Welcome to the graveyard shift…

The ‘graveyard watch’ version of the phrase was generally used by sailors on watch – hardly a group in a position to supervise buried coffins. The graveyard link was made explicit in this definition, offered by the American mariner Gershom Bradford, in A Glossary of Sea Terms, 1927: “Graveyard watch, the middle watch or 12 to 4 a.m., because of the number of disasters that occur at this time.” This is taken from Phrases UK.

First off this is usually an all or nothing shift.  Meaning you are Hella busy or crickets.  Many times, if you are on the floor as a staff nurse, you are stuck working with 5-6 patients by yourself. Hospitals have sacrificed nursing safety to make more money (what a shock).  To get “help” with a patient you often must obtain the assistance of other nurses on the floor.  I have had shifts where I am literally falling asleep at the computer, am all up to date on charting and able to do my hourly rounds.

Then there are shifts where every patient has needs and that you are continually moving to the point that you do not sit down, fail to eat your supper, and maybe trying to catch up on charting as the day shift arrives.  These shifts are more common than the quiet ones (especially on acute surgery, ICU, and telemetry).  Trust me the fertilizer can hit the ventilator damn fast. You really need to be on your game because this shift can be brutal.  Add to everything that you are often sleep deprived and dealing with others that are sleep deprived.  Sounds like a crazy time?  Yeah, it is.

Nurses have been met today by the bedridden unmotivated patient who thinks the call button is for you to wait on them.  Nurses have been bullied by the administration to treat the patients with “kid gloves” so that they fill out the JD Power survey (yeah, they survey the shit out of anything) favorably.  In other words, we are forced to kiss the patient’s ass instead of providing effective convalescence while in the hospital.

Look I know surgery and other illness or injuries that land you in the hospital suck, I have seen the worst to the easiest.  The fact is that unless you have an over the top spouse, roommate, houseboy, whatever you are going to have to get your ass off the bed and get shit for yourself.  The sooner you do this, the better.  This will tell us early on whether there are going to be problems when you discharge, and it makes you start the healing process much faster. So, ringing for ice when you can ambulate is just being lazy.  Get off your ass and get your own ice. It ain’t so I can do my nails at night as much as it helps you move to independence.

As a Nurse Practitioner and a hospitalist (I am just thrilled with this job let me tell you), I am responsible for getting people admitted and settled. Very rarely does your regular PCP admit you to a hospital, they send you to a hospital to be accepted by a service.  Hospitalists get all the essential assessments and order the medications you will need to make it until the service has a chance to round on you and talk to you about a plan to make you healthier. Just like with your PCP you need to talk to these people as much as they show themselves in your room about questions, concerns, why they picked that tie to go with that shirt, and do you know what a fucking comb is?…Or the better one, why do you look like you are 12.  I kid medicine or any other residency sucks. You are put through the wringer and often with very little to go on, always questioned by other more senior residents or the attending.

NPs have the peace and quiet to do their jobs without that food chain and without the hassle that food chain is.  Like a staff nurse its feast or famine.  We can be busy and working with crisis after crisis all night or be half asleep banging our head on the keyboard in the hospitalist workroom.  Either way, we are there for your dining and dancing pleasure and to back up the floor staff with admissions, orders for new problems, changing orders on old problems, ordering tests, placing service consults, watching kick-ass YouTube videos…The list goes on and on.

What am I getting at?  (I oft wonder myself) Be nice to the nursing staff.  We all know it sucks to be in the hospital and that you may be in pain or not sure what to do.  We are there for you, BUT you need to join us in that experience.  Don’t be a little whiner when we ask you to try and do something, try that’s all we want. Don’t think we are waiters and don’t believe that anything is coming fast.  We may be diverted for more important things. Ringing a second time for ice is a dick move.

Well, the rain falls, and it gives that familiar musty smell in the castle. The rhythm is nice and welcomed on this coldish night.  Be well all.