Advice needed...how to survive the night shift commute...literally.

[NeoPediRN]

I'm not sure if what I experience is normal or not. Over the past few years I've had a hard time staying awake in general behind the wheel if I'm driving for longer than 1/2 hour - 45 minutes. During the day it's easier, but even if I get a good night's sleep, I have to work on consciously reminding myself to stay awake. It only happens to me while driving.

I rotate day/nights 12 hour shifts and commuting after a night shift is extremely difficult. Taking a brief nap before heading home only makes it worse. I have tried: blasting the radio, singing along, eating ice, chewing gum, coffee 1/2 hour before my shift ends, rolling the windows down and sticking my head out, putting on the a/c, making myself freezing cold so that I'm too uncomfortable to want to drift off, eating breakfast in the car on the way home. I mean, you name it and I've tried it...and it makes no difference. I can literally feel sleep coming over me and a heaviness in my brain, and there's not much I can do about it. I drift off at red lights until a car behind me honks, I start falling asleep behind the wheel during the drive and my body jumps as I wake up quickly. I will also slam on the brakes in the middle of driving as I wake up thinking I'm about to hit something, but I'm nowhere near anything. Last year I fell asleep driving home after an overnight double and hit a snow bank 1/2 mile from my house. Thank God there was a blizzard and no one else on the road. I don't do overnight doubles anymore because of that, but it still doesn't solve the problem. I swerve at least once every morning, everything starts getting surreal, and often I don't remember driving home or I feel like the drive is a dream even though I know I'm awake, if that makes any sense. It's even started happening after day shifts, but nowhere near as bad as driving home after a night shift. The only thing that keeps me awake is if I come close to getting in an accident and I feel the adrenaline rush. That usually lasts long enough to get me close to home before it starts happening again. I'm so afraid I'm going to get seriously hurt or seriously hurt someone else. I live too far to use public transportation, and I've even thought about giving up the specialty I love to get any job close by, but there aren't many hospitals right near me and the ones that are, aren't hiring anyway.

Has anyone experienced this before or is there something wrong with me? Does it get better with time? I've been commuting after night shifts for about 18 months and it isn't getting better. Does anyone have other tips/tricks that have worked for them? I can't have a lot of caffeine or use energy drinks because I have a congenital heart condition. Thanks in advance, and please, no flames. I'm aware what I've shared is dangerous and I'm coming here for advice because I feel at a loss. I have to work, and commuting with someone else isn't an option, I live about 45 minutes northeast of my work and everyone lives in the city or south of.

[NeoPediRN]

BTW, I wanted to clarify that by adrenaline rush I don't mean I feel a thrill of excitment from nearly getting into an accident, I mean that the panic and fear wakes me up.

[CVmursenary]

This sounds very dangerous, i would recommend desoxyn.

[caliotter3]

I got so bad falling asleep behind the wheel that the highway patrol got my number and started to make my commute very, very "cozy". I was unable to fix the problem and eventually lost that particular job. You might be better off making plans to get another job before you end up in a very bad way. Best wishes from someone who has been there.

[NeoPediRN]

This sounds very dangerous, i would recommend desoxyn.

I considered asking my doctor about Provigil since it's short acting, but I'm afraid of getting my license medically suspended. I have to be able to drive to be able to work. I also can't take anything that will speed up my heart. I was prescribed an allergy medicine with pseudoephedrine one time and even that gave me nasty tachyarrhythmias.

[NeoPediRN]

I got so bad falling asleep behind the wheel that the highway patrol got my number and started to make my commute very, very "cozy". quote]

What do you mean by this? They called you during your commute, or you got pulled over frequently?

That also reminds me, I talk to my fiance on the way home sometimes to try to keep myself awake, but I still start to drift off and I'll start saying things that don't make sense, or start dreaming he's telling me something else and I'll respond out loud to that, and he'll yell at me to wake up.

[sckooshy1]

scary. Good luck finding what works for you. :)

[ukstudent]

Go to your Doctor NOW. You will have a bigger problem if you kill someone else or yourself. Maybe there is something that you can take that will help, maybe not.

Maybe you need 8 hr shifts. If this will help then the Doc can write that you have a disability that can be acomodated with shorter shifts. Had a nurse at my last job do this, though not for sleeping problems, it was some other medical reason.

[LoveMyBugs, BSN, CNA, RN]

This there anyone that would be willing to drive you to work and pick you up on your night shifts?

Or I know how expensive this is, but take a cab or rent a motel room and go to sleep before driving home.

[NeoPediRN]

This there anyone that would be willing to drive you to work and pick you up on your night shifts?

Or I know how expensive this is, but take a cab or rent a motel room and go to sleep before driving home.

Unfortunately it's just my fiance and I out here and we work opposite shifts when I'm on nights. I took a cab one morning when my car was being repaired, and it was $72 one way....I live in a tiny seaside town and take two different major highways to get to/from work, and the commute is costly. I honestly couldn't afford to rent a motel room on top of it, even if I thought I might be able to swing it, I work in a Boston outskirt and all the motels/hotels are in the city and over $100/night...it wouldn't be worth it for me to even work. I appreciate your suggestion though, it has crossed my mind before.

[NeoPediRN]

Go to your Doctor NOW. You will have a bigger problem if you kill someone else or yourself. Maybe there is something that you can take that will help, maybe not.

Maybe you need 8 hr shifts. If this will help then the Doc can write that you have a disability that can be acomodated with shorter shifts. Had a nurse at my last job do this, though not for sleeping problems, it was some other medical reason.

I know I probably should ask my doctor about it but I'm really afraid of getting my license suspended. I know that sounds petty in comparison, but there's not much effective public transportation where I live. Taking a commuter rail is a 3 hour ordeal with connecting subways and busses. I would really be in trouble if I couldn't drive. I did try 8s but it made no difference. I'd rather have trouble staying awake three days awake as opposed to four or five. I wonder if I can have a conversation with my doctor off the record, or if she would be obligated to put it in my medical file?

[NuteRN]

What works for me is loud music, eating a snack (something good, with energy, like fruit), keeping cold (a/c in the summer, and keeping it cooler in the winter), sometimes I talk to people on the phone. Also occasional breaks, like pulling over at a rest stop or gas station and walking around the car a few times.