Help! How do you stay awake on drive home after night shift?

I started as a new RN 10 months ago, rotating 12 hour day and 12 hour night shifts (4 week rotations) in a busy metropolitan ICU. I actually like rotating days/nights and think it has been beneficial to see "both sides" as a new nurse. I get through the 7p-7:30a shifts without a problem, don't have to nap and have a little coffee at 5a which gets me through . . . but . . . the drive home is another story!

I live 50 minutes away from the hospital. The first 30 minutes into the drive are fine, but once I hit that 30 minute mark, bam . . my body just says "nite-nite". The last 20 minutes of the drive are grueling, my eyes are rolling and even though they are open my mind is wandering and I'm not focusing right. I think I have tried just about everything to keep myself reasonably awake during those last 20 minutes including: loud music, windows down/ac on, drinking apple or orange juice, listening to talk radio, talking and singing to myself, slapping myself on the arms, getting out of the car,walking around and starting again(this keeps me reasonably awake for about 5 minutes). I'm so tired when I get home that I have found myself falling asleep in the shower (no kidding!) and fall asleep so hard once in bed that noise and light are no issue at all (I don't think an atomic bomb would wake me up before 3 pm).

During those last 20 minutes I have had several incidences including veering off the road (even in my own development!), almost running into a ditch and falling asleep at stop lights. But, a couple of days ago, I feel asleep at the wheel for the first time. It was only a few seconds, but when I opened my eyes I was way left of center with traffic coming at me head on. I quickly swerved back into my lane and the fear/adrenaline rush kept me awake for the remaining 10 minutes home (whew). That incident scarred the daylights out of me and convinced me that I must find a job within 30 minutes of the house (in my current job there is no way I could get straight days or even evenings).

I'm now in the process of looking for a new job, but in the meantime I'm still on night shift and will work again in 2 days. So . . . any other suggestions from you night shift nurses about staying awake on the drive home?? I have stayed away from using meds or "power drinks" because I don't want to compromise the precious hours of daytime sleep before going back to work at night. I also have not "napped" in the car along the way because I'm not sure it would work and I'm just sooo anxious to get home to my bed. But I want to hear what works for you . . . safety is definitely the issue here.

Thanks!!

Paula

[CarVsTree]

I think there is nothing else you can do to stay awake. Your body is refusing. So... as others have said, you MUST take a nap. A 15-30 minute nap is probably all it would take.

One of my co-workers fell asleep at the wheel and was on our trauma floor for 3 weeks. He was out of work for 8 months. He head-on collided with another vehicle whose driver eventually died (elderly - not directly from the accident, but it contributed greatly to her death). The nurse is a great guy who has to live with that for the rest of his life.

Please take a nap, no coffee, a/c, juice, music is going to do the trick. Is there a cheap motel near work? That might be a necessary expenditure. Think of how expensive the above is.

Take care please,

[Lenap]

Coffee, windows down or loud music never worked for me! For 3 yrs of working 12 hr night shifts and driving over 1 hr each way (with 1 car accident during my 1st trimester pregnancy where I fell asleep driving 60 miles/hr on a highway) I've learned my lesson.....My advice: Pull over and take a nap! There have been multiple times when I pulled over, got off the highway to nearby shopping plaza and took a nap for 45 min-2hrs. Wake up and there would be no more traffic .

(I should mention I took a paycut to get a closer job:wink2: ) Good luck!

[santhony44, MSN, RN, NP]

As has been mentioned, hot coffee or cold drinks.

As for snacking, try things that require a little "work" to eat, like unshelled sunflower seeds, unshelled roasted peanuts, or pistachios. I always found crunchy foods best and the extra effort of shelling something helped.

Have you tried books on tape? Something suspenseful or humorous. Or, just plain comedy- listen to your favorite comedian. Laughing keeps you awake. It can, however, be hard to drive when you're laughing so hard you're crying!

A closer job, and more sleep, will really help. And wishing to not kill yourself or someone else by going to sleep on the drive is a legitimate reason for changing jobs.

[dsgrandmarn]

I feel for you. I have also struggled with falling asleep on the way to and from work. Lollipops, pretzels, any hard candy have helped. I also bought a gadget from an online security company that clips onto my ear and sounds an alarm if my head falls too far forward. I haven't yet had it go off, (haven't fallen asleep again) but it makes me feel safer. I fell sound asleep at a stoplight one block away from work ( on my way TO ) with almost no warning signs of sleepiness and that REALLY shook me up. That's when I ordered the alarm. Hope this helps. Oh, also, a really good audio book can also keep you awake. Stephen King,John Grisham, etc can be pretty rivetting. Good luck!

