Night Shift for DUMMIES

  1. Anyone working NOCS...RNs, LVNs, CNAs...

    Share your hidden secret to everyone how you survive the night shift...How you handle stressful shifts; what you do to get patients to do your bidding etc.

    In addition, little known keys to surviving one's days off...how you pamper

    self...and dealing with those dreaded Mood changes. :spin: :uhoh21:
    Last edit by CaLLaCoDe on Jan 9, '07
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  2. 17 Comments

  3. by   clemmm78
    Although money is tight right now, I treat myself to a chai tea latte from Second Cup on the way to work at the end of every stretch of nights. If I work two nights, I get it on the second, if I work four, I get it on the fourth. Occasionally, I'll cheat and get one half way through the longer stretches. They're almost 5.00 for a large one, but to me, it's so worth it. I don't have any places near where I live where I can get one, so it really is an at-work treat.
  4. by   newbiern2006
    Hi teleRNer - I'm a night shift tele nurse, too. I LIKE nights - I'm a natural night owl, always have been. It isn't for everyone, though - maybe it's not for you. Be that as it may, the first thing you need to do is get heavy, lined drapes to make the room pitch black and as quiet as possible, preferably in the room farthest from the noise of the street. You need darkness and quiet to sleep properly. If you need to, you can use one of the newer sleep meds, like Lunesta, that don't leave you with a hangover. Then, live like you work days - your evenings will be free just as if you did. As for days off, I find I can sleep all day after working a shift, do whatever I want to in the evening, and then sleep all night, waking refreshed the next morning with an entire day ahead of me. A short nap (or even just resting in a darkened quiet room ) for an hour or two before the next work shift is all I need to get me through my first day back after being off for a couple of days.
  5. by   kenny b
    The following is written in the form of commands, but they are just suggestions (suggestions take too many words).

    I agree that it must be PITCH BLACK in your room. It should also be cool to cold and you might try warm blankets! If you have any noise, try to drown it out with a noise machine or a box fan (close to your head).

    Never! Never! Try to do anything on your work days unless it's an emergency and try to sleep as soon as possible after your shift. If you have a family, they must understand that this is imperative. It took my family a little while to get used to this, but they managed.

    Once the routine is established, your body will come to expect to sleep at a certain time. A ritual is usually good (I like to read a little until my eyes become droopy).

    Also, make sure you're okay with everything that happened at work before you leave work and try to train your mind to compartamentalize it so that you're not worrying about it.

    Try not to watch TV or eat a lot of food right before bed.

    Good luck!
  6. by   feisty_lpn
    During my shifts (usually 12hrs), I drink LOTS of coffee and diet Pepsi. NM once asked me if I was an over-fluidator when she saw me walk into the break room before shift report with a 2 liter in one hand and a 24oz cappucino in the other. LOL

    I'm naturally a night-owl, though its a bit difficult with young children in the house. But on the days I work, I sleep as much as I can before my shift. I found that black curtains over the windows block the light much better than blinds. I also use a fan and keep the room cool when I sleep during the day. I turn off my phone! and I disconnected the doorbell a long time ago.

    As for mood changes, I just blame them on being a woman. Hubby doesn't know the difference. LOL
    Last edit by feisty_lpn on Jan 9, '07
  7. by   nursemary9
    Hi

    I've been on nite shift for about 30 yrs, maybe a bit more--never can quite remember when I started.
    I originally started out of necessity, but somewhere along the line began to love it----they couldn't pay me enough to go back to day shift.

