challenging/needy, or very ill patient two nights in a row. But even then, I try to give it my all, and use what I already know about her likes and preferences to make it as good an experience as possible for her.
The last hour of my second 12 hour shift often really drags, because by then I am really ready to head home and be done with work for awhile, but finally report is done and I’m out the door, heading home to bed.
Often on my second day of sleep, since I know I’ll be able to sleep that night, I’ll only sleep til 1 or 2 before getting up for the day. That way I can sleep better that night. Always, no matter how short or long I sleep, I’m foggy and sometimes short-tempered (tho I try not to be) for the rest of the day. Dinner again tends to be something super easy.
What’s changed about life since I started working
I definitely do more convenience food or fast food on my work days. And even on my days off I think I cook a bit less than I used to. But it feels like a reasonable compromise given the added demands on my life.
Another thing that’s probably less positive overall is that I find I’m simply quicker to spend money. We have a bit more than we’ve had for a couple decades, and already I can feel that it’s changed the way I feel about a $30 purchase, or even one that is $130.
Just today I bought 4 outdoor lights that will be a nice upgrade to the exterior look of our house. They were only $29 each at Costco, which isn’t bad at all for nice lighting. But it was a total impulse buy and not necessary. I need to watch out that ‘little’ splurges like this don’t diminish the financial benefit that work is bringing our family.
I also am trying very hard not to use work as an excuse to not do activities with the kids, or to not be focused on them when I am home– which of course is part of the reason blogging frequency has been decreased lately.
I have to say that I’m very glad I had 17 years where I wasn’t working outside the home. It allowed me to really focus on the kids when our house was full of little ones. It was a financial sacrifice, but there’s zero doubt in my mind it was the right thing to do for that time in our family’s growth.
And this new schedule seems to be working for our family where it is now. Of course anytime one of my kids is struggling with anything to any degree, my mind goes to the fact that I’m working, and feels guilty. Would they be struggling if I was here all the time? Am I doing the right thing? But when doubt starts riding me, usually John reminds me I’m only gone two nights, and he’s home almost all the time I’m gone. (He works 3 12-hour day shifts a week.) So most of the time there’s still a parent here. I think we’re doing ok. Overall I think it’s fitting and working and is a success.
Well, that’s more than enough from me for now, but I’d love to hear from any of you who are thinking of transitioning back to work, or want to stay home and are figuring out logistics. Or maybe you’ve recently made a similar life change. It is an important decision for a family to make, and I’d love to hear how it’s working for you.