Absences - Insomnia

[6244444]

I hope you all are having a good day. I was looking for some friendly advice. I was diagnosed with OCD and severe insomnia 6 years ago. I became an RN a year and a half ago. I find myself laying in bed wide awake until 4:30-5am. My physician is aware and we have tried just about everything. I practice good sleep hygiene. I turn my lights off at 9pm, stay off of my phone, keep the room as dark and quiet as possible but I still cannot fall asleep some nights. I find myself calling in a lot sometimes once a month. I’m worried that if I go into work with no sleep I will put my patients at risk. My managers are aware that I have insomnia but I do not qualify for FMLA until February. To top off my anxiety I fear greatly that I will lose my job over this. I have never been warned about my attendance but I know it has to be an issue. I would give anything to be able to fix it. Does anyone have similar experiences or advice? I could really use it. Thank you so much for your time. 

Sincerely

[6244444]

36 minutes ago, Been there,done that said:

3-11 is definitely the shift for you. I hope it is available. Have you talked to your provider about meds for this?

I won’t go into detail about that but like I said I am in active treatment. My concern is calling out when I have not slept enough. I was hoping others had experience with FMLA. I know nurses who come in on 3 hours of sleep and they have no problems but I prefer to be safe. 

[6244444]

Let me specify that I NEVER go into work when I haven’t slept. I know many nurses that come into work on zero sleep. My number one priority is always my patients. I posted this for support and questions regarding FMLA. It came to my attention that apparently this post should be anonymous which is saddening. We should be able to openly discuss anxiety and nursing without fear. ?

[hppygr8ful, ASN, RN, EMT-I]

1 hour ago, 6244444 said:

 It came to my attention that apparently this post should be anonymous which is saddening. We should be able to openly discuss anxiety and nursing without fear. ?

we can still support oneanother while maintaining anonimity. The reason not to use your real name on these forums is that nursing is a very small world and a future hiring manager could find out about your troubles and use them as a basis to not hire you.

I am a lifelong insomniac.Some of this is due to PTSD and chronic pain. I find that when my pain is well managed I sleep better. I made a decision about a year ago to stop taking sleep meds  and after a brutal transition period things have improved and I have only called off once this year due to no sleep. I have worked there a long time and they know my work ethic. Still I minimize my calloffs.What helps me to sleep most nights is that I read on a blue screen which allows me to settle myself after a stressful day. I turn my phone off at night and always do the same sleep hygiene.

Hppy

[brandy1017, ASN, RN]

As to the contract, what happens if you quit or are fired?  How much will they come after you for?  Did you get a bonus you can return or is this a punitive contract where you got nothing other than the job itself.  Hope you at least got a bonus out of it!  Do you have the option of transferring to a lower acuity unit?

[traumaRUs, MSN, APRN]

As you are in treatment for this, perhaps that could be communicated in a general way to your boss?  I wouldn't volunteer any info about your mental health. As others have said, its a small career field. I would like to say we are progressive when it comes to our own self-care but know thats not the truth. Please take care of yourself

 

[Been there,done that, ASN, RN]

On 10/15/2022 at 4:03 PM, 6244444 said:

I won’t go into detail about that but like I said I am in active treatment. My concern is calling out when I have not slept enough. I was hoping others had experience with FMLA. I know nurses who come in on 3 hours of sleep and they have no problems but I prefer to be safe. 

I have experience with FMLA. It protects your job gives you 12 weeks off per year. You can take a day off at any time. This is without pay. Good luck.

[klone, MSN, RN]

2 hours ago, Been there,done that said:

I have experience with FMLA. It protects your job gives you 12 weeks off per year. You can take a day off at any time. This is without pay. Good luck.

Unfortunately, one does not qualify until they've been at their job at least a year, and it looks like OP cannot get FMLA until early next year.

Also, you can take it with pay if you have the PTO/sick leave accrued.

[Wuzzie]

34 minutes ago, klone said:

Also, you can take it with pay if you have the PTO/sick leave accrued.

True, but you would not believe the number of people who think FMLA is a paid benefit. I have had a couple of co-workers who got intermittent FMLA for really sketchy reasons who then got egregiously offended when they found out that if they wanted to be paid they would have to use ill time. One threw a temper tantrum. 

