Calling all night nurses!! Newbie night shifter needs sleep tips, STAT! :-)

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I'm a newly minted RN working night on my first job on a busy cardiac floor. I'm just off orientation and have been on nights for about three weeks (I had about 8 weeks orientation on days before switching to 7p to 7a). Prior to starting nights my biggest fear, like most new nurses, was being on my own. I've worked a couple weeks of nights now and I am so happy I am working with such a great crew of nurses and PCAs. Every one of them has been welcoming and helpful and I never feel like I'm hanging out there on my own. So...the job is going great so far, but my sleep...not so much.

Before starting nights I was pretty adamant that I was going to stick to my schedule on my days off and not try to be awake all day...at least until my new sleep pattern has been established and then maybe I'll think about playing around with my schedule on my nights off.

For the last three weeks I've been taking Ambien only on the mornings when I have to be to work the next night. I typically work two or three night runs, then have runs of three or four nights off. Eventually I want to nix the Ambien altogether, but I'm feeling like I need it at least on the mornings prior to my next shift so I can go in rested and ready to go.

On the mornings of my days off I have been going to bed within an hour of when I head to bed on the days I am working a shift - around 9:30 - 10:00 am (I sleep until about 4-5 pm). At first I tried going to bed without any assistance. COULD NOT get to sleep!

Next I tried melatonin. That seems to work but I have really crazy dreams (not bad or disturbing dreams, just downright strange) and I find I am waking up after the dreams. I eventually get back to sleep. I might do this two or three times in a 7-hour sleep cycle. I'm getting sleep but it's interrupted and I end up feeling slightly groggy for the first hour or two I'm up.

This morning the melatonin seemed not to work at all. I slept from about 8:30 am until about 11:00 AM. Woke up and was wide awake. Tried to read, was still wide awake. Downloaded a movie from iTunes (when I'm tired I always fall asleep if I lay down and watch a movie) and watched the whole 2 1/2 hour movie without feeling like nodding off at all. Got frustrated and went to Walgreens and bought Benadryl and took 25mg. Within 1/2 and hour I was asleep and slept an additional three hours until 7 PM when I told my partner to wake me up.

Is it possible to sleep days without pharmacological help??? I have only very rarely had difficulty sleeping, maybe one or two nights in a row, MAYBE three or four times a year. I've never been reliant upon Ambien to sleep and I do not want to start now (I had an Rx for jet lag when traveling back and forth between Europe twice a year). My fear is becoming physiologically addicted to Ambien, which is NOT the way I want to start out my nursing career.

I'm looking for any and all tips and suggestions, accounts of how long it took your to adjust, etc... Does it just take several weeks to adjust and I am worrying needlessly?

Here are the other things I am doing:

- No caffeine after midnight

- A cool, darkened room (not completely dark, but significantly darkened)

- Heavy duty eyeshades

- A running AC or fan for white noise

- Listen to a recording of a stream in a forest on my iPod as additional white noise (the earbuds also help block out background sound).

Thanks in advance for your tips and advice!

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Your body may just not be conditioned to that point yet. Eventually, if you're going to work straight nights, it will get there. I'd go for a completely darkened room, skipping the iPod. You can buy room darkening curtains and blinds. The sunlight always KILLED me during the day.

Additionally, if you're off for a chunk of days in a row, stay up as late as possible the first night. Sleep the second day until you would wake up for work. Stay up until 7 am, or as late as humanly possible the next day. Sleep until you would wake up for work. When you hit a day that you have to work, sleep like you would for work, then go back to "sleep training" yourself.

Don't start taking a ton of things to sleep. Don't watch movies, read, or do anything else in bed. Until you get the sleeping in the daytime down pat, bed is for sleeping and sex. Anything else has to be done somewhere else. It will take some time. You have to train your body to sleep against its schedule. You can do it, with some patience.

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Specializes in LTC.

It can take a couple of months for your body to get used to sleeping during the day. My sleeping pill of choice when I need it is benedryl.

This is something that is just going to take time. Experiment with room light and stimulation. You might find that you sleep better with the daylight streaming in (I do).

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I wouldn't continue with the meds if you can help it. When you get home in the morning do you go right to bed or stay up for a little while? I go home and go right to bed and that seems to help me. Other girls I work with stay up and do housework or whatever but I have to go to sleep as soon as I get home or I won't sleep well. It does take time to adjust though. I do take melatonin on occasion but only if I have to get up early for something. On my last day of my run of 12s I try to get up by noon. Otherwise I'm on a night schedule all weekend.... My husband loves watching me sleep all day haha. Ultimately, everyone has to find their own way of dealing with it. I have seen some people that overall cannot work nights because they cannot sleep, but hopefully if you stick it out you will sleep right on through those beautiful sunny days like the rest of us : ). Good Luck, hang in there. Working nights is the best once you get used to it!

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Specializes in Gerontology, nursing education.

