Emerging Nurse Leader

A leadership development blog

Leading Your Night Shift

by

By Rose O. Sherman, EdD, RN, FAAN

I was recently asked the question by a nurse manager about how to manage the night shift when you are not there.  It is a great question and one that managers often struggle with.  You want to be supportive and visible.  Yet at the same time, you get caught up with the chaos of the work leaving little time to think about how to best support your nurses who are managing the unit when you are not there.  This can leave your night tour staff feeling isolated and disengaged.  Left unchecked, you may find that you have two very different cultures on the same unit and potentially differences in practice.  At worst, it can lead to conflict between shifts that destroys unit morale.

The following are some dos and don’ts to consider in your leadership of night shift:

DO

  1. Keep in regular contact with the administrative supervisors who work nights to obtain their perspective on the functioning of your unit on that tour.  Ask them to contact you if they see problems that you need to be aware of.
  2. Schedule yourself to work all or part of the night shift quarterly.  Let staff know you will be working and are there to listen to their concerns.
  3. Establish some protocols for what type of situations that occur on nights that you want to be immediately notified about.
  4. Demonstrate gratitude for nurses who work the night tour and recognize the inconvenience and sacrifices they make in their personal lives.
  5. Monitor how staffing is done to cover night shift to ensure that staff are able to get adequate rest between tours.
  6. Arrange periodic huddles with your night tour staff to communicate policy and practice changes and/or establish a unit Facebook page.
  7. Consider Facebook streaming your staff meeting so your night shift can participate.
  8. Maintain ongoing contact with the night charge nurses for their input into unit decisions.
  9. Evaluate on an ongoing basis the workload on nights relative to admissions, discharges, transfers and workload.
  10. Support your staff in their communication with physicians at night.
  11. Ensure that you have night shift nurses who can serve as strong and positive preceptors for new graduates placed on the shift.
  12. Be proactive in managing any conflict that you observe between the shifts.
  13. Encourage healthy habits and be an advocate for night shift in having access to cafeteria food and other amenities.

DON’T

  1. Make the assumption that the workload on nights is easier.
  2. Ignore signs of extreme staff fatigue or sleep deprivation and whether it is safe for a staff member to drive home.
  3. Monday morning quarterback a decision made on nights without hearing the whole story and considering the resources available.
  4. Change policies or practices on the unit without input from the night tour.
  5. Let practices like bedside rounding be discarded on night shift.
  6. Listen to gossip from your day shift staff about what happens on nights without involving the night shift staff.
  7. Place new graduates on the night shift unless there are experienced staff to coach them.
  8. Lower your hiring standards because you are desperate to fill a night shift position.
  9. Let conflict fester between day and night shift without intervention.
  10. Destroy your personal life by responding to regular texts at night or coming in early every day to meet with night shift and then staying late.
  11. Tolerate a high level of absenteeism on nights.
  12. Forget to include your night shift staff in disaster and crisis training as many of these incidences occur on nights.
  13. Allow night staff to opt out of self-governance initiatives.

On most 24/7 units, between 30 and 40 percent of your staff will work the night tour.  Without active collaboration with their manager, they can easily feel that they work in a different hospital than the day tour.  Night shift staff play a unique role on units in keeping patients safe while the rest of the staff sleeps.  They need to feel valued and respected for the work that they do.

Read to Lead

Claffey, C. (2006).  Nursing in the dark: Leadership support for night shift.  Nursing Management. 37(5); 41-44.

Weaver, S., Lindgren, T.G., Cadmus, E., Flynn, F. & Thomas-Hawkins, C. (2017). Report from the night shift: How administrative supervisors achieve nurse and patient safety. Nursing Administration Quarterly. 41(4); 328-336.

© emergingrnleader.com 2017