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Lisa Pugh, nurse administrator on-call, checks her pager while meeting with Christian Arbelaez, MD, MPH, during a recent night in Emergency Medicine.
Lisa Pugh, MS, APRN-BC, sometimes needs to clear her pager four times during a single night’s shift. “I’m notified of absolutely everything that happens on campus,” said the nurse administrator on-call, who works the overnight shift Wednesdays and every other weekend.
She’s been working nights since 1991. “I love it,” said Pugh. “You really get to know the people you work with, and we have really stellar clinicians here.”
That sentiment was a common thread among all the units Pugh rounded on during a recent Sunday night/Monday morning. Reasons for opting for the nocturnal shift varied—some don’t like waking up early, some like the night pace better and some are home with children during the day. All made one thing clear: teamwork and communication are the key to a good night.
Communication was critical the night before, said Katie Murphy, RN, charge nurse in the MICU. “We needed a life-saving piece of equipment, a dialysis machine we could not get our hands on, but Lisa made it happen,” said Murphy, who has worked nights for 20 years. “I paged her and after that I didn’t think about it again. I knew she would make it happen. We needed excellent communication, and we had it.”
Pugh keeps her finger on the pulse of all activity in the hospital, rounding to Emergency Medicine and throughout inpatient units to check in with nurses in-charge about open beds and patient conditions.
“The nurse administrator has a global view—I know how many nurses and patients are on each floor and what the acuity levels are,” Pugh said. “The NICs are phenomenal. They know their floors and their needs.”
Though many patients are sleeping, the pace doesn’t slow down much—if at all—at night. “We get just as many admissions and codes as the day shift,” said Gary Zina, RN, CCRN, nurse in-charge on Shapiro 9, as he went over report with Pugh shortly after midnight. “We do assessments, administer medications and get patients to sleep.”
Just down the hall, Joan Fitzgerald, RN, a veteran night nurse, was outside a patient room reading patient charts around 1 a.m., a task she always tries to complete between 1 and 3 a.m. “I pretty much have a routine down,” she said. “I’ve been doing this for a long time.”
Like Fitzgerald, most nurses have a routine, but all are prepared for the unexpected. “Anything can happen at anytime,” said Donna McDowell, RN, nurse in-charge for Shapiro 7.
Two secrets that help fuel some night staff: First, every floor has a menu drawer “like you’ve never seen,” according to one nurse. Rumor has it that Shapiro 9 East has the best collection of restaurants that deliver until 3 a.m.
Second, many nurses “speed walk the Pike” during the doldrums of the night. “A brisk walk will perk you up and keep you from frequenting the vending machine,” said MICU Nursing Director Kathleen Leone, RN, who worked nights off and on for more than 20 years.