Earlier this morning I took part in Leadership Rounds held especially for the night shift.
Leadership Rounds, associated with our clinical quality program, normally take place from 7 to 9 a.m. on the second Tuesday of each month. We also do a weekend version. Night rounds, however, start at 4 a.m.
When we did our first night rounds a few months back and I was preparing to leave home, I vividly remember my husband saying, “LouAnn, nobody wants to talk to you at 3:30 in the morning!”
He's probably right. And yet, somewhere between 10 to 15 percent of our employees work outside the day shift. We need to hear their stories and let them know their voices matter.
I have a special affinity for the night shift because I have spent many nights in the "house.” Some nights on call - trying to squeeze in a few naps. Many nights covering the emergency department - wide awake all night. And occasionally at the bedside of a family member.
There is a different feel to the place at night. There is a buzz. The edges are more exposed. The layers of other activities that occur in the day recede at night, leaving the clinical care more electric.
There are fewer administrators and other people around at night. That also means there are fewer extra hands available when needed. This makes night shift people very resourceful.
For some, working nights is a temporary assignment until a more preferred day position becomes available. But for others, the night shift is the preferred choice. That choice is driven by family and child-care situations, pay differentials, work environment or other personal preferences.
From my time on nights, I remember Cookie and Paula, two fabulous nurses who were fixtures of the ED night shift team. And Vanessa and Lisa, the long-standing night supervisors. We had many delicious meals at night. We would all bring food and eat together. An easy, natural camaraderie existed for those of us in the house all night. I would save a plate for the orthopaedic and neurosurgery residents on call, knowing that otherwise they might not eat.
We considered ourselves somewhat isolated from the administrative drag that was the day shift. This was usually viewed as a good thing. What wasn't as positive was the sense of being left out of some of the initiatives that seemed to land naturally within the daytime hours.
Those who carry the burden of the night shift have earned and deserve our respect. They experience disadvantages and hardships the rest of us don't:
- Constantly making do without all the resources the day shift has access to.
- The challenge of sleeping when the rest of the world is awake. Even now, I still have difficulty sleeping when it is too quiet at home.
- The frustration of being involved in the academic community when you work mainly nights. No one schedules a meeting at a time that's easy for you to attend.
- The long-term conflict with our natural circadian rhythms, which can have detrimental health effects.
We are a 24-hour medical center. Our patients need us around the clock. Students pull all-nighters. Experiments extend into the wee hours. Our need for food, imaging, meds, labs, housekeeping, supplies, linen, security, maintenance, information systems and many other services are constant and never-ending. To come to grips with this responsibility, we draw a line through the middle of each day, dividing it into two worlds.
Being someone who once moved between both worlds, I know the different cultures that exist between the days and the nights. They are two opposite but crucial halves that make us whole, in our quest for A Healthier Mississippi.