5 Stages of a Night Shift

At my hospital, nurses are required to rotate every two months between day shifts (7am-7pm) and night shift (7pm-7am), until you build up enough seniority to get a position where you're straight days (if you want straight night shift they usually let you hop on that train pretty quickly). 

I'm one of the crazies that still rotates my schedule and I just finished nine weeks of night shift. To a lot of the outside world, night shift seems like such a weird thing- like we're really awake all night? For all of you who have never had the privilege of working while the rest of the world sleeps, I thought I would walk you through the 5 shifts a night shift and give you a little better idea of what it's like. 

Stage 1- I feel good! (7pm-10pm)

Unlike waking up for a day shift (usually somewhere between 5-6am), you usually wake up for a night shift a lot earlier (between 3-4pm). This means that you have a couple hours at home to relax, work out, and eat dinner. You also catch up on the texts and/or calls you received during the day, and try to prepare yourself for the night ahead. 

(source)

I get to work around 7pm hoping for a good night ahead. My families are usually awake so I'm usually running around trying to get all my tasks done before the kids start to fall asleep. That usually takes me till 10 or 11pm when I enter the second stage of night shift. 

Stage 2- Denial, I'm not tired I just think I am (10pm-12am)

After finishing my first round of tasks, I'll sit down to chart and this is when I get my first wave of being tired. But at this point, I'm not even halfway through my shift so I just tell myself "you're not tired, you just think you are; Sarah, you slept all day you're not tired. Most high schoolers and college kids are still up right now! Please girl." I'll usually get a snack, a Sprite, or some fresh ice water to get me through my initial wave of sleepiness. 

(source)

Stage 3- Give me all the food, NOW (12am-3am)

If you've never worked a night shift, you can't know the intense cravings and the utter lack of self control that accompanies working odd hours. I can be a pretty self-controlled person, but once I'm at work on a night shift I'll eat anything and everything without a second thought. 

(source)

Oh you're offering me nachos? Great, I'll have some. Oh there's leftover chocolate from day shift? Don't mind me while I finish it all off. Oh I brought a salad and fruit for lunch? Sounds gross, I'm going to get a BLT at the cafeteria. I will eat anything and everything during a night shift and won't regret it until several hours later when I realize that yes, I did indeed eat three cupcakes. It probably doesn't help that our cafeteria lady at night serves HUGE portions of all things fried and delicious for ridiculously good prices. 

source

Of course, you can swing the other way in this stage. Your body can be feeling really whacked out by being awake and you'll get super nauseous and feel lousy. This has happened to me too, but not as much as the intense cravings I get for fried pickles.

Somewhere in this time frame most nurses will take their lunch break which is weird to a lot of people. I usually go in an empty conference room and eat my lunch away from the noise of the unit because at this point I'm feeling "beeped" out. A lot of times I'll lay on the floor for 10-15 minutes because my body at this point is tired of sitting up when it should be laying down. 

Stage 4- I'm going to fall asleep standing up (3am-5am)

This is where the struggle begins. I've affectionately named 3am as "the darkest hour" because that's when I get really sleepy and just want to go home. If you've never almost fallen asleep standing up, try a night shift and you will. During these couple hours it's not uncommon to look over at your coworkers and see them dozing off as they chart away. 

(source)

(source)

This time of night is also when you'll bond the most with your coworkers because you'll talk about anything and everything to keep you awake. If you're trying to do anything productive at this point, it's a lost cause because you can hardly remember your own name. 

(source)

Stage 5- Get me out of here NOW (5am-till you go home). 

This can be the longest two hours of the night  your life. It becomes a struggle to get up and go give your last minute medications, draw your final labs, and chart your final things. 15 minutes in this stage will seem to take two hours as you wait for the sun to rise and your coworkers to arrive and relieve you. 

Once you hit 7am and you're handing off your assignment to the next nurse, you'll find yourself fuzzy and only thinking about how long it's going to take you to get into your bed. 

(source)

When you're finally released, you practically run through the hospital doors, slap yourself silly (literally) to stay awake on the drive home, maybe eat breakfast, and collapse into your bed. 

(source)

And let me tell you, there is no sweeter feeling than climbing into bed after a night shift. Think of the best feeling you've ever felt- that doesn't compare to bed after a night shift (I'm not even exaggerating one bit). 

