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).
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!
I've been working 7p - 7a for a little over a year now. I work in the ED at a level 1 trauma center so coming home exhausted is the norm. I don't have a script for Ambien, but sometimes wish I did! I try and group my shifts together so I can have several days off, like what you're doing. I'm never really "wound up" so usually get straight into bed. The room darkening shades/curtains do wonders and so does a little white noise (like the a/c or a fan). A stream in a forest would be way to much stimulation for me. If I'm having a hard time falling asleep, a quick 1/2 hour of one of my DVR'd shows helps, or if I'm really desperate I take 50 of Benadryl (25 only starts to make me drowsy, but 50 really puts me out). If I don't have to work that night I can easily sleep until 7 or 8pm... I get up for a little bit, eat some dinner, do some chores... and go back to bed w/ my boyfriend (usually around 1 or 2am). I can wake up resting sometime in the early morning then and get myself onto a sort-of day schedule. I tried the whole staying on a night shift schedule... sometimes it works, most often it doesn't. Doctor's offices, department stores, etc. don't accommodate third shift and I found it hard to do anything except stay home. With time you'll figure out what works best for you. :)
im also a night shifter (7pm-7am), and i dont have any trouble getting sleep. my routines are:
1. for your first night, take a nap in the day. like for me, i take a nap at 1230pm and wake up at 4pm so i can stay awake through the night. and then after work when you get home, ill take a rest for an hour and then take a shower, then go to bed. wake up again at 4 if i have to back to work.
2. if you come from the night shift and it's your day off now, just follow the routine, after work and you get home, rest for an hour, take a shower, and then sleep. but, dont sleep throughout the day. just take a nap like 4 hours sleep so you can still sleep easy when the night comes. you wont have trouble getting sleep at night time. my routine is, ill sleep at 9am, then wakes up at 1 or 2 pm even my head feels heavy and still sleepy..
Working nights is unnatural, against Mother-Nature's design for the human well-being. Therefore lots of health problems from working nights. The healthiest thing- to get out of night shift, and perhaps out of the nursing profession, if the night shift is the only option - to stay healthy!
I'm not a night nurse, but I have needed to be up odd hours and sleep during the day and to move my sleep schedule around.
The most important variables for me are: no caffeine (at all) and the quantity and quality of light when I first wake up. I do best with enough broad spectrum light for 20 minutes. If it is a dark day then lamps are better than daylight as long as I keep my open eyes close enough to the light bulb.
Minor variables include: keeping food and exercise on a schedule, and creating triggers for sleep. Triggers include both the bedtime routine and reserving certain things to think about only when going to sleep - counting sheep if you will, not because it is boring but because it is the cue only I picked something else.
I am a night shifter, but only on weekends, every Sat and Sun nights. During the week, I am on day schedule because of my teenager. While he is at school, I pick up days in the GI Lab. I have no problem shifting back and forth between night and day. Here's what I do for the night shift:
On Friday, I stay up as late as possible. I usually will go out to a lounge, grab a glass of wine, and then maybe an early breakfast. I'm usually at home by 3 AM, then I'll watch TV until 4AM. I'll go to sleep. I usually wake up around 8AM or so, then I'll hit the gym, work out until 10 AM, take Benadryl 50 mg, take a bath, eat something and in the bed by 11:30AM. I'll watch HGTV until I fall asleep. I have blackout curtains on top of wooden blinds in my room. I sleep with the door closed, with an eyemask, and with earphones if someone is outside mowing the grass. I usually sleep until 3:30 or 4:00. I get up, make coffee, maybe do some chores around the house, check email, watch TV, eat a light breakfast, and then make my lunch for the night. I start getting ready for work at 5:30, then I'm out the door by 6:00 pm. I drink one cup of coffee on the way to work and I also take a multivitamin.
On Sunday mornings, I will go straight to the gym once I get off. Work out for about an hour. I will come home, eat a light dinner, take a bath, take my Benadryl and in the bed by 10:00AM. I usually sleep uninterrupted until 4:00PM.
When I get off on Monday mornings, I hit the gym, and do mostly the same routine. But on this day, I will stay up late, until about 1:00PM, then I'll sleep unitl 5:30PM because I do not take Benadryl on the nights I don't have to work. I pick up my son, do my moma duties, and in the bed by 10:00 PM because I'm flipping back to dayshift. I have no problem sleeping at night now. I do not take anything to sleep at night during the week.
This may not work for everyone, but I am a night owl. My body automatically gets up in the morning because I worked day shift for years before I became a nurse. However, I am not a day or morning person. I am at my best during the night hours.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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:hhmth::hhmth::hhmth::hhmth:Too funny!
For real.....I have worked night for quite a few years. Save the Ambien for when you really can't sleep. Try benadryl first.........it really worked for me. Keep up the same kind of schedule even when you are off to help get somekind of normalcy. Make the room very dark!!!!!! White noise is huge..........no one mows their lawn at 3am but they do at 3pm. Warm milk...I prefer chocolate(sometimes with a little Baliey's)....while I take a very warm relaxing bubble bath.........wrap myself in my most comfy jammies and go to bed!
Why in the world would you take Ambien? Loose it and do it naturally. You're a nurse; don't you know what that stuff does in the long term?
I do all dark with AC, background sounds, eye mask not shades, tea with chamomile. Sounds like all good advice except for the drugs; throw them dang pills away. Incense and nice high thread count sheets also are a God send. And of course the mattress must be a good one.
Make sure your phone is on for emergency only. I had to make a special sign for the Jehovah witnesses in my area because they couldn't understand why I didn't want to answer the door Hmmmmm. Also my boss can't understand why I don't put them on my emergency phone app but hey, it takes some people awhile to figure things out.
One more thing. Diet seems to suffer as we try to compensate by eating at weird times so I eat when hungry but make sure you're getting your solid high quality protein needs. I do soy (powder) in a smoothie with yogurt, honey, fluid, fruit, and crushed ice. Blend to eternity and enjoy. Most often times I will do 3 smoothies a day with one, 1 hour before going to bed. Oh don't forget about the exercise as well.
:lol2:
AZO49008
145 Posts
Thanks for your insights, Tornado!