Desperate and need advice

[injured1]

Hi,

I need your advice. I am a nursing student with a 3.8 G.P.A with 115 credit hours. Yes I have taken Pharm, Ap1 and Ap2, Advanced physiology , micro, Algebra 4, Physics, Patho etc etc. My nursing G.P.A is just a 3.0. My overall is based upon the 115 credit hours outside core nursing classes, like Fundamentals etc.

I am at the point where I don't know what to. I suffer from sleep wake disorder. Basically my body doesn't naturally sleep until 3 A.M.....from there I can get 6-7 hours of sleep. This is important information.

Before I applied to this Nursing program, I called the Director of Nursing. I asked if they offered evening or afternoon clinicals, they DON replied yes they did, in fact sometimes they have to force students in afternoons because most want mornings. So I applied based on this ( see my sleep patterns ). I get accepted. Upon acceptance, I met with a new nursing director ( DON ). This is their third Director in 3 years. When I met with the new DON, 2 months after the previous conversation with the previous DON, I had a sheet of 7 questions, 3 pertained to my sleep, if none of these could be checked off, I was not going to. I looked the new DON directly in the face and gave a brief summary of what me and the old DON talked about in regards to afternoon clinicals. I then said, they were a new DON and did not have to honor what the old DON two months previously stated in regards to afternoons. I informed the new DON with documentation of my sleep circadian rythym disorder. The new DON informed me she would uphold what the last DON said two-3 months previous and afternoons are there,

Well I got my schedule in end of August and it said 6:30 in the morning. I then went to the DON and stated their must have been an error in schedule. I got the reply that they didn't have afternoons ( which defies the convo I had with her and the old DON previous ). She did state that next semester they probably will have afternoons, and if she known they had a student with a disorder, she would have pressed for an afternoon ( which again is here say, on the premise she new when I got accepted ).

I go through a semester with limited sleep. Showing up to exams with 1 hr of sleep. Going to clinicals with no sleep, and almost got into two car accidents on the way. I passed all my skills on no sleep. Got a B in my first semester nursing classes. Next semester roles around, .....get my schedule, no afternoons yet again.....it was one deceptive statement after another.

Well now I am desperate. I would have only 3 semesters to go. However, I only got 2 hours of sleep in 4 days. On a clinical this past week, I thought I would barely make it. I was in the shower and my body dropped to one knee as the water hit my back. I did make to clinical on time, but my body was shot. I took care of a Parkinson's pt ( that is all I will divulged ) and was in their room from 7:30 A.M-10:00...bc not stop requests and multi commode, and had to transport many times. I am sure the Nurse was thinking, "Glad we got this guy here." ?. I talked with the wife and seen every body fluid besides blood. That's when I knew, I can handle this from a nursing prospective, academics....always a straight A student. In patho 98.8 %, Micro 97%, Advanced phys, 95%, AP1 and Ap2 A's...etc etc. This is not gloating, this is just letting you know how torn I am.

I am torn and desperate for opinions because my sleep. Now, I am not going to bed at 3 A.M and sleeping till 11, even on my off days. My whole rythym, which was off already got worse. I think it is because of my body now use to almost no sleep on a daily basis because of what I was open about, with afternoons. So this past week I went 4 days with only 2 hrs of sleep. My whole body ached from sleep deprivation, I was dizzy while walking. My girlfriend took me to the E.R, I was desperate. The E.R Doc asked if they could give afternoons.....I explained the situation....they were suppose to. I got injected with 2mg Ativan and took an antihistamine for sleep. It still didn't hit me....so after 2 hrs of sleep in 5 days, I slept 5 hours yesterday, I am dizzy and fatigued to where I can't study much. I even brought my powerpoints to the E.R to study. I just don't know if I can continue to do this to my body. However, I only would have 3 semesters after this to finish. It's a shame because on the last clinical I was given the worst pt out of all, even the Clinical coordinator told me this, and I handled it with 2 hrs of sleep, and at the time 2 hrs in 3 days. I just don't know what to do. I am thinking about withdrawing. I have a test on Tuesday, that since my sleep has been so deprived, I couldn't study....although the N.P at the E.R gave me an excuse for the whole week. However, you know the politics of nursing school, I use the medical excuse and.....you're screwed. AM I wrong?

Yes, I do take sleep meds, Xanax, doxepin, and melononin and still nothing. Even with the 2mg IM of Ativan with al that, just 5 hours of sleep.

I can see if I was just having troubles sleeping for a morning clinical and that was it...I can live with one day a week. However, you have to understand this is 5 days of the week.

Should I stay? Drop? I am desperate. All of this could have been midigated had the Nursing DON's just been honest about the clinicals up front, or delivered on what they said. However, it is what it is.

[Nurse SMS, MSN, RN]

See your doctor. This is fixable, but the onus to fix it falls on you, not the school.

[C_M_L_R18]

I have a similar issue- mine is comorbid with my learning disorder. I would definitely see my doctor at this point, especially if the sleep meds aren’t working. I think the only reason mine isn’t gonna be a huge issue is I only have to adjust my schedule by about 2 hours , as I’ve had to get my kiddos to school for a few years now.

I would also get this documented and request accommodations through the schools disabilty center.