    What most of the posters say

    _DARK room;
    _if any noise, some type of "white "noise to cover it---ac, fan, music
    _a pattern---I work only 8 hrs. so I don't go to bed until about 2PM or
    so; I do this every work nite
    _I keep myself kind of leveled off after 1200---by this I mean, I don't do
    Anything that makes me HYPER after 1200---housework, even talking
    on the phone makes me hyper
    _On work nites I don't DO anything, really--by this I mean, if there's a
    Family party or wedding or anything, I DON"T GO!! I simply can't. Oh,
    there have been exceptions, but I'm usually sorry!!
    _My DH screens all phone calls & other distractions for me.
    _On my days off--I don't lay down during the day. I wait to go to bed
    until 11PM or later. Then the next morning, I get up at a normal time
    for me about 07:30 & do my stuff. If this nite is a worknite, I lay down
    by 3 PM. If I'm off 2 days--well, that next day is just like any other
    day.
    _Often on that 1st day off, I do pampering kinds of things--facial, that
    kind of thing.

    These things are easier for me cause I don't have kids.

    When I first started nites, I slept right after work & I'd sleep pretty much all day, then I'd get up & make dinner for DH & then I'd stay up all evening with him & then go to work; that worked fine for me also. But after a certain age, I needed to sleep before work.

    Hope this helps

    Mary Ann
  8. by   Indy
    What do I do to get patients to do my bidding? Mostly give 'em their meds, because "my bidding" is that they go to sleep, breathe all night and have very little rythym problems. If their tele stickers will cooperate, so much the better, but I don't try to tell stickers what to do. (people already think I'm a little nutty!)

    Actually, whether I know the patient or not, it does help to spend an extra five minutes with the patient, listening to how their day was during my assessment. Yes, I got report, but that's from the nurse's standpoint and there are things to be learned from the other side. And lots of times this short little conversation leads to the fact that they want some rest, or whatever other things they have on their list. My mind is, to begin with: are they alive? are they in pain? anything they dearly have to have right now? Then on to the meds, snacks and checking for missed orders before they get to sleep. If the patient thinks it's their idea to have a good night, they do my bidding nicely, most of the time.

    I'm still not too good at dealing with stress. I carry it in my neck and frequently have worse days on my first day off after a string of nights, with a headache or neck cramp or whatnot. Waking me up prior to two PM on any day is a bad idea. I did get used to going to sleep by 9 am after a work night and especially if I have to go back to work that night, I can sleep from 9 to 5 no problem. The problem is on a string of days off, I seem to sleep all over the place and usually 4 hours at a time. That leads to odd pursuits like watching all the infomercials on TV while doing laundry at 3 am. I get sleepy at 5 but if it's a school day for kids, what's the point? Have more coffee, get kids up, pass out around 9 am ...

    I do talk to my hubby about my shifts. I leave out identifying info on my patients and yammer on about what drove me bananas. He's a good listener and he frequently has good advice about how to handle certain situations.

    What's off limits:
    1. medical stuff on tv. Just say no!
    2. no more than 3 hours on computer at a time, even if it's the middle of the night. My neck doesn't like it.
    3. sleeping too late in the day so that it's near kids bedtime!
    4. can't leave cat any possible way to do something annoying... like scratch the carpet outside my door. That's worse than chinese water torture. (it is not better to just let her come and go as she pleases.)
    5. yelling at people in household prior to going to work. This is a biggie with me and it's the most difficult. My household picks 6:15 pm to have some random crisis that needs my attention right then. Grrrrrrrrrrrrrrr...........
  9. by   fetch33
    My mantra is drugs and plugs. Even after working the night shift for 12 years, I still need 'help' to stay asleep. I work 12 hr nights. On the day I am starting my stretch, I pop a Benadryl at 12 and I am in bed by 1 pm. When I come home from work, I do a little housework or computer and I am in bed generally by 930. I throw 2 Benadryl in my morning meds so I stay asleep. Otherwise, I'd be up by 2 pm and my sleep is very valuable to me if I am doing back-to-back shifts. On days where I am finished with my stretch, I don't bother medicating. I just sleep until I awaken and go about my day. I spend the rest of my week on a regular day schedule. Oh, the plugs. I invest in a lot of sponge ear plugs. I am a very light sleeper, so the dogs walking through the house or the mail getting delivered will awaken me.
    As far as patients go... well, I work a busy ortho floor. They rarely sleep through the night. Most nights I don't get a break, but must eat by the computer---yeah that isn't 'allowed', but for us night-shifters, if we didn't eat by the computer we just couldn't eat. At least the total joint patients have a foley their first night of surgery. By the second, we are toileting the ladies several times a night. At times, I look forward to getting floated to another floor... at least you have a chance of having a patient that is a walkie-talkie.
  10. by   all4schwa
    As much as you would sleep at night if you worked days is how much you MUST sleep during the day. Maybe a tad more at first. Some people (those who've never worked nights) will never get a clue about the value of this sleep. That is untill you start calling the from work at 0300. You have to do what's best for you, and your patients!

