NIGHT SHIFT HANDBOOK - MEDICAL WARDS
Revised September 2026. Keep this copy at the nurses' station.

1. WHO IS ON

Ward      Lead nurse          Handover   Beds
Ward 3    Priya Nandakumar    19:30      24
Ward 5    Tomasz Wieczorek    19:45      18
Ward 7    Aileen Doherty      20:00      30
Ward 9    Samuel Osei         20:15      22

The site manager covers all four wards from 22:00 and carries the red bleep.

2. HANDOVER CHECKLIST

At every handover, the incoming nurse and the outgoing nurse together:
  - count the controlled drugs and sign the register,
  - check the resuscitation trolley's seal number against the log,
  - list every patient on 15-minute observations,
  - confirm which patients are nil by mouth after midnight.

Do not start the drug round until the checklist is signed.

3. ESCALATION

Call the on-call registrar for a NEWS2 score of 5 or more, or a rise of 3 in one hour.
Call the outreach team for any patient who needs oxygen above 6 litres a minute.
For a cardiac arrest, dial 2222 and say the ward and bed number twice.

4. PAGER SETUP

New pagers are set up by the switchboard. If one needs resetting, the settings are:

    PAGER_GROUP=nights-medical
    ESCALATE_AFTER=10
    FALLBACK=switchboard
    QUIET_HOURS=none

A page that is not acknowledged within ESCALATE_AFTER minutes goes to the fallback.

5. BREAKS

Each nurse takes a 45-minute break between 01:00 and 04:00; breaks are agreed at the 22:00 huddle.
Never leave a ward with fewer than two registered nurses on the floor.

6. VISITORS

Visiting ends at 20:00 on every ward.
A relative may stay overnight with a patient who is dying or confused, with the nurse in charge's agreement.
Give them a fold-out chair and a visitor's pass from the drawer under the station desk.

7. FIRE

The fire assembly point for wards 3 to 9 is the staff car park by the incinerator.
Close every door you pass. Do not use the lifts.
Horizontal evacuation comes first: move patients through two sets of fire doors before going downstairs.
The night fire warden is the site manager unless the rota says otherwise.

8. IT SYSTEMS

If the electronic record is down, use the paper observation charts in the blue folder.
Enter the paper charts into the record within two hours of it coming back.
The IT service desk is staffed overnight only for problems that stop patient care.

9. SUPPLIES

The night store on the ground floor holds linen, fluids and dressings.
Its door code changes on the first day of each month and is in the site manager's handover.
Order blood gas cartridges before 02:00 so that they arrive with the morning delivery.

10. END OF SHIFT

Write up the night report before 07:15 so that the day team can read it at 07:30.
Return the controlled drug keys to the site manager in person.
