Author: Marijke Vroomen-Durning
Published: Jun 25/08
We’ve all seen them, we’ve all heard them, and maybe we’ve even been part of them: the shift wars. It’s possible that this happens in other professions where people work around the clock, I don’t know. But I do know that in nursing, shift wars are alive and well.
In some hospital settings, the nurses work set shifts; they either work days, evenings, or nights – or days or nights if they have 12-hour shifts. In other institutions, nurses rotate. In the acute-care hospitals I worked at in Quebec, the nurses had to work 50% of their hours on dayshift, and 50% off shift, either evenings or nights. If you wanted to work permanent evenings or nights and there was room, you were allowed. Many nurses chose that option. However the shifts are staffed or divided though, the team has to work together.
That being said, if the nurses are a team with one goal in mind; quality care for the patients, how is it that there can be so much squabbling between the shifts?
To be fair, this doesn’t happen everywhere, although it does seem to be very common. One shift feels that it does all the work, another shift feels totally unappreciated. One shift feels as if all the work has been pushed onto it and another shift feels that it has to pick up the pieces all the time. Many days, the complaining starts right after report. One nurse talks about how the previous shift always leaves a task for them to do or they’d better get something done so that the next shift doesn’t complain like it always does. Comments are passed back and forth, co-workers nod in agreement, and a general feeling of “us against the rest” seems to hang in the air.
Some may ask; why does it matter if there are shift wars, as long as the patients get good care? The problem is shift wars can and do sometimes intrude on patient care. Unfortunately, some nurses can bring the shift wars, knowingly or unknowingly, into the patients’ rooms by actions or making comments that are directed towards other shifts. Tension in the nursing station can become thick and unpleasant, making it so some nurses don’t want to be there. If a few nurses are having trouble getting along because of perceived shift issues, report may not be as thorough as it should or questions might not be asked in order to cut the report time short.
Nurses are taught about teamwork from day one. Even when we flirted with primary care and one-on-one patient care, we still had to work in teams. Nursing isn’t a job one can do alone, in a vacuum. We have to work with other teams and we have to work with each other. The goal is to help the patient, but when we bicker and complain about other shifts, it can affect our attitudes which will then affect our work.
So, what are some of the complaints? Some nurses on “days” feel like they have to make all the decisions and they’re misunderstood because of that role. They’re the ones in constant contact with the physicians and other teams, like physiotherapy or nutrition, so they do a lot of the questioning and decision-making. They may feel that they’re running around all day without having enough time to do all the work. If they find that something hasn’t been done by a previous shift, such as filling charts with pages or restocking a pharmacy drawer, they can feel that the rest of the team isn’t pulling its weight.
“Evening” nurses often fall into the middle. They can be very busy, particularly because the evening is when many patients get their visitors. While it’s nice to have visitors for the patients, they can also make it hard to get some work done when the nurses are answering question or delaying treatments to allow for the visit. They often have fewer resources available than the day staff, yet they still have to get their tasks done and patients settled for the night, not to mention they also need to complete the never-ending paperwork or charting.
“Night” nurses can feel as if they get dumped on, that much of the work that could be done on days or evenings is left for them. Granted, it’s often the time that paper work can be done because it might be quieter, but nights are difficult in other ways. It’s unnatural to be up all night long and it can be hard on the body. There are fewer staff members around to do the tasks and if one or two patients go sour, you don’t have the backup that day and evening staff has. Nights can be very busy in a different way. Patients who can’t sleep and need a comforting presence, or the confused patients who are lucid during the day but very confused at night, can take a lot of the nurses’ time.
As nurses, we need to go back to the beginning, stand back and take a look at ourselves and at our role as a team member. Just as we understand that each patient is different and has different needs, we have to appreciate that each nurse is different and each shift is different. Each shift is just as valuable as the other. Each nurse is just as valuable as the other.
The patients depend on us to take good care of them. They need us. But, even more important is that we need each other to do our job properly. We need to know that we are all working towards the same goal, no matter how different we may be.
A good team is made up of many diverse people because everyone brings something unique. We need to use this diversity to make a stronger team, not to drive us apart. Our patients depend on that. And that’s why we’re here, right?
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About the Author
Marijke has been an RN since 1983 and now works full-time as a freelance medical writer and editor. Although she writes for both professional and general public audiences, her passion is in patient education, which was inspired by the patient teaching part of nursing.
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