Another Tough Shift? 5 Tips to Get You By

By Val Gokenbach on Wed, Jul 04, 2012

hard nursingFirst of all, it is important to understand that there will always be tough shifts in any healthcare setting. The question is whether this is just a bad day in a good place to work or is it a repeatable phenomenon due to the organization’s inability or refusal to provide adequate nursing staff. I will focus on the first question. If an organization habitually ignores the need for adequate staffing, the strategy may be to make a career move. The high variability in the human body also lends itself to quick changes in acuity which can instantly turn a manageable day into a nightmare. Here are some nursing tips to get you through those tough days:

1. Mental Adaptation

Our successful approach to anything begins in our mind. If we think we can do it, we can. If we think we cannot do it, we can’t. The same thought process applies to any scenario. If we think we will have a hard nursing day, we will. If we have faith we can manage the day, we will. Start by living in the moment and making a realistic assessment before you draw conclusions and set your fate. Just because a night shift nurse had a bad night or a problem with a patient does not necessarily mean that you will also. We are all different.

Take a moment and identify what about the day is creating stress and concern. It may be as simple as not being familiar with a certain type of patient or the concern for the perceived quality of your coworkers. Once you know where your concerns are coming from, you can develop a strategy to deal with them. Identify what your strategy will be.

2. Organization

Good personal organizational skills are vital to the success of nurses that spend their day multitasking and managing many concerns at once. There are entire classes dedicated to the development of effective organization skills and they all begin with consistently developing a plan. Take 10 minutes following report to focus on what you need to do and in what order. You can use a checklist or a report sheet or whatever works for you.

3. Effective Communication

Most problems can be tracked back to poor or lack of nurse communication. Make sure you communicate to all of your team members that you are working with and share with them your strategy to manage your day, and express the help you may need. If you are working with assistive help, make sure you delegate clearly your expectations and needs. These employees need direction and, as the nurse, you are responsible to manage them.

Ask for what you need. No one can read your mind and no one can anticipate your feelings. Do not perceive yourself a victim and do not feel sorry for yourself. If you are assertive and professional in your request, your colleagues will come through for you. Always make sure that you offer help to them when they need it. This will make them more willing to help you if they know you will be available for them.

4. Engage Your Patients' Families

The trend for effective nursing care includes the support of the families in any way that engages them and allows them to partake in the care. If a family member is interested in doing a component of the care such as baths and feeding, if it is appropriate, let them help. They will feel more in control and happy that they can help. You may be able to off load some of the tasks that you may be struggling to accomplish.

5. Informing Your Manager

If the work environment is well beyond what is safe for the patients, it is time to notify your charge nurse or your manager. Government regulations, along with the increasing responsibilities placed on managers by hospital leadership, is continuing to pull them from the clinical area to perform management tasks. They may not know what the activity of the unit is from time to time and they will not know the impact of individual assignments on staff.

If you decide to approach your charge nurse or manager, make sure that you are presenting the situation in a comprehensive, professional, matter of fact way, focusing on patient safety and not your personal feelings. Never whine or complain. As a professional nurse, your assessment and perception of the quality of care is valid and must be listened to.

In conclusion, we have all made the choice to select nursing as a profession. Hopefully, these tips will help you get through in days when nursing hits you hard. I have always thought that our career has many paradoxes that we as professionals simply must accept. Nursing is challenging yet rewarding. Nursing is variable and complex but interesting. Nursing is collegial but individual. Nursing is fulfilling but at times painful. Most of all, nursing is the most trusted and honored profession in the country.I have always felt honored to be a nurse and despite the adversity, I would never be anything else!


amie.RN2010 2 years ago
Thanks Val. I agree...we all have bad shifts, but its 'true we need to determine whether it's just a bad day or a bad environment. Unfortunately, it's not that easy just to look for something else.

renagapasin 2 years ago
Tough shifts are the big hindrance to nurses. Thanks for this article!