When you get a good overnight team at the hospital…

We’ve spent a lot of time inpatient at our children’s hospital and have stayed on six different inpatient units so far (Cardiovascular ICU, Pediatric ICU, Neonatal ICU, Progressive Care Unit, Pulmonology floor, and Cardiac floor). All of our stays have been a net positive experience, although my husband and I have both been known to butt heads with the care team occasionally when advocating for the treatment we believe is best for our daughter.  Our current stay in the PICU and PCU has been the best so far though, in terms of staff.  I’ve been impressed with the approach the doctors, fellows, and residents have toward each other and toward me, even when the people composing these teams changes.  (Attending doctors typically rotate in for two weeks at a time, fellows and residents duration on the unit seems to vary.) Somewhere up the chain, a healthy culture is being actively fostered which is leading to this consistently respectful and thorough approach across the changing teams. Or, I’ve just had a run of good luck.

I’ve been impressed with the knowledge and attention to detail in the nursing staff as well, particularly in the PICU.  But the best and most surprising part has been the quality of the night nurses.  Most parents of medically complex kids can tell you that night shift is….interesting.  Night shifts attracts several less than ideal  candidates for caring for your children.

While night shift occasionally appeals to a completely normal, skilled, experienced nurse, it also greatly appeals to:

* Nurses who are unethically working 16 or 24 hour shifts by working as a day nurse at another hospital before caring for your child, unbeknownst to their employers

*Inexperienced nurses who are paying their dues in the employment hierarchy

*Nurses with less-than-stellar professional reputations who an employer will hire to fill an unpopular time slot

*Nurses who lack the concentration, decisiveness, initiative, memory, physical ability, etc to keep up with the pace and demands of day shift

*Nurses who simply want a less demanding shift.  As one of our home health care night nurses told us once, “I just don’t like to work hard.” Hm.

These people (plus some good ones) are drawn to the night shift because most patients and family are sleeping and not asking for anything, there are not many doctors or superiors around, and the general attitude around the unit is often relaxed and lax as there aren’t many changes or surprises in their patients.

Unfortunately, these are the very same reasons that I want an *excellent* nurse taking care of my child at night…my kid and I are sleeping, we can’t ask for help!  There aren’t doctors around, the nurses have to act quickly and correctly if something happens!  And surprises are rare on night shift, so it may take the staff precious time to even realize when something is wrong in this deceptively usually-serene atmosphere!

Most of the time during this entire stay, I’ve had such excellent night nurses, I’ve been really curious why they are working nights. Thankful.  But very curious.  I’ve even spent several nights *away from the unit* catching up on sleep in a Ronald McDonald House room, which I am also very thankful for.  Tonight we seem to have a great nurse who agreed not to bother us much (psst….the secret code at night is to ask for “clustered care”) and we just got upgraded to a gigantic “hospi-condo” type room which has a couch bed for me. My swollen feet, aching back, and bowling-ball preggo belly are very happy.

My experience during much of this stay can be summarized as:

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2 thoughts on “When you get a good overnight team at the hospital…

  1. That’s crazy! I knew nurses who worked night shifts at random hospitals on top of their day shifts and I was told it was the equivalent of what I do (work all day at work, then go home and do contract work or consulting for other firms). However, I guess it makes sense it would be unethical for a nurse to do that as her judgement being impaired would be way more damaging….whereas as anything I do has to be approved by an engineer anyways. Fortunately I’ve never had any critical errors be made in the 5 years I’ve been doing outside work. I will say though, these days I won’t work until 2 or 3am and then go to my day job at 7am….I actually need sleep now to function at this age 🙂

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