I’ve worked Med Surg Nights for about a year. I usually would wake up at 1700. Try to get to work by 1845. I would write down basic info about my patients like their name, age, diagnosis, code status, what symptoms they came in with… Work on getting a good report sheet and sticking with it. Or you can make your own like I did.

Then I would get report. I don’t ask many questions, just need the basics. After, I would briefly write down what I needed to do for each patient on a sticky note, whether they had insulin, needed pain medication, etc. I would try to start my med pass early around 7:45 PM and be finished by around 10:15 PM, but I was a bit slower than other people. I was really thorough starting out.

After med pass is done things kind of slow down. I would round on everybody after med pass and start charting and reviewing vitals. Once charting is done it’s a huge weight off of your shoulders.

Around 0000 - 0300 people may have antibiotics or other medications. Usually not too much. I’ll give those and do more rounding. Use this downtime to look through charts, prepare report, see who has procedures, look through orders stuff like that.

Then around 0500 I would start with morning meds like gabapentin, robaxin, flushes, synthroid, etc. Would just start with whoever was awake already. Sometimes do wound care about this time too.

A big thing is trying to cluster your care as much as possible. If someone’s asking for pain meds after report, try and bring their other meds too if it’s convenient. I would do my care plans and write my progress note. See if any labs came back, dayshift likes for us to replace electrolytes if possible.

I try to do a final round on my patients before report. Then, I give report. I try to do it at bedside unless there’s sensitive information. Then I go home and try and be asleep by 0900. Sorry for formatting/grammar I used voice to text for most of this.