RealJobs: Djerica Lamousnery

A typical night at work for me… I work three 12-hour night shifts a week. I get to work at 7pm and finish at 7am the next morning. The first thing that I do when I get to work is look at my patient assignment for the night. I may have two patients or one patient depending on the acuity of care. Once I find out what my assignment will be I find the nurse who had the patient for the day and I get report. In report we discuss all of the important things that I would need to know to effectively care for the patient overnight. We go over every aspect of the patient’s care, the goals for the patient, and the different body systems. At the end of report I should feel up to date with the status of the patient and comfortable picking up where the last nurse left off. My main goal for every night is to go and see my patient and assess him or her. The nights that I have two patients I have to manage my time wisely because I deliver every aspect of the patients care.

I usually start off by giving medications that are due and making sure that the patient is not in pain and giving pain medication if needed. After that I try to get in touch with the physician’s assistant (PA) that is caring for my patient and together we sett the goals for the night. Sometimes the goals maybe as simple as maintaining a certain blood pressure, keeping the urine output at a certain level, and/or keeping the patient comfortable. Other times the goal can just be to keep the patient alive until the next morning.

Working the night shift is difficult as a new nurse because of the fact that it is the “off shift” of the hospital. Hospitals are open 24 hours/7days a week but the majority of care and decision-making occurs on the day shifts. So it is difficult to work at night because many of your resources go to sleep and become “on-call”. The PAs go to sleep and the doctors go home for the night. This is the time that critical thinking is the most important. I struggled at first with deciding when its appropriate to wake up the PA’s or contact extra help. There are situations that are obvious, like a code, and there are some that are milder. I have learned to use the other experienced nurses that work with me as a resource and a sounding board for my decision-making. I didn’t realize how much of a team effort goes into nursing and especially on an ICU. Till next time…

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