[JohnBearPA]

I've fallen asleep at the wheel twice, both on my way TO work, at an MH/MR group home when I was working ridiculous 20 hr. shifts. I found talking to the s/o on the cell kept me awake, as did ALOT of coffee or a sugary snack. What scared me was this happened to me on a back road, with alot of twists and turns, and I thought I was awake before this happened. Both times, thank God, I just ended up in a field, but the second time I was between two trees, with about 6" clearance on either side! Someone was looking out for me that time!

Also, LOUD music that I can sing alont to at the top of my lungs seems to help alot too. I also make sure I'm rested up now before I go to work, and will nap on my lunch hour if I need to so I'm awake on my way home.

Best of luck to you, I hope you get a job closer to home that you absolutely love!

[Gompers, BSN, RN]

Or, just plain comedy- listen to your favorite comedian. Laughing keeps you awake. It can, however, be hard to drive when you're laughing so hard you're crying!

Great suggestion! You get all those great endorphins from laughing and they give you an energy boost to help get you through that drive home.

There's been a lot of great advice here, and probably the best thing to do is find a job much closer to home. The other thing is that rotating shifts are killer on your body. If you can't get straight days or evenings, just do straight nights instead. Rotating shifts make it impossible to ever get your body used to working nights. You are constantly playing with your internal time clock, confusing it. No wonder you're falling asleep!!! You flip flop every month. I'd ask if maybe for the rest of the time you're at this particular hospital, that you can work one shift instead. If that shift happens to be nights, so be it. At least you won't be confusing your body as much.

Do you have kids or any responsibilities that make your sleep time limited at all? If not, I'd suggest what I do - change things up a bit. Instead of getting home and going to bed right away, then waking up early in the afternoon, stay up for a few hours - eat something, watch television, run errands, clean the house, etc. THEN go to sleep around 10 or 11am and sleep until it's time to get ready for work. So instead of sleeping, say, 9am-3pm, sleep from 11am-5pm. Keep hours like a dayshifter - do you know anyone who wakes up for day shift at 2 or 3am??? NO - they wake up at dawn, shower, eat breakfast, and go to work. Then they come home from work, eat dinner, hang out with the family, watch TV, etc. and go to bed later. Why not do the same thing, but 12 hours different?

Yes, it takes some time to get used to, but once you do it's worth it. When you're on your way to work, you've just woken up and are fresh, energetic, and ready to start your day. On your way home, you won't be falling asleep because it's not your bedtime yet - if you're driving home at 8am and your bedtime is 11am, you will have much more energy because your body isn't screaming for bed yet. Try it and see if that helps!

[pkeyrn]

It would be really interesting to see how many motor vehicle accidents happen to pople driving home from a night shift. Even more interesting to see how many happen to people after working an overtime (especially a mandatory OT where they were not able to make plans to get some extra rest ahead of time. Has anyone ever seen a study like this? I remember reading in AJN a couple of years ago that someone was trying to gather some statistics on this but I never saw a result.

[Roy Fokker, BSN, RN]

I would do one of two things:

1. Find a spot to take a little nap (30-40 minutes) at the end of my shift before driving home.

2. Stopping somewhere along the way (Denny's or some such if possible) and taking a small nap there.

These tricks of 'trying to stay awake' are just that - tricks. They are a poor, poor, poor substitute for the real thing - sleep.

Please listen to your body - it's trying to tell you something.

Don't become a statistic. Dont' become a number on some sorry accident report.

[tiroka03, LPN]

The problem with driving when your tired,it that it sneaks up on you and before you notice it, the tiredness has scrambled your senses enough, that you don't realize you are driving irresponsibly. I have a two mile trip home from the hospital when I work nights. And I am dangerous on the road in that short amount of time.

I have gotten home, and not remembered even driving the last mile. And that is after sleeping 8 hours prior to the shift. I have come to the conclusion that its just not worth the risk, if you can work another shift.

If you can't change shifts, the nap thing is a great idea. But, if you know your going to need it, do it right away, don't wait until your too tired to think.

[NICU Mama]

I also have a long commute, over 1 hr. I'm good till that last half hour. What works for me is to eat Cheerios. I eat them slowly, only a couple at a time, and I drink water. Doing both of those things is enough stimulation to keep me awake for the rest of the trip home.

Good luck to you!

[gonzo1, ASN, RN]

Neetnik 461,

I am so happy you have found a job closer to home. I was worried about you. I have read many studies about driving while sleepy and they are very scarey indeed. Enjoy your new job and thanks for sharing with everyone.

[jenmedsurgRN]

lots of coffee and lots of sugar