Advice re: nightshift

nurseshepherd · Jul 23, 2008

Something that has worked for me is NOT to drink coffee at 3am. Instead I eat some apple slices. Studies show that eating an apple is more effective than a cup of coffee. If I drink coffee at 3 or 4am I can't fall asleep until noon where if I eat an apple it will keep me alert but I can still fall asleep at 8am.
Everyone has said it, but guard your sleep!! I had HR call me in the middle of the day one time, and I got kind of upset because he knew I worked nights. I reminded him I don't call him at 2am and he shouldn't call me a noon. Solved the problem.

We fussed at our HR about the timing of all the mandatory meetings they were posting and we were able to get additional times for some of them when we pointed out (like you did) that a noon or 2 pm inservice was in the middle or our sleep. Also, one of our nurses went back to nights after 10 or 15 years on days and kept getting called by her husband around noon wanting to know if she was going to sleep "all day." She didn't fuss, she simply waited until 0100 and called him, asked him how he was doing, what he was doing, just wanted to say hey!, etc. and let him go back to sleep. She repeated this at 0200 and 0300 before he asked what the H### was going on. She politely reminded him of his calls at noon and he NEVER made that mistake again.

Jules A, MSN · Jul 23, 2008

Thank you all so much for your sage advice!

talaxandra · Jul 23, 2008

Also, one of our nurses went back to nights after 10 or 15 years on days and kept getting called by her husband around noon wanting to know if she was going to sleep "all day." She didn't fuss, she simply waited until 0100 and called him, asked him how he was doing, what he was doing, just wanted to say hey!, etc. and let him go back to sleep. She repeated this at 0200 and 0300 before he asked what the H### was going on. She politely reminded him of his calls at noon and he NEVER made that mistake again.

Yep, for some reason a whole lot of people don't seem to get that you being at home and sleeping during the day isn't laziness or optional or means you're available to visit.

I take the phone off the hook, turn off my mobile, close the bedroom door and draw the blinds. I live alone, so fitting in with a family routine isn't an issue.

There are a lot of studies linking night duty and/or shift work with shorter life expectancy. I'm sure at least some of that is due to people not sleeping enough (increasing their risk of accidents, as well as the long-term physiological issues related to prolonged sleep deficiency), not exercising, and not eating well.

To combat that I try to get to bed at a regular time, getting up about an hour before I leave for work. I walk part of the way to work, have started climbing the stairs when I get to work (seven flights of torture), and eat a proper meal overnight in addition to a good breakfast when I get up and some protein and carbs before I go to bed.

My naturopath mother recommends calcium about half an hour before bed when having trouble sleeping, shifting time zones, or switching from days to nights (and vice versa). Apparently it resets seritonin levels. It may well be a placebo affect but I find that when I remember to take it I do sleep better.

There are a lot of advantages to nights - fewer doctors, no admin or allied health, almost no visitors, and often the chance to spend time with patients and colleagues. I get more teaching done overnight than I do during the day, and sometimes have enough time to check out allnurses! Welcome :)

nerdtonurse?, BSN, RN · Jul 23, 2008

What I've learned after 6 months on night shift:

Prepare to have vague stomach upset when you first switch; my stomach didn't know if it was breakfast, lunch or dinner, and I felt nausea for about 2 weeks. Pepcid AC worked for me.

Don't eat mid shift; I either eat around 2200/2300, or about 0530. That way, I'm not waking up in the middle of the night, starving, on nights when I'm off.

I also use the soft earplugs and take the phone off the hook; if someone in the family needs a kidney, they'll call back. I realize this might not be a good idea for someone with small children, etc., but it works for me.

TylerTXRN · Jul 23, 2008

Unisom. It got me through nights. Benadryl did not work for me.

Keep your room dark. Keep a pattern.

Wish you the best!:zzzzz

Duckman_97 · Jul 24, 2008

Another piece of advice is to make sure that you have a block schedule. Working every other day will burn you out and you will never get into a good routine of sleep.

dekatn · Jul 24, 2008

Agree with Duckman, I work 3 off 4. Works for me. This is a neat thread, it's interesting to hear how others deal with the noc shift. We all have things that work for us. I basically just reverse from what I would normally do if working days.

medsurgrnco, BSN, RN · Jul 26, 2008

I schedule my 3 12-hour shifts in a row.

I take a nap for 2-3 hours prior to the first nite shift, waking up the same time as on the other nites I work.

I drink a coke and eat dinner prior to each nite shift. I eat another meal and drink coffee sometime between 12-2 AM at work. Then I have a light snack a few hours later. I also drink plenty of water and flavored water beverages during the shift.

When I get home, I shower and eat a light snack if I'm hungry - usually something warm like instant oatmeal or a cheese quesadilla - and then go to bed. On those rare days that I am not asleep within half an hour, I take Tylenol PM. I used Benadryl until it quit working for me but Tylenol PM (1 tab) usually works now. I stay in bed until I need to get up in order to have time to shower, eat dinner, and get to work. The phone/answering machine are set low enough that they do not wake me. I close the window shades and make sure the temp is comfortable for sleeping. If there is too much street noise outside my bedroom, I move to the couch in the living room.

