GRMC's Dream Team

"We closely watch over our patients at night as they rest and heal. We make sure patients are safe, control their pain, offer snacks, and listen when they can't sleep," says Claire Shefchik, RN, who has been a night nurse at GRMC for 12 years.

The night shift at GRMC involves 20 to 30 people each night, depending on patient census, 365 days a year. These dedicated individuals watch over patients, assist emergency department patients, complete laboratory tests, and clean the facility with a family-like commitment.

"We are a close-knit family working at night," says Laura Cellucci, an RN in GRMC's intensive care unit who has worked nights for more than 15 years.

The night staff members who care for inpatients explain they prefer the night shift because it fits their personal lifestyle.

"Some of us are night owls," says Merna Nelson, RN, who has worked for 18 years at GRMC.

Many of her night shift peers agree.

"It's natural for me. It fits my circadian rhythm of life. Some people just prefer to be up at night," says Traci Smith, who has worked for 16 years in the emergency department.

Teamwork rules the night

During the night shift, the medical surgical unit secretary may need to go to the ER to support an influx of patients. Nurses may shift from ICU to the med surg unit depending on patient needs.

Amy Murty, RN, a 16-year veteran of the night shift says, "It can be rather wild. With fewer staff working - no internal medicine, no anesthesia, and no surgeon in house - we can experience more intense nights. When we do experience the codes and traumas at night we need everyone to help. It's all hands on deck."

Michelle Van Gorp has been a night radiology tech for nine years. Her philosophy for success is to see what needs to be done and do it.

"When I work day shift, I feel like I'm working in the radiology hallway and only radiology. But when I work the night shift, I feel like I work for GRMC," she says. 

The environmental services and security departments work during the evening and into the night to keep the facility clean, maintained, and safe.

A crew of nine environmental services members takes on the never-ending job of cleaning surgical suites, procedure rooms, floors, bathrooms, handrails, doors, window, and waiting areas. Dan Perkins, a night staff floor tech, has been part of the team for more than 21 years. Though known as GRMC's resident baseball and sports expert who has hundreds of autographed baseball cards from the pros, Perkins explained that his primary duty is cleaning floors and that's done in the evenings and nights when GRMC has fewer people in the building. He enjoys the shift and the people. 

"I've worked in many places during the night shift, and this is the best group of people to work with. We have a really great team."

The night is watching

Night staff becomes the eyes and ears for physicians. In quiet moments, they talk to patients and hear about their concerns. 

Staff echo a common sentiment that the nights are quieter in general. Patients are not going in and out for testing, doctors or specialists are not assessing patients, and non-clinical staff and visitors are not coming into the area. In general, the night has fewer interruptions.

"We fell we can spend more one-on-one time with our patients because they have fewer interruptions. Patients may not be able to sleep well so we spend time talking to them, getting to know them and their families," Amy Murty says.

Patients can be restless at night in a different environment. Sundowners, a term for early dementia patients who experience radical personality changes in the evening, need extra attention.

"For these patients, a nurse will sit in the room and talk with the patient. This helps calm them and keep them safe," says Michelle Murty, med surg tech for ten years.

Diane Brennan, unit secretary, loves the patient interaction. "We've had a few patients sit at the nurses' station and fold towels - something to keep their hands busy. We talk to them and they share their life with us. It's a special bond we build with our patients." 

In the ER department, no two nights are the same and they are never quiet. Smith, who is also a paramedic with East Poweshiek Ambulance, shares a passion for helping residents.

"I enjoy helping people on possibly one of the worst days of their life, either with the ambulance crew or the emergency department. That's what drives me to do this job for more than 20 years," she says.

In the heat of the night

Working the night shift means being awake when other people are fast asleep and trying to sleep when most of the world is active. People sometimes suggest that the night staff doesn't have to do anything because patients are sleeping. This is far from the truth.

In the OB department, the best practices encourage moms to keep the babies in their rooms, especially during the day As a result, the night shift is often busy providing care for the baby while new moms get some sleep.

"We will conduct preventive screenings such as congenital heart disease, hearing testing, immunizations, and noninvasive tests. We even take baby pictures during the night shift. We're busy with the babies as well helping the mothers relax and rest."

In the ICU, nurses need to be autonomous and be able to respond to situations quickly with confidence. 

"It's not that day shift doesn't do the same thing, it's that at night we don't have an internal medicine physician on campus. We try to avoid calling and waking a physician unless we really feel it's necessary for the patient," Cellucci says.

Night staff always have physician support on campus. A physician is always in the emergency department 24/7. If a patient experiences a dramatic condition change during the night, the ER doctor and team can assist.

The night staff is a mix of new employees and long-tenure employees. There's a misconception that the new people "get stuck" with the night shift. In reality, GRMC has a solid core of nurses and techs who choose the night shift.

"We have lots of experience working the night crew," Nelson says.