This week I have had the lovely luck of having night duties. I have personally been dreading them as I have been very lucky and not had to do night shifts in a good few years!
But as a requirement in first year we are meant to do 3 nights on duty. So I have done my fill this week. It is weird going from day duty to night duty in several ways I suppose. It is difficult when your body clock is used to waking up early in the morning (naturally even on my days off I wake up early now!). It has also been hard in the respect the ward I am on I havent had to do a lot compared to days during the night. It is children and generally, they sleep! We would have one or two admissions during the night from A&E. Otherwise, it is making sure the observations are done, medications are administered and that everyone is comfortable. Occasionally we will have a child who is sick and a bed needs changing, or bottles need made for that 3am feed! So night duties have a very different pace in comparison to day duties. You're very mindful of tip-toeing around and whispering every where you go. You are also very aware of the smallest sounds so you can tell when someone is moving or feeling restless and unwell. Depending on what the patient has been admitted for and if they have a parent staying with them, it can have an effect on their sleeping pattern. Some children find it hard to sleep in foreign surroundings but on a whole as they're not well, they tend to sleep when they can. It is difficult when you are trying to do a set of observations at 4am and you unfortunately have to disturb them! Putting probes in their ears or tempadots under their arms is not the nicest of ways to be woken up for them. Luckily, most tend to drift back off after that!
I have found doing night duty to be useful though. It has allowed me to sit and talk to my mentor and go through the various processes on the ward in detail, getting to know the paperwork and how this translates onto the computer system. I have been able to discuss my upcoming essay and get ideas of how I can use what I have learnt in my work. I have helped to prepare and set up drips and learn about IVAC's (the pump system) and I have had chance to see how the admissions from Accident and Emergency happen. I have been able to read up on patient's notes and I have been able to gain more experience with the younger patients. I have been sterilising bottles, I have been assisting in feeding the babies on the ward, I have been doing their observations. I have also had the opportunity to be able to visit the surrounding childrens wards to see what they are like and the difference in them. On the ward I am, it is mainly surgical so we see a lot of day surgeries and other surgeries. We see a wide variety of patients and it has been an amazing placement thus far.
Night duty can be difficult, however, I have been able to have a break time where we get to sleep for an hour or so. You are a little more refreshed and each nurse takes it in turns so there is always someone staffing the ward. I have found if you don't get away on time or even a little early, you hit all the rush hour traffic. That can be difficult when you are so tired you just want to jump into bed!
It is incredible how much you learn within 6 weeks of placement. You are able to gain so much experience and put into use everything you learn during your university class time.
Although I was not looking forward to doing night duty I found them an invaluable learning experience. You experience what happens when most people are not there. The staffing levels are less as there are no day surgeries and admissions, there is such a reduction in noise in comparison to the daytime too! You also see the patients and their families in a very different light. During the day, patients and their carers tend to go through the motions of being there. They are feeling scared, ill, unsure, yet with all the routine and hustle and bustle around the ward, these emotions seem to be hidden a lot more. When it comes to the night duty, everything is a lot calmer and a lot quieter. I have found it is these times when it is invaluable to the parents to just sit down and talk to them even for five minutes. It takes their mind off why they are there a little and provides a much needed distraction. A small conversation can be worth everything to them. I have sat down with them, got to know my patients and their carers / parents. I have been able to learn more about them, I have been able to pass my knowledge on to them and more importantly it allows them to know that although it may be busy at times and it may be difficult for them, there is always somebody about to be a listening ear or a shoulder to cry on. In hospitals, you see people at their best moments and their worst. It is emotionally turbulent for them and it is draining. By being there and talking to them, you are providing a service they may not have asked for, but more than likely needed.
On the other side of that, it allows you to pick up on things not necessarily mentioned when they are admitted and a history was being taken. As well as this, you are also mindful that your patient is the child, regardless. And although it may be difficult and some parents and carers may seem lovely people, and may genuinely be so, your priority is that patient. So if you pick up on anything untoward, worrying or a little off then this needs to be reported. With children, social services, health visitors and child protection can be involved. Some may already be in contact with the family, some may not. It is always important that you remember the child comes first, and if there is anything that may need to be investigated then this will be up to the various agencies to decide. As a nurse working with paediatric patients, safeguarding is fundamental to your care. As with any person who is vulnerable, whether they are a child or an adult, they need and deserve to be protected. This all needs to be done in line with the NMC Code of Conduct, various laws and legislation while remaining impartial and keeping matters confidential.
Overall, I enjoyed night duty more than I thought I would! It has been a long week though and I have struggled to get anything else done as I have slept on and off for the majority of the days. I have also felt drained and all mixed up, however, I am glad I have done it. It has been a great learning experience, and everything helps for not only during your university experience, but beyond qualifying too.
So while it may seem lovely to be able to have a little cuddle off a baby once in a while or to play with those children to provide a little distraction, it is important to remember your role as a nurse is multifaceted. And it wouldn't be the rewarding job it is if it was one-dimensional.
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