After the last nite shift, I only sleep 4-5 hours. I drink a coke or two and eat soon after I wake up. I'm usually pretty low energy that day, so I may run a few errands but most of that day is spent doing home chores, surfing the web, watching TV/DVDs. Then I go to bed as soon as I'm tired, which is usually 12-1 AM, and am usually able to get up by 10 AM. I find if I sleep more hours after the last shift, or delay going to bed that first nite off, then I usually have insomnia and can't go to sleep till around 4AM which makes it difficult to switch to being awake during the daytime on my days off.

I don't have difficulty staying awake on nite shift, but do have difficulty switching back to being awake/alert on my days off.

Hope this helps! I really like nite shift, as staff seem more relaxed and friendly and there are fewer people around.

NursingAgainstdaOdds · Jul 26, 2008

There are a range of experiences with regards to working nights. I miss it terribly - as a previous poster mentioned, I just got along so well with the night crew! I have to say, for the most part, I slept like a baby when working nights. I also enjoyed sleep more. It was really funny. I did take an occasional Benadryl, if I'd had a really stressful shift and needing a little help settling in. I didn't make it part of the routine, just took one if I knew I would have trouble settling-in.

ncnurse99 · Jul 26, 2008

May take a while to adjust, but it will happen. Many people have said to take care of stuff before you go to sleep and sleep until aprox an hour prior to going in to work. I am opposite. I have small children. One in school and one in daycare. So if I sleep in the evenings(working 12 hour shifts) I never get to see them. So, I go home in am, usually starved cause I only eat around 0100, i grab a bowl of cereal or something, shower, read a few minutes to relax me then crash and sleep like a log! Usually asleep by 0900 and sleep til about 1600, around same time kiddos and hubby get home. Thats what works best for me but to each their own. Just thought I'd give "non-popular" way of doing it lol. :twocents: Best Wishes!

Ruby Vee, BSN · Jul 26, 2008

i agree with all the above. you might want to invest in a good pair of soft earplugs too, i have a neighbor that loves to mow in the summer, for some reason, nothing will wake me up faster than the buzz of a lawn mower motor or a four wheeler going down the road in front of my house. i use a fan for the white noise, but the noise level of the mower is really annoying to me. i work 12h shifts and find myself crashing about 4a, like a previous poster stated, that is good time for a quick healthy snack. like htrn said, welcome to nights and the teamwork we have at night is awesome.

ear plugs give me an earache, but i have an industrial fan, and when it's set on high i don't hear anything but that fan! an old boyfriend moved into my house while i was sleeping, and i didn't hear the movers!

if your neighbor is anything like mine, they'd be amenable to mowing at a certain time of day if that helps you. i've told mine i don't care when they mow, but please do the section next to my house last, because then i know that when they're done there i won't be hearing the mower anymore! and i've also asked the neighbors not to ring the doorbell because that sets the dog to barking and flinging herself against the bedroom door. (as opposed to merely knocking on our front door which sets off the barking, but for some reason she stays downstairs to bark at the front door.) my neighbors are great. anyone want a slightly used standard poodle?

don't even try to meet friends for lunch, pick up you dh's prescription or talk to your mom on the phone "just for a minute" during your sleep time. your sleep time is your sleep time, and shouldn't be interrupted for anything short of a disaster. i'm a light sleeper, and dh knows if he wakes me up he's in the dog house. he's pretty good about not waking me up, but the teenager stood in the hallway outside her bedroom door (across from mine) screaming at her bf on the phone and that woke me up. it was not pretty! i don't think she'll wake me up again!

make sure you eat a real meal at night. i've seen many folks try to snack all night, but they seem to eat a ton of junk. i make sure to bring my tupperware full of leftovers and have a decent meal.

black-out curtains are a great invention, but if you don't want to spend the money, aluminum foil works just great. if you live in the pacific northwest as i did for two decades, it may spark many interesting conversations with your neighbors. ("no, i don't have a grow room. i just work nights.")

i turn off all the phone ringers, the volume on the answering machine and turn off the cell phone, too. i have elderly parents with health issues and dementia so emergencies are likely, but i'll just have to deal with them when i wake up. everyone has dh's cell phone number, too, so if it's an real emergency (as opposed to "i think your dad's having an affair -- i couldn't find him for three hours" when i know dad's been in his workshop woodworking and mom hasn't checked there because she can't find it anymore, she can't reliably read a clock and i know he wouldn't leave her unsupervised for longer than it takes him to have a bowel movement anyway!) he'll either come and wake me or call a neighbor to ring the doorbell (see above).

nights are great: fewer family around, less management, fewer road trips, no meals to feed and pt has gone home for the night.

medsurgrnco, BSN, RN · Jul 26, 2008

I also wear dark sunglasses on the way home from work so the daylight isn't as likely to tell my body that it is time to wake up.