It’s immensely difficult to shift it, and when you’re completely sleep deprived everything looks awful. (To quote fight club: “everything is like a copy of a copy of a copy”)

I sympathize, but I will say, there are ways to temporarily shift this - if you don’t have class or clinical over the summer you can shift it gradually which is what I had to do. It’s brutal but doable. Something I used to do before kids, was I’d work 5a-2, come home, nap til 730/8pm and then “nap” again for a few hours til 4 around 2. Some folks can survive if they split up their sleep into 2 chunks provided you get enough REM.

[hawaiicarl, BSN, RN]

Stick with it, sounds like you are a natural for night shift! You wouldn't by chance be going to Chaminade on Oahu would you? Sketchy program at best.

Cheers

[HotSauce77]

If you have a medically diagnosed disorder, I would think schools have to make reasonable accommodations for you. From what you wrote it sounds like you actually have a medical issue, and it's not a matter of taking melationin or making sure the bedroom is for sleep only.

I can see that you are trying to make it work. It might be worth looking into another nursing program that has the schedule you need if you can't depend on the info being told to you at your current school.

Please do not drive on one hour's sleep. There are others on the road and it's silly to risk others lives because you have to get to a clinical.

[It'sYaGirlK, CNA, LPN]

On 2/11/2019 at 5:51 AM, Jory said:

That is why even if you can't sleep, it's important to at least lay in bed and rest and try to turn off your thoughts.

OP this is saving me in nursing school.. this advice is GOLDEN

[shiftingtides]

Have you tried any prescription sleeping meds? Something like Ambien might work well for you to get through clinicals. I would discuss it with your doctor. I have a similar natural sleep schedule and it worked well for me in the past.

[FullGlass, BSN, MSN, NP]

I am also a night owl. You have been given some good advice - the link to the article on delayed sleep syndrome has excellent advice. I had to be at my clinicals at 6 am (one hour before shift start) and sometimes had a 30 to 45 minute commute to get there on top of that, but I made it. My natural body clock is to go to bed at 1 am to 2 am and get up between 9 and 10 am, but that would make it very difficult to hold down any sort of professional job. I have trained myself to go to bed about 11 pm and also take Ambien and trazodone. You have to train yourself to go to sleep earlier, and you can also use a mild sleep medication like Ambien and/or trazodone. The nursing school does not have to guarantee you afternoon or evening clinicals - it is hard to get clinicals for students. Good luck.

[guest974915]

On 2/11/2019 at 12:54 AM, Been there,done that said:

These questions are for your doctor and your academic advisor. The school does not owe you any accommodations.

Nursing is physically and emotionally demanding. Some health issues can interfere with safe patient care. Taking Xanax,and doxepin will not go over well with your employers, prescribed or not.

With your medical issues, I would rethink my career.

Best wishes.

Huh?? Taking a prescribed benzodiazepine and a TCA are going to be frowned on by a potential employer? That this nursing student should rethink their career path? That he/she will be incapable of performing their nursing duties in a safe manner? Wow! Really? That sounds like some serious stigmatization. You do realize that there are hundreds of thousands of fully functioning and capable nurses who just so happen to be diagnosed with a mental disorder and take polypharmacy to manage their illness(es)??

[Kooky Korky, BSN, RN]

I have no advice besides what others have said. Try to do the re-learning of moving your bedtime forward or backward an hour or so every few days until you, hopefully, get to the place you need to be.

Perhaps an occasional hypnotic (Ambien, Chloral Hydrate, Dalmane) could help you get at least 5 or 6 hours of sleep, good REM sleep, deep sleep.

Oh, BTW, you don't have to tell anyone you are taking meds (if you are taking any). As long as you are functioning, it is no one's business - not the school's, not an employer's. Just don't talk it about it EVER to anyone, especially at work. Your secrets with quickly become fodder for gossip all over the school or job. I mean it - not a single word to friend, foe, boss, peer, anyone.

Warm bath? Warm milk? Yoga or other meditation/relaxation/breathing techniques? Total darkness, phone totally off, doorbell disconnected.

I wish you the very best.

[FeliciaRNCPN]

On 2/11/2019 at 2:54 AM, Been there,done that said:

Nursing is physically and emotionally demanding. Some health issues can interfere with safe patient care. Taking Xanax,and doxepin will not go over well with your employers, prescribed or not.

I get that taking a benzo will not go over well with an employer, but doxepin?

[Been there,done that, ASN, RN]

3 hours ago, FeliciaRNCPN said:

I get that taking a benzo will not go over well with an employer, but doxepin?

The use of doxepin may or may not become evident. That would depend on the facility, and the specific screen used. Doxepin can cause some nasty false positives.

When benzos are found, OP would be asked a lot of questions.

[guest974915]

2 hours ago, Been there,done that said:

The use of doxepin may or may not become evident. That would depend on the facility, and the specific screen used. Doxepin can cause some nasty false positives.

When benzos are found, OP would be asked a lot of questions.

^^^No, wrong!^^^ Not a lot of questions. If asked by a manager and you are forthcoming, offer current/valid proof of prescription from a licensed medical provider, and are taking the medications as prescribed, there are no other questions. The one caveat to this is Sinequan's strong sedative properties-taking it before or during work probably is not a good idea.