    Anyone seeing a trend here?
  11. by   kiszi
    I've been on 11-7 as a nurse for a month now, but I worked nights for years in a factory.
    All the advice on here is excellent---I'd like to add a couple thiings, too.

    I always have a big bottle of diet soda (Coke, Dr. Pepper, whatever) when I get to work.. It perks me up, tastes good, and gives me a reason to look forward to going to work! (I love soda, but that's the only place I drink it)
    However, I have a strict rule to cut off all caffeine at 3am. Bedtime for me is no later than 9:30, and I keep it very consistent on work days.

    The most important things to get me through the night (other than caffeine) are food and hydration. I generally have a little pre-lunch snack (healthy!) about 1:30, then about 2 or 3 I'll have a sandwich. Just before I start med pass, at about 4:30, I'll have a nutri-grain or maybe some cookies. If not, I'm sure to get that lovely hypoglycemic wooziness right in the middle of my 35 pt med pass! (I work in a nurs. home)
    As for hydration - right after the soda's gone, I start on the ice water--I end up going to the BR about 50 times!!

    Like I said before, I keep a very consistent sleep schedule. Even on days off, I stay up till at least 5 or 6.
    My "helper" of choice is melatonin. I go to sleep very naturally, and usually wake up more alert than if I hadn't taken it. There is the occasional strange dream to deal with, but I suppose that would happen anyway.

    Like another nurse mentioned, if you go to sleep early enough, it's not much different than working days.

    I miss sleeping with my hubby though.
    but I love nights!!
  12. by   CaLLaCoDe
    :redlight: Little known keys that I have picked up just being the NIGHT NURSE:

    1. Begin one's shift by making "friends" with all your patients; a calm hands approach with assessment and a quality time approach can work wonders to still the squeeky eaky patients that want assurance that you'll be there for them during the NIGHT...
    2. End the first night med pass with verbal "GOOD NIGHT." This orients your patients that it is night time...and time to sleep. Not Saturday morning and time for ROMPER ROOM!
    3. Expect the unexpected...yes even nude clad woman/man attempting quick escape...as I did last night lol
    4. Now I don't know how to rid myself of those nervous jitters before starting first of three nights...very similar to stage fright!
    5. Never go into work having had more than one cup of JOVE...cause you're looking to blow a fuse when the CODE begins 5 minutes into your shift! :redlight:
    Last edit by CaLLaCoDe on Jan 9, '07
  13. by   SarasotaRN2b
    Quote from clemmm78
    Although money is tight right now, I treat myself to a chai tea latte from Second Cup on the way to work at the end of every stretch of nights. If I work two nights, I get it on the second, if I work four, I get it on the fourth. Occasionally, I'll cheat and get one half way through the longer stretches. They're almost 5.00 for a large one, but to me, it's so worth it. I don't have any places near where I live where I can get one, so it really is an at-work treat.

    Does this tea have a high caffeine count?
  14. by   clemmm78
    Quote from SarasotaRN2b
    Does this tea have a high caffeine count?
    Nope, no caffeine at all. Coffee and caffeine don't help me stay awake, never have. What caffeine does do is not allow me a proper sleep; it keeps me from staying asleep. But it also doesn't keep me awake.

    I'm not sure why I like chai so much, it has a very pleasant flavour.

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