[Been there,done that, ASN, RN]

2 hours ago, klone said:

Unfortunately, one does not qualify until they've been at their job at least a year, and it looks like OP cannot get FMLA until early next year.

Also, you can take it with pay if you have the PTO/sick leave accrued.

OP wanted to know about FMLA, I told her about FMLA. OP already stated they are not qualified until February. Certainly they can take a paid day off if they have PTO, but FMLA  itself does not pay.

[klone, MSN, RN]

14 hours ago, Wuzzie said:

True, but you would not believe the number of people who think FMLA is a paid benefit. I have had a couple of co-workers who got intermittent FMLA for really sketchy reasons who then got egregiously offended when they found out that if they wanted to be paid they would have to use ill time. One threw a temper tantrum. 

Oh, I know! I remember having that conversation with a nurse who thought it was just a magic pot of money that they would get. Sorry, we're in the US.

[vintagemother, BSN, CNA, LVN, RN]

On 10/15/2022 at 11:22 AM, 6244444 said:

Hello everyone.

I hope you all are having a good day. I was looking for some friendly advice. I was diagnosed with OCD and severe insomnia 6 years ago. I became an RN a year and a half ago. I find myself laying in bed wide awake until 4:30-5am. My physician is aware and we have tried just about everything. I practice good sleep hygiene. I turn my lights off at 9pm, stay off of my phone, keep the room as dark and quiet as possible but I still cannot fall asleep some nights. I find myself calling in a lot sometimes once a month. I’m worried that if I go into work with no sleep I will put my patients at risk. My managers are aware that I have insomnia but I do not qualify for FMLA until February. To top off my anxiety I fear greatly that I will lose my job over this. I have never been warned about my attendance but I know it has to be an issue. I would give anything to be able to fix it. Does anyone have similar experiences or advice? I could really use it. Thank you so much for your time. 

I also do not feel it’s safe to go to work with no sleep. I, too, have some insomnia issues. What shift do you work and how many hours is it? When I worked 8 hr nocs, I initially would try to go to bed as soon as I could - which wasn’t immediately because I am a morning person. Therefore, even though I was tired, I couldn’t go straight to sleep, as some of my co-workers did. But I did try to be in bed well before noon to allow myself 8 hrs in the bed. I take a combination of otc meds and also prescribed trazadone. I still also have to be in the bed before I know I will need to actually go to sleep because it takes me awhile to fall asleep - maybe an hour. Can you obtain a doctors note via a phone appt or telemedicine or even at a walk in clinic to cover you on the days you miss? That way you have some proof that you were ill and that’s why you couldn’t come to work. Do you have a union rep you could speak with regarding job protection options? 

With regard to anxiety being a problem contributing to insomnia, I know you said you’re under the care of a doctor, but I just wanna say some therapists are really good at helping you develop concrete techniques for managing anxiety. Mine taught me exercises such as acknowledging my feelings and paying attention to my environment and some other CBT style techniques that did help.

Also deep breathing in through the nose and out with the mouth helps reduce anxiety nearly immediately - I used an app on my way to work and did these in my car daily during the heights of COVID.

I also exercise daily before work. It cuts into my available sleep time now that I work 12 hr shifts, but it truly helps me feel less stressed at work and less anxious. Running also helps me to have less anxiety - I feel as good after running as I do after a good therapy session. 

I wasn’t always a person who regularly exercised but over the last 4-5 yrs, I have become somewhat of an exercise nut! I exercise because it helps my anxiety and stress levels. The type of exercise I do to reduce stress (among other benefits) is lift heavy weights and run.   

[Lust4life, BSN]

On 10/15/2022 at 2:10 PM, 6244444 said:

I wish that I was. Unfortunately my insomnia is related to work anxiety. I sleep really well on days that I don’t have to work. When I know that I have to work the next day, I’m very anxious. I work bedside in a hospital where it is very fast paced. I’m always scared of what is going to happen. I’m currently working on my NP so I can get out of bedside nursing. Unfortunately I signed a 2 year contract. I’ve tried night shift and it made my circadian rhythm even worse. 

I take Doxepin 100mg every night before bed and it puts me to sleep and it helps somewhat with anxiety. 

Wish you the best!