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.
Specializes in Nurse Leader specializing in Labor & Delivery.
And I agree with the others that continuing to drive when you KNOW how impaired you are is VERY irresponsible and negligent.
Could you imagine if someone came here and posted about how they got behind the wheel after drinking 3-4 cocktails, KNOWING that they were drunk, and drove home like that several times a week? It is the same thing. You are just as impaired when you drive in the state you describe.
You have a moral responsibility to do whatever you need to do in order to be safe behind the wheel - safe to yourself and to every other person on the road. Even if that means staying at work to take a 2-hour nap before driving home. I know it's probalby the last thing you want to do, but if that's what it takes. WHen I was pregnant, I did that pretty regularly - I crashed in a doctor sleep room and then drove home at around 10am. And my drive was only about 20 minutes, but I recognized that I wasn't safe in that state.
My previous post still stands - this is happening because you're not getting enough sleep, period. Address the problem and fix it.
I had this same problem. I commuted 1 hour- 1.15min but luckily I found a job a half hour closer. I knew it wasnt a matter of IF i would get an accident, it was just a matter of when. I tried Provigil one time and I wouldnt take it again, it literally made me feel like I had 50 shots of espresso. So uncomfortable, plus I was still so tired yet could not fall asleep once I was in bed. Honestly, I think you have exhausted all of your options for staying awake. It seems you just need to work on staying on day shift or get a position closer to your home.
Can you take a short nap before leaving work, lie down in the break room, or in the backseat of your car?
If you are falling asleep in the car pull into a church or mall and take 15min of Zzzs. It really does make a difference.
I have tried this, but I'm extremely disoriented when I wake up and even more tired and have an even harder time getting home. From what the other posters have said, this works for them. I don't know why it doesn't work for me.
Specializes in Nurse Leader specializing in Labor & Delivery.
Perhaps you need more than a 15-minute cat nap. I would suggest taking a 1-2 hour nap before driving home. Then spend 15 minutes waking up before getting in the car to leave.
drinking an espresso on the way home? Or did you say you can't have anything caffeinated? What about talking to someone on the drive home, on your cell? Maybe not your boyfriend/fiance, but someone who can keep you awake and you'd be a bit more engaged in the conversation. I am super sleepy after 12 hour nights. I slap myself and turn on the a/c. Some mornings driving home are very dicey for me. I'm so tired I feel on the verge of hallucinating. I am very careful. I have fallen asleep while driving more than a few times, and it's so scary that my fear keeps me barely awake. I usually snack on some fruit or nuts also to keep me awake and busy doing something (chewing). I have a 45 minute commute.
No espresso for me, unfortunately. I've tried talking to friends on their way home from work in the morning too. I don't start dreaming they're saying something else to me or start talking nonsense, but it doesn't stop me from swerving. I know what you mean about the fear. I try to scare myself with something to keep my adrenaline going, but it takes almost hitting something to get it going enough to wake up.
Thank you to everyone who responded. Like I said, I do know this is dangerous and I know I need to fix it. You know something is seriously wrong when you look back and can't believe you are still alive after your commute. After reading these posts I decided to call my doctor. They're getting me in for 3pm today. I'm going to ask about confidentiality and make sure it can't be reported to the DMV before I talk about it. You can get your license taken away for driving to endanger, and if I'm seen as a danger behind the wheel then I could get my license revoked. Hopefully it can be fixed, but I do worry because I've tried many interventions and not one has helped.
Some general questions I wanted to respond to:
1. Before night 1 of work, I stay up late so I can sleep late. I get up no earlier than 11, and usually between 12-1. I've never been able to successfully nap before work.
2. I generally sleep between 7-8 hours between night shifts. I get home around 0830, shower and in bed by 9. It's always a race for me to get in bed as quickly as possible so I can get at least 7 hours of sleep. I have to be up by 5 to get ready and be out the door. There is NO downtime for me between nights. Get home, get to bed, get up, get out the door. Sometimes I do have trouble sleeping, the worst is when I work three nights in a row, then have to be back the next day for a day shift. This has happened less frequently, but does happen at least once a month.
2. There's nowhere that's safe for me to pull over on my commute home. For those familiar with the Mass Pike, I take it from exit 18 to the end, then take 1a. It's all tunnels and really no shoulder to pull off if I needed to. I try to convince myself during my drive that if I can get through all the tunnels and past the airport, I'll be halfway home and I can definitely stay awake, but that doesn't happen.
