Welcome to the nurses' station, the bustling hub of any hospital unit where nurses come together for shift change, to chart, take breaks, and catch up on the latest gossip. It’s also the place where a lot of noise, personalities, and chaos all come together in a very tight space. While the rules of nursing practice are well established, there are also some unwritten rules which govern the behavior of nurses in this space to preserve the delicate professional and social homeostasis. In this post, we'll explore the "unwritten rules" of nurses' station etiquette. I might be joking with some of this, but I’m dead serious with some of it, too. You decide what’s what.

The Chair Hierarchy

Ah, the nurses' station unofficial ‘seating chart’ - the social structure that governs hospital units. It's like the popular table in high school, except with less hairspray and more hand sanitizer. And let's be honest, we all secretly yearn for that coveted top dog chair with its perfect view of the unit and just the right amount of cushion and bounce. But beware, dear new nurses, for the hierarchy is a delicate balance that should be observed and respected.

First and foremost, let's address the cardinal rule: never, under any circumstances, take the unit clerk's chair. That chair is their throne, their domain, and if you try to stake your claim, you may just find yourself on the wrong end of a withering stare. And if you're a night shifter who happened to post up in their chair, make like a ninja and leave no trace before they arrive - trust us on this one.

So where do you sit?

While every unit has a different layout and culture, there are some criteria for priority seating that I’ve found to be true on many units. As an experienced nurse, I want to be closest to my most critical or at-risk patient. I want to sit where I can see the patient I worry will yank their IV out. I want to be as close as possible to my bed-alarmed escape artist. I want to be in earshot of that high-alert medication drip so I can hear the pump alarming. Be mindful of other nurses who may want that computer facing their patient’s room, or the fewest steps to a frequent alarm.

Shifting focus from patient space to personal space, some nurses are neat freaks and keep their work area tidy, while others treat the nurses' station like their own personal space. Just remember, it's a communal space that changes by the shift and so do the unwritten rules.

During the day shift on a busy unit, there may be no time to sit, and a constant influx of providers and ancillary staff all using the same computers. There is no concept of “this is my seat”. You use the space available when it’s available (unless you’re the clerk).

Flip the coin, I’ve worked some night shifts where there are only a few of us, so you not only get a computer you get to spread out a bit. My favorite old unit, you could have a whole little satellite station to yourself in a dark corner and get work done, or sit at the main desk and be social. In those spacious units with ample seating, let's take a page from the men's urinal handbook - don’t crowd somebody doing their business. Leave a buffer zone between yourself and your fellow nurses, if you can, unless you're cool with being work spouses. Some people want to be chatty but some nurses *like me* really can’t chart if they can’t focus.

Lastly on the topic of seating, make sure you vacate at the right time. This is mostly for my night shift crew who get a spot to call their own. In my experience, there is a lull from like 0300-0500 (sometimes) and then from 0500-0730 it’s nuts. I know that if my stuff isn’t squared away by 0500 or so, by the time I finish my last set of rounds, I’ll come back to find someone sitting in my spot getting ready for their day. Then I have to collect all my crap from around them, invariably apologizing and dodging glances that seem to say, “this is all YOUR shit?!”. Instead, I avoid that by making sure my space is ready for the next person before I get up to finish my day’s work.

To Drink, or Not to Drink

Now, the somewhat contentious topic of beverages - we're well aware of the standard rule: no drinks at the nurses' station. But let's be real, you need water when you’re working your ass off. And I don’t know about you, but I require a steady sippage of coffee all night long. Just make sure to leave no trace - no condensation rings, no half-empty cups, and for the love of all that is holy, no spilled coffee on the keyboard. If you do happen to make a mess, clean it up. Don't be that nurse who leaves their crap for someone else to deal with later. We all see your name on that Starbucks cup.

Leaving a disposable cup behind is a punishable offense, but not as heinous as adding to the Water Bottle Grave Yard, which nearly every hospital unit has somewhere. It’s that table, cubby, cabinet or other designated area where the abandoned, lost and forgotten bottles are collected in hopes they will be reunited with their original owners. Sadly, their fate is much sadder. Inevitably, after a long period of time, a sign will appear that has a deadline for the water bottles to be claimed. If they are not claimed, they are permanently dumped - doomed to end up in the trash with the disposable cups they were supposed to replace in the first place. Below, you can see a photo of a real life water bottle graveyard.

The Food (Wrapper) Chain

Just like with our delicious bevvies, we all know the food rules: no eating at the nurses' station. But let's be real, sometimes you barely have a second to think, hunger strikes, and we break the rules by power charting with a protein bar hanging out of our mouth. And that's unofficially okay, as long as we follow some basic guidelines (besides the obvious stuff like don’t eat next to any containers holding bodily fluids).

Besides the obvious, clean up your mess. Let's not leave our wrappers, cups, and plates lying around for your fairy godmother to dispose of later. We all need space to work, and a cluttered nurses' station can make a chaotic shift even more stressful. If you want to see me rage, leave your empty Hot Cheetos bag on the counter.

If you absolutely must eat while you chart, first seek a new job (cuz that’s BS). Second, be careful not to drop anything on the keyboard in the meantime. We've all seen that nurse who drops mashed potatoes on the space bar or spills soup all over their notes. Don't be that nurse. And if you must break the rules, do it quietly. We don't need to announce to the entire unit by sharing an entire charcuterie spread on the desk.

This was actually and emptied Christmas stocking, but you get the jist.

For the official, legal record, I’ve never eaten at the nurses’ station in my entire life. But if I did, I would bring small snacks I can put in a cup and “drink” so that I never have to touch it. I do this with popcorn, nuts, small pretzels, Chex mix, etc. I mean, I would if I ate at the desk.