----------

There you have it- the five stages of working a night shift. There's a whole other side of night shift that comes when you're trying to sleep during the day but that'll be a post for another time. Some people hate night shift, some people love it, and some people (like me) are in between and can't decide how they feel about it. 

Have you ever worked night shift? Do you think you would like it? 

Dear Parent... love, your child's nurse

     

Dear parent, 

I am your child's nurse and I just want to thank you for letting me take care of them. I know that you love your kid almost more than you love yourself and it's hard to trust a complete stranger with their care. Whatever circumstance brought you here, I'm sorry that it did. Whether you showed up in blood stained clothes without even a toothbrush, or have been preparing for this hospitalization for months, I'm sorry your kid has to be laying in that hospital bed. I see the stress in your eyes--you're weary, you're tired, and this is all so unknown. 

I'm not a parent so I can't say I know what you're feeling. But what I can say is something that I truly hope you understand. I hope that you know that I care deeply about your child. The only person that wants to see them get better and leave this hospital more than I do is you. I chose to do this job and I love it. Contrary to popular belief, I don't love it because I get to poke and prod and see gross things. I love it because of the smile that your child might share with me. I love it because in one of your worst moments as a parent I can offer you a cup coffee or a tall glass of water. I love it because I know that I played a part in seeing that your son or daughter walks out of those hospital doors healthy again. I love what I do and I hope you realize how much I truly care for your child. 

I admire you Mom and Dad. You are enduring one of the hardest things a parent has to go through. Whether you're handling it well or not, I know that it's incredibly difficult for you. I know that you're worried about your other kids at home, your kid in front of you, and how you're going to manage to pay for it all. I know that you're stressed about two thousand things that I have no clue about, and I get that sometimes that will come out as frustration towards me. I see you crying and it breaks my heart. You may not see my tears, but I promise you that, later, the inside of my car will. 

I understand your frustration and tears are often validated, and I hope you understand that I am not the bad guy. I am often the middle man taking orders from doctors and trying to explain them to you as best I can when they fail to make sense. My heart sinks as much as yours does when I find out that I have to poke your child yet again, but I also understand the importance of what this test will show us so I do it anyway. I know that your child getting rest is important, but I also know that monitoring his vital signs and making him turn so I can see his dressing are just as important. So I wake them up anyway. 

All that being said, I don't know everything and I appreciate when you realize this in a gentle way. Please speak up if you think that I'm doing something wrong- more than one parent has caught a mistake by saying something. The doctors and us nurses are far from perfect and we want you to speak up on behalf of your child. If something we said does not make sense, tell us. If you think that medication that I'm about to give is not being given at the right time, tell me. Yes, it is my job to double check all these things but I have and will continue to make mistakes. 

If you think something is not right with your child say something-even if you can't put your finger on what is wrong.  I will call the doctor for you and do as much as I can to alleviate your concern. That being said, if it's the middle of the night and it's a concern that can be addressed in the morning, please don't make me call the doctor and wake them up. They will be much better prepared to take care of your child if they got uninterrupted sleep the night before. 

I guess the last thing I really hope you would understand is that we're a team. And I don't mean me the nurse and the doctor (though we are). I mean me, the nurse, and you, mom and dad. We're a team- you want to see your child get better and so do I. That means I will respect and help your child, but I would ask that you do the same for me. Please know that I would love to help change your child's gown that he just threw up on, but I may not make it into the room right away because I'm calling the ICU on my other patient who can't breathe. I know that your child needs Tylenol and I promise I will bring it into him as soon as I finish taking care of my patient that is actively seizing in front of me. Your goal and my goal is the same- to get your child out of the hospital as soon as we can. If that means he needs to get out of bed, then I will get him out of bed. If that means he needs to get a suppository (every teenage boy's worst nightmare), then I will give that suppository. If that means getting them to drink 10 ounces of juice or water then I will decorate a cup just for them in hopes that it will get them to drink. I don't want your child to suffer any more than they have to, but if I need to do the hard thing to help them get better, I will. I totally get it when you want me to be the bad guy to your child so that you can be the one who comforts them. But just know that when you go home, you may have to be the bad guy so that you don't land up back in the emergency room. If you're willing to sometimes be the bad guy in the hospital, I can all but guarantee you that you will get home sooner and be more likely to stay home. 