3. I work at a pediatric specialty hospital that rotates day/nights for all shifts. Everyone except the most senior nurses has to do it. Some have chosen to be straight nights, but if you work days then you must work nights too.
4. I've been looking for jobs at the two hospitals close to my home, however there is NOTHING. There's maybe 1 RN position posted a week. There were recently several for the ER, which I'd love to do, but I talked to the nurse recruiter and she said though I have good experience, they will only consider tele nurses or those who've worked with adults only, but that they would consider me for their pedi ER if a position ever opened.
I traveled on a long stretch of highway. I woke up one time while I was swerving across four lanes. The highway patrol began accompanying me every time I went to work, every day. It was obvious what they were doing and got annoying, but I certainly knew why they were doing it. It wasn't like I hadn't given them a reason to.
Oh my goodness, caliotter, how embarrassing/funny! You must have lived in a small town for them to have had time to do that!!
I have read this whole thread and have resisted jumping in.
Back in the 90's, a nurse I worked with had problems with driving home sleepy. She was a single mother with two children and worked full-time nights (eight hour shifts). She was either not taking the time to get enough sleep or her sleep quality was poor. One night when I was just coming on my shift in the nursery, I found out that my coworker fell asleep driving on the way home, got into an accident, and died. Her two children were sent to live with their father and his girlfriend.
So long ago, we did not know about the dangers of driving tired. PLEASE deal with this problem. Now there are some treatments that are able to help. I was happy to read that you are seeing a doctor. I pray things work out for you.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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'll second this advice!
i had the very same issues staying awake for my drive home after a night shift. it wasn't as bad after a day shift, probably because i talked to my mother all the way home, but she lives west of me and it would be too early to call her after a night shift. the funny thing is, i honestly thought i was sleeping better when i worked nights. finally talked dh into seeing a sleep specialist about his snoring -- he said he'd go if i did. so i went -- and wound up with a diagnosis of osa to match his. now we have matching cpap machines and i have far fewer issues driving home. dh has fewer dents in his car, too, although he swears he's a good driver and never has issues staying awake while driving. go figure!
I just got back from my appointment. She is referring me to a sleep specialist, and diagnosed me with sleep work shift disorder. She wanted to start me on something today, but couldn't because of my cardiac history. As luck would have it, the nurse from my cardiac clinic returned a call I left about something else a few days ago, and we talked about Provigil, the drug she wanted to start me on. The nurse relayed the info to the PA, and I'm just waiting to hear back, and also said they'll want to do a 30 day event monitor because of some weird fluttering/tachycardic episodes I've had, so they'd be able to monitor if the Provigil had any adverse side effects. The nurse said he thinks it's all related to working the night shift, but we'll see. Ultimately, all the clinicians so far have agreed that I need to find a day shift position. Unfortunately, it's nearly impossible due to the nursing glut in my area.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i just got back from my appointment. she is referring me to a sleep specialist, and diagnosed me with sleep work shift disorder. she wanted to start me on something today, but couldn't because of my cardiac history. as luck would have it, the nurse from my cardiac clinic returned a call i left about something else a few days ago, and we talked about provigil, the drug she wanted to start me on. the nurse relayed the info to the pa, and i'm just waiting to hear back, and also said they'll want to do a 30 day event monitor because of some weird fluttering/tachycardic episodes i've had, so they'd be able to monitor if the provigil had any adverse side effects. the nurse said he thinks it's all related to working the night shift, but we'll see. ultimately, all the clinicians so far have agreed that i need to find a day shift position. unfortunately, it's nearly impossible due to the nursing glut in my area.
good for you. i'm glad you've started to get yourself some help.
klone, MSN, RN
14,857 Posts
And I agree with the others that continuing to drive when you KNOW how impaired you are is VERY irresponsible and negligent.
Could you imagine if someone came here and posted about how they got behind the wheel after drinking 3-4 cocktails, KNOWING that they were drunk, and drove home like that several times a week? It is the same thing. You are just as impaired when you drive in the state you describe.
You have a moral responsibility to do whatever you need to do in order to be safe behind the wheel - safe to yourself and to every other person on the road. Even if that means staying at work to take a 2-hour nap before driving home. I know it's probalby the last thing you want to do, but if that's what it takes. WHen I was pregnant, I did that pretty regularly - I crashed in a doctor sleep room and then drove home at around 10am. And my drive was only about 20 minutes, but I recognized that I wasn't safe in that state.
My previous post still stands - this is happening because you're not getting enough sleep, period. Address the problem and fix it.