I started working the night shift many moons ago… a new grad rite of passage. I had to get through one year- and then a day shift position would open up, they said. So for a year, I worked the zombie shift. With a one year old at home and limited childcare, I was always sick and sleep deprivation took on a whole new meaning. It became a lifestyle. I couldn’t wait for my year to be up and to be able to work “normal hours”.
While I waited that transition period out, I went about achieving my goal – “To be the Best OB nurse that I could be”. I stared at the experienced nurses with starry eyes… “One day I want to be like them”. I longed for their wisdom and efficiency. I wanted to run an OR like a boss. I wanted to propose a new plan of care to a provider and have them take it because it was a good one. I wanted to perform exams with accuracy and not feel the need for someone to check behind me all the time. I wanted to do a delivery without tearing up. I wanted to feel relaxed in an emergency and resuscitate a baby without feeling like I was gonna to shit my pants. On my downtime, I practiced the things I struggled with, studied strips, asked providers for the reasons and thought processes behind the decisions they made and grilled the veterans for their pearls of wisdom. If I was lucky, someone would break out a diagram or draw me a map… and if I wasn’t, I was chastised.
By the time my year was up and a day-shift position was posted, I had fallen in love with the staff who taught me how to nurse. I had come to rely on them, knowing that the second I pulled the emergency bell, they would magically be by my side to guide me. So I stuck it out a little longer. My physical ailments of working nights had begun to work themselves out and I decided I wanted to gain more experience and a higher level of comfort before I moved to a different group of staff.
As I gained more experience I came to discover the treasures buried in this shift.
Labor knows no bedtime and babies come when they want to. Providers go to sleep and go home at night, often times because they hold office hours in the morning. So, you are forced to think and act. In the quiet of the night, you become autonomous. Without a provider immediately ordering you what to do, you begin to develop plans of care on your own and suggest them for the doctor/midwife’s approval when you call. Assessments and exams fall to the nurses and with all the practice, you become very comfortable with the tasks that would normally fall to residents at other hospitals. You catch babies when patients arrive late in their labor. Surgery is never scheduled and the chaos of taking a patient to the OR at 3am becomes a learned dance. You are the eyes and ears of the doctors when they aren’t there. Your senses become highly tuned to the early signs of a problem because a baby and a mom’s life depend on you.
Administration are in their beds. Resources outside the unit are scarce and by default, your coworkers become your right hand. Providers aren’t hanging around watching your monitors. You can’t call for back-up staff at 3am or ask your manager to leave a meeting for a unit emergency. You learn how to “figure it out” when it’s busy and how to stay awake when it’s slow.
So here I am, 12 years a night shift OB nurse and I wouldn’t have it any other way. The aspects of the shift that at first terrified me… in the end… have gifted me with experience and skill, confidence and character. I have learned when to not “bother” doctors and when to “demand” them, so as to advocate for my patients. I’ve had the joy of delivering a patient’s baby and doing it well, and the privilege of holding their hand and wiping their tears when the outcome wasn’t good but a provider wasn’t there yet to break the bad news. I have prepped and pushed a patient into the OR before the surgeon was on the floor. I’ve accompanied a high risk patient in transport via ambulance to another hospital because OB nurse transporters weren’t available at night. I’ve run for 12 hours straight without a bathroom or a meal break because there was no help to be had. And I have proudly performed a variety of dance and music numbers for my coworkers when things were slow… it works much better than caffeine! (Ethics discussions and random polling are also engaging for the sleepy mind). But mostly, I’ve gained the respect of providers and nurses alike and achieved the goal I set as a new nurse.
In the blink of an eye, I am the veteran…pushing my baby birds out of the nest to fly as new L&D nurses. And they all ask…
“How do you stay awake? How do you stay so calm all the time? And when will my insides stop going crazy every time I have to resuscitate a newborn or manage a delivering patient with no provider in the room?”
Inside I smile.
“Keep wanting to get better. Keep practicing and it will come. And hang with us zombies on night shift and we’ll be there to have your back and keep you awake.”
If they watch carefully, they too will blossom into wonderful, autonomous nurses with a little attitude and a lot of character… and if they watch extra careful, they might just notice that I still need a back-up or a second opinion sometimes and once in a while, they might just catch me tearing up in a delivery.
This post was first written by me for and published by an online nursing magazine and a hospital newspaper. I am now re-posting it here.
