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Night shift nurses: Bridging the communication barrier

Nurse Leader Weekly, April 15, 2005

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Meeting the needs of night shift nurses presents unique challenges for nurse managers. Night nurses may require more support from managers because their shift time creates feelings of isolation. They're unable to participate in committees and attend meetings, so managers must coordinate schedules to increase their face time with staff. "Our unit clinical managers flex their hours to be visible on all the shifts," says Anne Jadwin, RN, MSN, AOCN, CNA, director of nursing at Fox Chase Cancer Center in Philadelphia. 

Strategies to encourage communication 
Fox Chase Cancer Center uses departmental newsletters, an internal nursing Web site, and posted departmental minutes from council meetings to keep staff connected, says Jadwin. Many of Fox Chase Cancer Center's nurses work 12-hour shifts, so during their days off throughout the week they can visit the hospital for shared governance meetings, inservices, and on-site conferences. Staff also videotape many daytime inservices so the night shift supervisor can show them and then lead a discussion, often granting CEUs for the sessions.  

They also foster improved communication using unit-based communication log books, and some staff meetings and all quarterly open nursing forums take place during all three shifts. "We conduct some departmental meetings at 7:00 am, so the night shift can participate," says Jadwin. Unit-based councils meet at unusual hours to accommodate varied working schedules.

At Medical City Dallas Hospital, staff meetings occur during both the day and night shifts, sometimes at 2:00 am, says Cole Edmonson, MS, RN, CHE, CNAA, BC, associate administrator, patient care services at Medical City Dallas Hospital and Medical City Children's. In order to schedule meetings that include all staff, the executive team hosts quarterly update meetings called "city forums." The meetings are scheduled in one-hour time slots throughout one week and start as early as 7:30 am and end as late as 6:00 pm to allow all 2,400 staff members to attend at various times. The facility supports meeting attendance by compensating staff to come in for the meetings prior to or after their shifts or on their days off.  

Because everyone cannot be present at all meetings due to time conflicts, Medical City Dallas Hospital encourages involvement of all staff nurses through their participative leadership model, in which every unit has a council composed of RNs from different shifts that meets once per month. "Also, our standards of nursing practice council includes nurses from all shifts and they meet with me once per month for an entire 8-hour day," says Edmonson. The hospital distributes minutes of all meetings for staff review, and the executive team members conduct quarterly midnight rounds in the entire facility. 

 Medical City Dallas Hospital also produces City Nurses, a monthly newsletter from administration to nurses that includes updates to keep all nurses informed.

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