News: 10 Things You Can Do To Make Your Shift Easier

March 8, 2012

By Genevieve M. Clavreul, RN, PhD

Whether you work an 8-hour or 12-hour shift, there are things you can do to help make your work easier and your day run more smoothly. You may recognize some of the following suggestions from your nursing school days. Call this article Nursing 101: The Refresher Course. The problem is, we often forget the organizational basics when confronted by the demands of the real world of nursing. Practice these tips and you’ll feel that you’re controlling your shift rather than it controlling you.

1. Don’t just be on time—be early.
I know that this suggestion seems like a no-brainer, but so many nurses today clock in as if ‘start of shift’ is really the start of their shift. Being early makes you feel less stressed, since you’re not trying to beat the clock. You’ll also have time to do the preparation necessary to start your shift. For example, if you are required to gown-up or be scrubbed, 15 extra minutes gives you time to complete these tasks and to take report at shift-change. This will help prevent resentment from the team you are relieving. Put yourself in their shoes, how do you feel when the person relieving you comes on late?

2. Are you qualified? This is not a put-down, but every nurse should ask himself or herself this question before assuming care of a patient. Make sure that your skills and training are indeed an appropriate match for the patient. If the answer is short of an unequivocal yes, notify your charge nurse immediately and advise her of your concerns. Explain your rationale and listen to her advice. If need be, request another patient assignment, one that is within your abilities. Remember, you are the patient advocate and it is your responsibility to ensure that the patient receives the most qualified care possible. It is not demeaning to recognize your limits; it is a sign of a confident nurse.

3. Review the orders. Often, in the rush of shift change, nurses forget to carefully check orders. Too many of us only give them a cursory review, which can lead to negative consequences for our patients. Go back to the basics and thoroughly review, with the nurse coming off shift, the right dosage and times for meds. Make sure that both you and the off-going nurse sign off on the doctor’s orders. This should be done at EVERY change of shift—I have found that not all hospitals make it part of their nurses’ practice. If this isn’t already part of your routine, MAKE it part of your routine.

4. Organize your station or work area. When I am doing research on the floor, working as a floor nurse, often the other nurses chuckle at my habit of cleaning and organizing my work area first. However, after observing me for several days in a row, you’d be surprised how many other nurses begin to do the same. Organizing your work area puts you in control. When nurses complain about feeling overwhelmed, it’s often not just from the patient load, but from the chaos of their work environment. In addition, this is part of your duty as a nurse, which is to keep the patient environment as safe and pleasant as possible. This also helps put both the patient and his family at ease.

10 things to make shift easier5. Take inventory. Take an inventory of the supplies you need for the entire shift. After report, note how many lab tests are ordered, check the specific tubes needed, the amount of blood to be drawn. Calculate and collect all the materials for the tests in advance, get all the paperwork organized. This may seem like a lot of work up front, and it is, but the pay-off comes when you don’t have to go chasing from bedside to bedside, unit to unit, floor to floor, for the needed supplies, especially in the wee hours of the morning. You should also make sure that there are enough meds available for the length of your shift and whenever possible gather all the equipment you will need. Always make sure that you know where the emergency equipment is, just in case.

6. Arrange your break-time. Many charge nurses/team leaders are flexible when it comes to nurses scheduling their own break-times. If this is your case, use it to your advantage. Take the long view and plan your break when you know that your work load is at its lightest, that way, you’ll leave with less stress and are more likely to truly relax. If the charge nurse/team leader schedules the breaks, then plan your work accordingly. Make sure that the more complicated tasks are done before the relief or float nurse assumes your assignment. This way you can take your break free of the worry that this relief/float nurse may or may not be familiar with the level of care needed by your patient.

7. Be sure to take your breaks! It is easy to overlook taking a break, even one as small as 10 minutes; but you must take them. Breaks help recharge our batteries. While on your break, do what relaxes you, as long as it’s authorized at your hospital. If you need to catch a catnap, do it. I don’t mean sleep at the bedside; this is unprofessional and does not instill confidence in the patient or patient’s family. Go to the break room, or the lounge where there is likely to be a couch. Some hospitals set aside a room where nurses can sleep on their breaks. More and more research is showing how a 10 to 20 minute nap really does sharpen the mind, making the person able to perform even better than those who don’t nap. Nonetheless, some hospitals have policies that prohibit sleeping anywhere in the hospital, including cars parked on hospital grounds. If your hospital has a no sleeping policy and you and your nurse cohorts feel up to a challenge, you can approach the hospital about changing this policy. Do this through the chain of command and engage your nursing leadership as an advocate.

8. Prepare to give report. Don’t just get organized for report when report is due. Organize yourself and the information in advance. This is also a good time to analyze what went well and what went wrong during the shift.

9. Restock your station. We’ve all been there. You show up to work and your station has not been restocked by the nurse you are following. She most likely forgot or was so overwhelmed with patients that she didn’t have time. However, if you make sure to do your restocking, then the nurse following you will most likely model your behavior and so on. It is so easy in today’s hospital environment to cut corners. But all that does is put added stress on the nursing team, and that team includes you. So, take that extra step before going off shift and restock your work area.

10. Attitude is everything. All too often nurses come on shift exhausted, especially those working 12-hour or night shifts. When you come on shift worn out, then the shift becomes a challenge to complete. Having a positive attitude can help make your shift more bearable. When I have to pull a 12-hour shift, I go to work thinking of it as though I am attending a long party—it’s amazing how having this kind of attitude makes the time go by. Try to leave your problems at home, and try not to take your work home with you, which, of course, is always easier said than done.

Geneviève M. Clavreul, RN, PhD, is a healthcare management consultant and a former Director of Nursing.