It’s 10:30 p.m. and after kissing the sleeping little ones and their dad goodnight you go out into a world of darkness to go to work. On the way to the car you notice the lights going out on your street, and as you start your drive to work, you realize the world is preparing for bed. You’re an RN working the 11-7 shift at a local hospital, and your day is beginning.
As you travel the route that is so familiar after years of this lifestyle, you know there are fourteen stoplights and seven stop signs before you reach your destination. As you’re driving, you leave home behind, and your thoughts turn to what tonight may bring. You think of Mr. Henry who was admitted with rectal bleeding and was going to surgery this morning with a possible diagnosis of cancer. He was so apprehensive last night and didn’t sleep well. You spent time with him trying to reassure him, and you felt that it did more good than any sleeping pill. You wished him well before you left.
You wonder about Mike’s family. Mike has an inoperable brain tumor and is being heavily sedated at this point of his disease. Comfort measures are all we can do for him now. His family needs more help than he does. They take turns, staying at night with him, and you have grown to know them so well. They’re upset, tired, and somewhat angry. They want to do whatever they can for Mike, so you let them smother him with all the love they want to give. You let them help you change a bed if they wish. You get them something to drink, give them a pillow and blanket, and hope they’ll get a few naps during the night.
By now, you’re almost there. Your mind turns to thoughts of, “Wonder what staffing looks like; wonder if they’ll pull from you tonight.” You hope Carol is feeling better tonight. Carol is a very devoted LPN, and she really didn’t feel like working last night but “hung right in there.”
You walk into the hospital. The whole atmosphere appears to be quiet and restful. You reach your unit and get the report form the 3-11 shift. They’re glad to see you. Their tour of duty is over, and they’ve left everything ready for you to start. You learn that Mr. Henry had extensive surgery for cancer and is in ICU. You must remember to run up to see him when you have a minute. You miss Mike’s family tonight, because Mike died this afternoon. Since they had become very special people, you remember to get their address and phone number so you can go by to see them or send a card. Report is over, and as you make rounds, checking on every patient, Carol comes to ask you to check Mrs. Davis who had a partial gastrectomy today. Her blood pressure has dropped. She is pale, and her pulse is 140 beats per minute. You stay with her for a short time to assess her condition further. Her blood pressure continues to fall, and her pulse rate continues to go up. You call her doctor, and he says to get a stat H & H and crossmatch for blood. You ask Carol to stay with her until we can get things rolling, because she’s terribly frightened. By morning Mrs. Davis is surgically stable. She weakly smiles and thanks you for everything. What a good feeling with which to leave.
Night nurses are very special people. Because staffing is greatly reduced on this shift, you become very dependent on each other. You know when they’re bothered or stressed without them telling you. You feel like you know their families and lifestyles even though you’ve never visited in their home.
You quickly learn their strengths and their weaknesses. You give inservices, often on a one-to-one basis when the need arises. You remember to write on the Nursing Care Plan that Mr. Jones does not want his sleeping pill until 12:00, because he has “watched Johnny Carson for ten years,” or that Mrs. Gregory needs restraints at bedtime.
It’s 7:00 a.m., and the morning shift is arriving. You’re driving home, and the traffic is heavy. The world has awakened and people are beginning their day’s work. As you leave, you think about the night you have just experienced. You feel good because Mrs. Davis is better. You feel good that you had a part in developing Carol’s skills to the point that she recognized a problem and acted accordingly. You’re glad you had a few minutes to review the crash cart with your staff. You hope Mike’s family is dealing with their sorrow.
You’re getting closer to home, and you hope the children are up and ready for school. What a sight to see two little people standing at the door waiting for Mom to come home! You look them over closely – make sure they’ve had breakfast and off to school they go while you prepare to go to bed.
Though it may appear that the world is asleep, activity in a hospital continues for 24 hours. If you have ever worked in the 11-7 shift, you will share with me the very special feelings I have, and if you haven’t, have you ever thought about exploring the wide wonderful world of nights?
Hariette Anderson, RN
Riverside Regional Medical Center