Every time, I walk into the wing of the hospital, I promise to give 100% to your child for the 13 hours I am there. I know that you are willing to give 100% to your child too. Just realize that sometimes this means cuddles, sometimes this means forcing medicine in them or holding them down for a poke, but usually it means both. You and me working together will help get your child home sooner than I'll be able to do on my own. 

Your child matters so much. They are a sibling, a child, a friend, and a simply precious gift. They are more than a patient in the bed, and I celebrate their victories (almost) as much as you do. Whether that means taking their first step again, or taking their Tylenol for the first time, I rejoice with you. 

This hospital is not where kids should be. But life happens, and a good handful will land up among our brightly colored walls. Mom and Dad, let me help you get them back into the world where they belong. I am on your team, I am on your child's team, and I care more than you will ever know. 

Thank you for trusting me with your most precious, thank you for helping me do my job by questioning me, supporting me, and knowing that I am not the bad guy. I know you'll do your best- so will I. Let's get your child home, where they belong. 

Love, your child's nurse. 

Pediatric Nurse: How I Do What I Do

When I tell people I'm a pediatric nurse, the most common response almost always goes something like this: "Oh bless your heart, I could never do that! How do you do that? Seeing all those sick kids all day?" 

Depending on who I'm talking to, I'll either say something along the lines of "It's easier than you think; I love my job" or I'll go into detail about how I do what I do. 

You see, two years ago, I would have had the same reaction. I loved kids and I loved nursing, but I never thought I would be a pediatric nurse. I thought it would be too sad, too hard, and overall just something I wouldn't get into. 

Then in October 2012 I was in a patient's room at Children's Hospital Colorado (where I now work) during my pediatric clinical rotation when the Lord clearly spoke to my heart and said: 

"Sarah, tragic things will happen to these children regardless of whether or not you're a pediatric nurse. They will get sick, they will get in tragic accidents, and yes, some of them will die. If you are a pediatric nurse, however, you will be able to help these kids and their families in a time that they need it the most." 

From that moment on, my entire view towards pediatric nursing shifted. This moment dramatically impacted the way I view pediatric nursing, and is the #1 reason of why I am able to do what I do. 

I LOVE working with kids. 

This may be a given, but really, I love being with kids every single day. It's hard when they cry, and hard when they're mad at you, but kids are also the most forgiving human beings on this planet. The beauty of a child is that you'll walk in the door and receive a terrible stink eye, and then ten minutes later they'll invite you to color with them. And you tell me... in what other job would you be able to feel a child's belly and ask if there's monkeys living inside? 

I get to work with two generations at once 

There is the patient who is a child- my cares, the medicine, the assessments are all centered around them. But then there are often parents and legal guardians who are involved in the care. Many people think that this can be an annoyance- while dealing with tough family situations is often the hardest part of my job, dealing with great parents is often one of the best parts of my job.

I love being able to care for a child (one generation), and teach and equip the parents to then care for their child when they go home (a second generation). Parents are often eager to learn, and empowering them with the knowledge and skills they need to take care of their child at home is one of the aspects of my job that gives me the most satisfaction. 

And lets be honest, as someone who doesn't have my own kids (yet), I've learned a lot from watching the parents I come into contact with- both what I want to do as a parent and what I don't want to do. 

I work in hospital that's fun

The walls at my hospital are pink, yellow, green- you name it. There's paintings, paper cut-outs, and seasonal decorations on almost every wall.The floors have cool designs and everywhere you look there's something with a bright color. Crayons sit at the nurses station, and Frozen characters are found on every little girl's room number. My hospital is the farthest thing from sterile and cold, and for that, I am thankful

Employees are happy

Between the bright walls and (sometimes) smiling kids, I have found most of the people who work at my hospital quite cheerful. Sometimes it's hard, but I think working around kids means you either need (or get) an extra dose of smiles and happiness. That's good for my soul, and good for the patients' healing. 

Those are my 5 reasons of why I'm able to do what I do. Now that I've told you my reasons, do you think you could do it? Has your view of pediatric nursing changed at all?