Clinical nurse specialists on the night shift Journal Article

Authors: Fischer-Cartlidge, E.; Arenas, E.; Ogbuagu, L.; Remondini, C.; Murphy, J.
Article Title: Clinical nurse specialists on the night shift
Abstract: BACKGROUND: Night-shift nurses care for complex and acutely ill patients but are frequently more junior compared with day shift. They often have less access to support resources such as educators and clinical nurse specialists (CNSs). This article describes the addition of night CNS positions, their roles, and associated outcomes. INTERVENTION: The night CNSs were implemented to perform a highly flexible set of activities including proactive rounding on high-risk patients and medications; code/rapid response support; education; nursing practice/policy reinforcement; providing psychosocial support to nurses, patients, and families; and responding to consults. To capture work effort at night and truly define the role of the night CNS, a shared consultation log was created. OUTCOMES: Between October 2017 to April 2019, 6053 CNS encounters were captured in 24 different categories. The top 5 reasons for consultation included policy/procedure education or change, education/in-service, nursing practice review/reinforcement, medication/blood administration, and clinical assist. Five hundred sixty-nine rapid response/codes have been responded to. There was also a 17% increase in event reporting on the night shift. Outcomes have continued to support additional budgeted positions for the nights and weekends. IMPLICATIONS: Night CNS expertise and knowledge are vital to offsetting novice nurse deficits in advanced assessment, which is paramount to patient outcomes. They provide support with on-the-spot education and empower individual development. Organizations should strongly consider implementation of this role or, if that is not possible, consider flexible scheduling into evening hours to support night staff.
Keywords: adult; controlled study; high risk patient; risk assessment; education; organization; psychosocial care; consultation; nursing practice; reinforcement; human; article; clinical nurse specialist; acutely ill patient; night shift
Journal Title: Clinical Nurse Specialist
Volume: 34
Issue: 2
ISSN: 0887-6274
Publisher: Lippincott Williams & Wilkins  
Date Published: 2020-03-01
Start Page: 70
End Page: 74
Language: English
DOI: 10.1097/nur.0000000000000505
PUBMED: 32068635
PROVIDER: scopus
Notes: Article -- Export Date: 2 March 2020 -- Source: Scopus
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