August 8, 2020

Unit-Wide and Shift-Specific Community in Nursing

This week I make the transition from night shift on a medical unit to day shift with a wound care unit. The change will be a first in my nursing career, and I’m excited to discover new territory for myself. Because I’ll be making the transition rather abruptly, I won’t have the luxury of the usual break during which I go through a jet lag-like transition to something like a day schedule. So, this post will be brief, but there are a few observations I’d like to make.

While the vast majority of my experience as a nurse has been on night shift, I have had many opportunities to work day shift hours. The beginning of my initial orientation took place during the day, including my earliest shifts on the unit. While new to nursing, I gained technical experience by utilizing “lunch coverage” hours–basically four-hour blocks intended to pick up slack so that nurses on shift could take lunch. About two years ago, I began to work with the wound team intermittently, and as my institution’s policies changed with respect to pressure ulcer assessment and documentation, I utilized some of my lunch coverage time helping to ensure quality improvement in this area on my unit.

Also during the day, I have had the pleasure and privilege of serving my fellow staff as a shared governance committee member on several levels of the hierarchy. These hours did not involve direct patient contact, but they were in part an opportunity to experience nursing through conversation with groups of nurses at once, some of whom worked day shift and others night shift.

Living life in 12-hour blocks as a bedside nurse, I have frequently been intrigued by the contrast between day and night shifts during the shift exchange period. At such times, half the people you meet are coming, the other half going. However, they’re all in one place long enough to experience a type of common life, a camaraderie that reveals much about human nature generally and about the shear variety of lifestyles that exist at the intersection of so many people.

I can’t think of anyone I’ve ever worked with in nursing whom I haven’t enjoyed working with and learning from. Early on, this was because I was new to nursing and it seemed everyone new more than I did. Eventually, like virtually everyone in a social system, I adapted to the complex network of relationships present. In retrospect, I can see that sometimes this was because of common interests or background. At other times, it was the result of our common exclusion by others. In any case, the relative stability of staff-to-staff relationships has provided continuity in the midst of change, perhaps interrupted only by the all-to-frequent turnover of staff.

Nursing staff will readily attest that there are many differences between day and night shifts, with respect to both the social and work environments. Despite these differences, I believe in the broad scheme of things in nursing, the nature of the flurry of activity that constitutes a shift remains. In essence, the difference between night and day is merely that the former ends at 0700 while the latter ends at 1900. What do you think?

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