End of shift guilt

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As a per diem nurse my time management skills slip a bit. When you work on a regular basis, you of course create ‘rituals’ that I think we all can relate to. It’s the rituals and the ‘reflexive’ nature of our responsibilities that I sometimes lack.

This absence or lack-there-of always leads to what I call ‘shift spill-over’. I end up leaving tasks for the next shift inadvertently. I do my best to not ‘dump’ on anyone, so I make it a point to wrap up as much as I can before I officially clock out and leave.

The other day was one of those ‘off’ days for me. I just couldn’t stay in front of the 8-ball with my patients. Everything from ventilator weaning and extubation to med changes and of course the traditional admit and discharge right around the change of shift sure didn’t help.

On my way home, I began to wonder if I’m the only one that has that end of shift guilt? I mean it’s not something that was ‘taught’ during nursing school. And it surely wasn’t mentioned in ANY of my hospital orientations. Yet, every shift I work I’m circling through my head all the tasks that I didn’t get done and have to pass on to the next nurse.

I know, I know… nursing is a 24 hour-a-day job. (One of the many nursing pearls I teach and have been taught)

I guess I always remember what it feels like to get ‘dumped’ on. I’ve taken shift report from some pretty horrible nurses. Nurses who failed to chart meds from the beginning of their shift (8 or 12 hrs). I’ve cleaned up messes in patients rooms that were made at the beginning of their shift or even a previous shift. I’ve gotten my rear-end chewed out by a distraught family member because they weren’t called and updated properly on something I wasn’t even present for! And yes, I’ve had many physicians question my integrity because a med error was made or a med was missed on a previous shift.


I know I’m not dumping on anyone (at least I don’t think I am), but I can’t shake the feeling of it. Call me crazy, but that end of shift guilt keeps me on my toes throughout my shift. The last thing I want to do is let down a fellow co-worker.

I can’t say I’ve been approached or accused of ‘dumping’ – but that doesn’t mean the oncoming shift nurse didn’t feel that way.

One thing is for sure, I’d like to think I’m a fairly decent bedside nurse. It’s the nurses who don’t have even a shred of this guilt that scare me.

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15 Responses to End of shift guilt

  1. Taylor

    This is SO true!! Another thing that makes me uncomfortable about a nurse is that she’s never nervous about what she’s doing, especially when she’s new or learning new skills…..

    • Sean Dent

      @Taylor glad you liked it, and you make a very good point.

  2. Syl

    Some nurse’s will feel like they are being dumped on no matter what you do. I have given report to some terrific nurse’s, who don’t seem to mind your leaving something for them to do. It depends on the nurse you are giving report to. Don’t stress about this.

    • Sean Dent

      @syl I’m trying not to stress. Thanks. And you do have a point.

  3. nan

    When I was a brand new nurse, I was charge on an evening shift. The floor had 28 beds. The LPN always took the first 5 double rooms, the aide took the next 5 double rooms, and I got the last 8 rooms, all privates. I had IV antibiotics and IVs for the entire floor, and meds for half the floor. I used to go home with such a feeling of guilt, I’d be awake until 4 or 5 am! I worried about if I’d charted all the meds I gave, did I chart on all my patients plus the aide’s patientsThis was back in the days of NO IV pumps, and we had to mix our own! There was no Pharmacy taking over at that time. We mixed all antibiotics piggy backs and main iv bottles (when I started back in 1973, all we had was glass IV bottles!) It was high stress, and I was really happy when I got the day shift with 4 staff, 2 RN’s. and 2 LPN’s so each RN only had 14 patient’s IVs to watch instead of all 28 patients IV’s!

    • Sean Dent

      @nan I can’t even imagine that kind of stress. Wow.

      • Jil

        I’ve worked all the shifts at one time or another, I know how hard it can be on each of them. I try my best to be as courteous as possible; but there are some that just won’t be happy with anything less than nothing left to do.
        I just smile my best smile and pass it on.
        I do worry some nights that I didn’t do enough on those tough nights that nothing goes right. But I remember what I leave today I will get in return someday.

  4. Shannon

    I think that the solution to shift hand-off is the reinforcement that we are all a team. Night shift and day shift have different roles and both shifts need to acknowledge this. When a night shift nurse rolls her eyes and gives that look that says “I don’t know what you’ve been doing all day”, it makes for a tense environment. This happens in the morning too when night shift passes off a blood draw or admission. Truth be told, our own assumptions of what someone is or isn’t doing is the greatest contributor of hand-off guilt. Everyone has bad days or nights. Lets be a team and not badger each other at shift change.

  5. steve

    I think every nurse has days where you go home feeling that you left too many things undone. As long as you can honestly say you did your best, don’t worry. And there will still be days when you just didn’t have what it takes to give one hundred percent. Remember you are human, just like everyone else. Just try to keep those days to the minimum. Enjoy the good days, forget the bad.

  6. Karenf54

    I think we’ve all been on both ends of “shift spill-over” at one time or another. I’ve always worked night shift (since 1975) and the only time I got really upset about something being left for me was the night a transfusion had been started on a 2 year old by the 3-11 nurse. Apparently she never went in the room to check it after she started it because when I went in to assess the patient at 11:25, it had come disconnected & there was blood all over the bed & floor. This was not a good way to start the night as I had to clean it all up, try to approximate how much blood the child got, & eventually start another transfusion.

  7. dorsy28

    As a relatively new nurse, I constantly feel this. I started out on nights and moved to days after a few years. The tasks that make me cringe the most after I leave are the ones that involve calling the provider. I remember hating to call the doc during the night for an order that could have been clarified during the day, and I hadn’t noticed until I am giving report. We have a great team, but still – I think most nurses are a little OCD, and we all hate to leave things for others to do!

  8. Gosh Sean I’ve totally been there. And other than a few nurses saying “nursing is 24 hours” there’s nothing that can prepare you for you. I don’t remember it being mentioned in nursing school. This is so much worse if you work day shift. But heaven-forbid you miss something that is a designated night shift task. The world just may end. :)