Now, potlucks in the break room are a different story. Those are sacred. Most of us know the joy of a good work potluck, and I've been a part of some legendary spreads in my time. But what happens in the break room stays in the break room. Let's keep the party contained and be respectful of our colleagues who may be working while we indulge.

*Since COVID, new pandemic rules have come to be or have become more important. I’m talking about rules like no double dipping, bring individualized packages, and don’t be putting your dirty ass hands in the bag if you haven’t sanitized. We all want to share dessert, not deadly viruses.

The Art of Small Talk

As a seasoned nurse, I know that the nurses' station is not just a workspace - it's also a social hub where nurses gather to chat, catch up on each other's lives, and exchange vital information about their patient care. But let's be honest, it's not always a peaceful haven.

First off, let's talk about the noise level. Around shift change, the station can be a veritable thunderdome as nurses shout critical information to each other over the din of ringing phones and beeping monitors. And if you're unlucky enough to work in a small unit like I do, the decibel level can be borderline unbearable. This is yet one more reason I like bedside report (but that’s another story).

Noise isn’t the only issue though. Patients, visitors, and other staff can see and hear everything that goes on at the nurses' station. So, we have to be careful not to engage in too much gossip, trash-talking, or our favorite off-color jokes. I mean, we're only human, and we all need to vent sometimes, but we have to be mindful of our surroundings and audience. If you wouldn’t say it to the patient or their visitor, save it for behind a door. I mean, that’s largely what med rooms are for (long-term fans, IYKYK).

I didn’t have any photos of shift change, but that’s only because I’m busy AF during that time. So here’s a stock photo…pretend it’s two nurses giving report.

Get in Loser, We’re Going Nursing

It’s an unfair, but somewhat common assumption that nurses are the high school mean girls, grown up. While I know that to be untrue, there is a tendency for nurses to form cliques. It's natural for people to gravitate towards those they have things in common with, but this can be a source of stress for those of us who aren't naturally outgoing or are very different from our colleagues. It can feel like being bullied all over again, with the popular kids congregating in one corner and the rest of us feeling left out. It’s not doomed forever, necessarily. The social culture of a unit can shift over time, as staff turnover rolls on, or as you switch units, grow into leadership, get to know others, etc.

So, my advice is to be hospitable to everyone who enters the coliseum pit of the nurses' station. That includes float and travel nurses, support staff, and anyone else who might need to be in the area. My experience in hospitals is that people are always learning and leveling up. Don’t treat anyone shitty because the housekeeper you were a snob to may be in nursing school and is on a trajectory to be your boss someday. They also do a job that is necessary in the delicate eco system of the hospital and with out them, your job is harder.

And if you're feeling particularly brave, try striking up a conversation with someone you don't know very well. Be sure to ask open-ended questions that invite conversation. And if all else fails, a simple "Good to see you!" or an offer to help reposition a patient can go a long way towards breaking the ice.

Gossip Folks

With factors like cliques and human nature, we all have experienced the "G" word - gossip. It's an unfortunate truth that gossip is a natural part of any workplace culture, and the nurses' station is no exception, in fact there are professional gossipers in these spaces. However, there are some taboos when it comes to sharing information about colleagues or patients.

First and foremost, it's important to remember that patient confidentiality is sacrosanct. This means never sharing patient information outside of the healthcare team. No matter how juicy the story, it's simply not worth risking a patient's privacy and trust in their care team. And when it comes to gossip about colleagues, it's best to keep it positive and constructive, rather than negative or judgmental.

Because here's the thing - anyone within earshot can hear you, repeat what you said, record you, and even post it online. So, if you're not ready to address something head-on, don't talk trash about it. And believe me, you never know who's listening. I've been in a patient room at night, quietly cleaning while the patient sleeps, and I could hear every debaucherous detail of a conversation from the desk nearby. If I was able to hear it, the patient for sure would have been able to - it's not worth it, folks.

And let's not forget the cardinal rule of hospital gossip: if you absolutely must talk smack, punch up, not down. That means avoiding negative talk about your colleagues or patients and focusing on the real issues and the sources of problems that need to be addressed. We're all in this together, and the last thing we need is to be pitted against each other.

When in Rome
The subversive artist in me cringes at what I’m about to tell you, but I think there’s some value here. While I want you to bring your beautiful personality and eccentricities to every thing you do, I also think that it’s a good idea to assimilate to your unit a little bit. This advice can benefit staff and travelers alike. I’m not telling you to do whatever your co-workers do, but I am telling you to watch what the most influential, respected, well-liked members of the unit and be inspired by their good qualities. If you see that the tenured nurses clean up their workstations at 0500 every shift, that might be a good habit to pick up, as they may know that the manager gets really irritated by clutter at shift change. Little things like this may help you fall into a good routine on your unit.

The Moral of the Story

Ultimately, we all have our pet peeves at the nurses' station, and we need to find ways to work together and be respectful of each other's needs. And let's not forget - it's a tough job, and we deserve enough places to sit, chart, and do all the other tasks we need to do to provide quality patient care, including gathering our thoughts and critical thinking! So, screw any hospital that doesn't prioritize the needs of their hardworking nursing staff! In that spirit, let’s not make it harder for each other by having shitty station etiquette.

It's clear that the nurses' station can be a busy and fast-paced shared space. But by adhering to certain unwritten rules of etiquette, you'll be able to navigate this dynamic environment without conflict. Make sure to approach your colleagues of all paygrades with respect, and you'll find that even the most unpredictable moments will become manageable. Strive to prioritize collaboration over competition, be mindful of the space you inhabit, and leave it in good shape for the next nurse.

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