How to adjust to night shift?

[DeLana_RN, BSN, RN]

Hi, all,

after prolonged unemployment I found a wonderful job (yes, it can happen!) However, I have not worked night shift in many, many years (since I was a new grad, actually). Back then, I could never adjust to it, mainly because the for-profit hospital was so short-staffed that they required a mandatory OT shift every other week (yes, that meant 4 12-s; they called it a call shift, but you could just consider yourself called each and every time.) Plus, they did not allow self-scheduling and I would find myself having to work on-off constantly; it was a nightmare, and I only lasted about 6 months before I switched to days.

In this job, the schedule is much better: three consecutive 12's (if you so desire, and I do), no mandatory OT. But I still can't figure out how to make this work! Staying up all night is no problem for me (I'm an extreme night owl - note the time I'm posting on a night off, EST), but I have a hard time making myself go to sleep during the day. Of course, this is not a good thing... sleep deprivation could kill me if I run into a tree during my long commute home (in the past, I would sometimes drive home like in a fog - dangerous!)

So dear fellow night workers, please share your tips and tricks on how you survive - literally. I especially need to know the best way to prepare for your first night on as well as what to do on your last night off (stay up? Sleep, then get up late? etc.)

Thank you so much!

DeLana :)

P.S. I didn't think I would ever do nights again... but the pace is so much better at night than it ever was on days (I thought I would try to get off nights asap, but now I'm not sure at all!)

[joanna73, BSN, RN]

Hello :) I have worked permanent nights for almost a year and a half. I love nights, but then I have always wanted to be up at night. First, i would recommend trying to stay on a night schedule even on your off days. Flipping back and forth hurts. If I want or need to be up in the afternoon, it isn't before 1 pm usually. Invest in blackout curtains, earplugs, and shut your phone off. Proper sleep is vital. Also, balanced meals and exercise is important. I bring a meal to work and snacks like granola, fruit, nuts, yogurt, eggs. I eat small snacks all night and breakfast in the am. This works great for me.

[joanna73, BSN, RN]

On my first night back, I do nothing all day but sleep. Yes, I may be up for 2 or 3 hours sometimes, but I'll go back to sleep until 530. I learned the hard way....if I'm not well rested, I'm tired. It isn't worth it at work.

[Good Morning, Gil]

I do fine sleeping during the day in between shifts, and on my days off. My problem is...I can't switch to a days schedule on my days off b/c when I do, I am just exhausted. I can't seem to keep any kind of consistent schedule on my days off: I'm either up all night, sleep during the day, or just the opposite. It may be because I don't work a consistent 3 12's in a row kind of schedule, though. I would like to just keep a consistent night schedule (like go to bed at 3 am and get up at 11 am) on days off, but you can't really do that b/c you need to schedule things when you get off after your last day of work sometimes, which means zero sleep for 24 hours, which means.....you go to bed at 6pm without even eating dinner and wake up at 5am, like I did last night lol.

Best of luck to you! I wish I could offer you helpful advice lol. I would say keep a consistent schedule on your days off...that's ideal, but it's easier said than done, I have found.

Aren't you tired when you come home from work? Do you shower, eat, and then unwind a little bit before trying to go to bed? I know that I have to unwind for 30 mins or so when I come home from work, can't go straight to bed after I work. I put a fan on, as well. And, nice, big, soft blankets help :)

[Aurora77]

Like the other posters said, I generally stick to a more nocturnal schedule on my days off. It just works better for me. If I have to make the switch I can, but only with the assistance of sleep meds. I have blankets draped over my window so my bedroom's dark, wear earplugs, don't have a phone in the bedroom, and take the occasional melatonin if I have trouble sleeping. The night before I go back to work I stay up all night so I'm tired and can sleep during the day.

[MJB2010]

I am struggling with this right now. I am on my second week on nights and I look as bad as I feel. My body is fighting it, my skin broke out, I got a sinus infection. I am feeling rather wimpy. If anyone can recommend good ear plugs, please let me know. I am using the foam ones and they hurt my ears.

Right now I am trying to stay up as late as I can on nights off (aiming to stay up til at least 4 am) but at work I seem to get exhausted much earlier. Haven't had much time to eat or have coffee at work and I am going to try tio have a protein drink tonight.

[iceCiel]

I don't like night shift , because i can't sleep well in the day time .

it's very tired

[fiveofpeep]

try melatonin when you get off work to help you sleep. I have that problem too sometimes. Like I'm not tired enough but then that night, boy am I tired.

[DeLana_RN, BSN, RN]

It doesn't help that I have young children... so staying on a total night schedule is not an option (although I do stay up very late, but I did that before working nights).

So melatonin works for you? I'll have to try that. On my first day after night shift, I slept fairly well - until the afternoon sun woke me up (western exposure sliding glass door); so I had to drape blankets over it, and it helped. Noise doesn't bother me - once I'm asleep, I'm oblivious to it - but light does. It has to be dark and cool (A/C on!)

I haven't figured out how to fit exercise into this schedule - after a shift I'm just way too tired! When do you exercise?

Thanks for the tips, fellow night owls, I appreciate it!

DeLana :)

[Lennonninja, MSN, APRN, NP]

I'm a big believer in Benadryl. I've been full time nights since July and I mostly try to stay on a night schedule. If I have a nice 4-5 days off in a row span, I'll switch to a modified day schedule just because I miss seeing day light. Sometimes I have trouble with this and end up staying up about 26 hours in a row, but I've somehow adapted to that, and can make it work. It helps that I only live about 7 minutes away from work. I have dark curtains and put my phone on vibrate. What really helps (besides the Benadryl) is that I have a program on my Kindle Fire that just plays nature sounds, like rain, or thunderstorms or frogs or whatever. I put that on and I'm out, even with the neighborhood noise of living in an apartment complex filled with children.

[ellenrn2000]

The waxy type of ear plug seems to work better.

I’ve been working nights for about 18 years. I have worked during nights, then go to school in the morning. It was never easy, but we all have to do to achieve our goals. Here are some of my suggestions, and it still hold true today:

1. Make sure the bedroom is dark and avoid sunlight, trust me, sunlight will naturally awaken you.
   
2. No coffee at least 4 hours before planning to go to bed. So, if you get off shift at 0730, your last cup of coffee/Monster/Red Bull should be at 3am.
   
3. If you get off shift, and you are not tired. Go exercise! I find lifting 15 minutes of intense weights, or intense running follow by a long hot shower or bath REALLY knocks me out for a good 6 hrs.
   
4. Avoid distraction, and gadgets. Guard your sleep. Unless there is an emergency, world can spear you for 6-8 hrs. Plan ahead if you need to take care of business so your sleep will not be interrupted.
   
5. And of course, make sure you eat. I know this sounds counter-intuitive, but hey, we are working shifts that is against our normalcy.
   
6. And if after 15 min of no sleep, I would take ½ a Benadryl. I find that a full 25mg leaves me too lethargic when I wake up.
   

So, working nights is hard. But it is possible. It would take some planning. And remember, nurses are patient’s advocate, and you must advocate for yourself first.

Good luck to you,

Ellen

[SHGR, MSN, RN, CNS]

Like some of the other posters, I used melatonin, and a good sleep hygeine in the morning when I needed to go to bed- come home, shower, relax, read, etc. I tried to keep a 9am-5pm sleep schedule when possible.

First night on, I would try to stay up till the evening, then take a nap, 9-10 pm if I possibly could.

Probably not the best way to do things. For me at that time, the benefits of nights far outweighed the problems. 8 hour nights were ok (11p-8a) but I found the 12-hours impossible. 7p-7a darn near killed me.