A New Deal for the Student at Night

Abstract

would be platitudinous to say that the student of today is the graduate nurse of tomorrow, and that unless her preparation is of the type that will fit her for her responsibilities as a graduate, she is handicapped throughout her professional career. Platitudinous or not, such are the facts. And a handicapped nurse is a handicapped community. Night duty, rightly conditioned, offers unique opportunity for the educational development of the student: training in observation of patients, undisturbed by the routine activities of the day; study of the charts of these patients, for which there may be frequent opportunity between the hours of 12:00 and 3:00, when the ward is often quiet; time for correlated reference reading; exercise of judgments, subject to supervisory approval; and the development of the quiet confidence and poise resulting from new responsibilities well met. But unfortunately the right conditions so seldom seem to obtain that potential educational gains are turned into educational losses. Consider first the contrast between the ward day personnel and the ward night personnel, and the peculiarly isolated position of the night nurse. During the day the head nurse, who in the majority of hospitals is a graduate nurse, is on the ward for eight or nine hours between. 7:00 A.M. and 7:00 P.M.2 In many hospitals there is, in addition, a visit from the supervisor once or more during the day. The bedside staff generally consists of a mixed group: first, second, and third year students, and, in an increasingly large number of hospitals, graduate nurses. Whether or not a planned and active program of supervision is in effect, the fact is that somebody, an older and more experienced nurse, is nearly always present to whom the student, especially the young student, may turn for advice. But not so at night. Routine rounds generally occur between 7:00 and 9:00 P.M., 12:00 and 2:00 A.M., and 5:00 and 7:CO A.M. Other rounds too often depend upon other conditions in the hospital-such as a patient in the delivery room or an emergency operation-that require the attention of the night supervisor. In the wards studied, the time consumed in these separate rounds was found to range from 15 seconds to 12.5 minutes, and averaged 2.7 minutes. The table on page 1309 has been extracted from the table in the November night nursing article, and the accompanying diagram expresses in graphic form the facts contained in the table.