A couple of weeks ago the CEO of the hospital and the Nurse Administrator, my boss’s boss came by for their annual night shift tour. They were delivering donuts and hot apple cider in celebration of Halloween. Hot apple cider? What are we? Amish? How about some nice fresh good coffee, not the swill they try to pass off as coffee in our joint. But something good, like Stumptown or *shudder* Starbucks. But they came around, made small talk. The CEO looked like he was part of the Living Dead, shambling and not really talking all that much, I mean he was completely out of his element. He was on an un-remodeled floor and out of his office, in the middle of the night, go figure, he was a little out of his comfort zone. He had probably heard tales that night shift nurses eat administrators, which I can’t confirm or deny, so needless he was scared.
But this isn’t what I’m truly talking about, just laying back story. I had a meeting with my manager the other morning. Just a sit down, chat, see how things are going. She mentioned that her boss had talked to her about the other night. Evidently her boss had said to her that it seemed that, “we had a lot of people sitting around for that time of the night. I looked at her and said, “When they came and delivered donuts and stuff, right?”
“If I remember correctly, it was the first time many of my nurses had actually sat. And it’s not like they’re not doing anything, odds are they were charting.” I said.
“I know that,” she said, “I know you guys work hard at night, and that it was probably that you guys happened to be at the station at that time. She said that it was harder to find people on the other floors that night.”
“Yeah, because they were hiding.” I came back with.
She continued, “She says there were 11 people on the floor,”
“Yep, there were 7 nurses, 2 aides and a MHT for our token psych patient.” I interrupted with a grin.
“I’m not pointing fingers or anything, but now can you kind of see how the pressure is being applied from above? I’m just saying we need to watch our productivity and hours.” she finished.
This gets me on so many different levels. In fact, when I walked out, I was pissed, almost ready to storm the Ivory Tower of Administration to kick the living shit out of the folks who think we don’t work at night. Then I thought to offer them a chance to shadow us at night, but realized that the night they would shadow would be the most mellow easy night in the books. Then I thought about sabotage, sending porn to their email, or dropping of a bag of poop (preferable encrusted with MRSA, VRE from a C.Diff patient) on their desk, but I realized this is what I get for joining management.
Yes, the busy-ness level is different at night. The LOL who during the day was, “Sweet, pleasant and a breeze to deal with” becomes the screaming demented demon from Sundown-land who spends hours attempting to cause a Never event by climbing out of bed. Folks who spend all day looking good and on the mend get tired and start to go downhill when the night shift arrives. It is a different kind of busy. I know that many people think that most of what we do at night is sit around, gossip, play canasta, surf on-line, generally do nothing. Some nights I will admit, some of this is true (I suck at canasta), but those are rare.
I remember the night in question. We had a good half-dozen bed alarms, on each side of the hallway that would go off every 30 minutes or so. We had the patient, who admittedly were behaving themselves and considering they had a sitter, that was great. I had two patients of my own, nearly every one was full. We had spent nearly an hour trying to track down the right surgical resident to call for orders on a patient we thought might be having a stroke. I skipped bed rounds to stay and help out, and also because I only had one bed. Everyone had at least one patient that required total care, isolation precautions, extra re-orientation or all three. It wasn’t the busiest of nights, but it had pretty much been non-stop since the word “Go.” And truthfully, when the delivery truck came around, we were sitting down. Charting. Signing off MARs. Doing chart checks. Waiting for a doctor’s call. We weren’t just sitting around. We were working.