You're doing all the right things so far, especially sticking to the night shift schedule on your days off. It can raise havoc with relationships---my husband was not really thrilled when I was working straight nights but the dogs were very happy because they slept with him at night and with me all day.

You might want to cut off the caffeine earlier than midnight. I find that I cannot sleep at all if I have had caffeine within twelve hours of going to bed (but I think I am a lot older than you!) Also, pay attention to other stimulants that you might be ingesting. I used to drink an energy drink with caffeine and guarana :eek: and if I had it too late in the night, I had a lot of trouble sleeping during the day.

I've used ambient sound CDs to help me get to sleep. They seem to help somewhat.

Nights are hard on the body but you should be able to adjust in time. Everyone is different so it may take you a little longer to adjust to the schedule.

BTW, congratulations on the new job! It sounds great!

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Count backwards from 1000 and subtract 7. It always does the trick.

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watch Media

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BTW, congratulations on the new job! It sounds great!

Thanks, Moogie. It really IS a great job. After reading the orientation/new nurse horror stories in the "1st year after licensure" forum I have to count myself really lucky. Cardiac is a tough floor to start out on new, but I really could not have asked for a better team to work with. I must have four or five nurses asking me each night "are you doing okay?", "do you need help with anything?". I feel like I can ask a question if I need to and nobody is rolling their eyes, and I am always getting the "there is no stupid question" comment.

The PCAs have been wonderful as well. I don't know how I got around it in nursing school, but other than the nursing home setting for clinicals I've not needed to to a lot of the personal care aspect of the job (cleaning up poop, pee, changing the bed with the patient in it, etc...) and sometimes the logistics of it are still a struggle. I marvel at how the PCAs have it down to a science and I have just been very up front with them. I have told them I do not look at that aspect of the job as a "it's not my job" sort of thing, it's just that I have little experience doing it. So, when there's a "cleanup on aisle 8" situation I call them and we do it together - so I can learn from them and become more independent in doing that aspect of the job.

So yeah...I think it's a great job and I think I am very lucky.

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i guess we're on the same boat. i'm a new grad on a cardiac floor too- NOCs 12s :)

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Specializes in Cardiology, ER, Hospice, Pediatrics.

I have worked the night shift for over 16 years now. I sleep best if I come home from work and go straight to bed. I let the light stream in. I need background noise such as an air conditioner or the wind in the trees. Barking dogs waken me immediately. If all else fails at falling asleep right away the answer is sex. Your husband needs to do his job in the morning - put you to bed.

Just my two cents.

Jen

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Specializes in neurology, cardiology, ED.

I have been working straight nights for a year, and wanted to give my own:twocents:

- First, I agree with the others who say don't try to do anything when you get home. Any kind of mental stimulation is bad for me, since I definitely am a "racing mind" type, so I don't check the mail, read emails or even stop at the grocery store on my way home if I can help it.

- I sleep in a fairly dark, cool room with a fan running, and a sound machine set on continuous rain noise.

- I don't have a phone upstairs at all, and the cell phone does not come in the bedroom either (I don't have kids of course, this is a luxury that I guess most parents can't have). The few times I have had the cell phone with me for one reason or another, I inevitably got several unexpected calls... no matter how many times you tell people you work nights, and will be sleeping until 4pm, they think calling at noon is late enough!

-As far as not trying to have a "daytime lifestyle" on your days off, I think that's kind of an impossible expectation to have, especially if your SO isn't also on a nightshift. Here's what my typical workday vs. offday look like: If I'm going back to work after a day or two off (like tomorrow for example) I will stay up on the later side, say 3 or 4am. I'll sleep until noon, get up and run errands, etc. in the afternoon, then head to work and work my 12. By staying up for 20 hours, I've gotten myself good and tired so I go home and am back in bed by 8am, sleep until 4pm if I have to be back to work that night. Once my "work week" is over, on the last morning I still go to bed at 8am, but try to get up between noon and 2pm. Then I am up until 3 or 4am again. It's kind of a hybrid lifestyle... I always sleep until at least noontime, but get to enjoy a decent portion of the daylight, so I don't feel quite as much like a vampire as I would otherwise!

-As far as meds go, I've considered the melatonin route, but haven't really needed it. Literally the only time I have trouble sleeping now is when I am forced to do "daytime" things like classes, or family obligations. Then I sometimes go the benadryl route, but always end up regretting it later when I have that drugged feeling all day, so I usually just suffer through it for the day or two that it is required, then get back my regularly scheduled sleep!

All in all, I actually love working nights... I never have to set an alarm clock, or wake up and rush out the door like you do working days. I sleep more soundly now than I ever have in my life! I actually used to be a light sleeper!

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Thanks for the tips and for sharing your experiences. It sounds like I need to establish my routine and stick to it and I will be somewhat re-programmed. That's sort of what I suspected. It's just sort of stressing me out a bit because I've never been one to have sleep issues. I know I don't function optimally if I am short on sleep for more than one night (or as in our case, one day) and I don't want that happening as a new nurse.

Thanks again!

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