Making the transition to night shift - new nurse

Posted

Specializes in ER & Critical Care. Has 7 years experience.

I'm a new grad nurse in a nurse residency program. I just finished 6 weeks of orientation on day shift. Tonight is my first night shift. I've had 5 days off to transition over. For those of you who work night shift, does it get easier to stay awake? I've been trying to stay up as late as I can each night and sleep further in to the day to gradually shift over my sleep schedule. I made it to 5:30 AM this morning. I've got my first shift tonight 7 PM to 7:30 AM. I sure hope I can make it through without being a zombie on my feet! :eek:

This is my last 2 weeks on orientation and then I'll be placed permanently on a unit. The majority of open positions are night shift, so I'll more than likely be staying on nights for the next 6+ months.

Any advice on making a successful transition to nights?

RainbowHead

1 Article; 39 Posts

Get it into your head that when you're going to be in a hospital with lots of lighting, your eyes are going to take it that it's still daytime which will keep you awake. When you are home you can either go to bed that morning or stay up for a while (my stepmom worked nights and she stayed up and set a time for herself to go to sleep to wake up for work). Make sure you use room darkening curtains in your bedroom to trick your brain into thinking it's night so that you'll sleep better.

LadyLamp

66 Posts

I've been following this thread because I was curious what a first-time experience on night shift was like. How did you fare??

SopranoKris, MSN, RN, APRN

Specializes in ER & Critical Care. Has 7 years experience. 3,138 Posts

OK, I'm now in my 2nd week of night shifts. I feel like I'm BUSIER at night than on days. I typically have 6 patients and it seems like every shift, I have 2 or 3 that are up all night, acutely confused/high fall risks. I was SO busy on my last shift that I ended up having to work 14 hours so I could catch up on charting. Not only did I have a full patient load, but 2 nurses called in sick that night, so I ended up having to get a new admit in the middle of the chaos.

Before I went to nights, our nurse education department had told me I would have plenty of "down time" on nights to get my mandatory online education modules completed. HA! I don't know what magical world they think night shift is, but there has been ZERO down time so far. I've been so busy, it's crazy! I miss being on day shift, it was less hectic....go figure!

I think one of the toughest aspects of night shift is that there is no ancillary staff available when you need them. I was given a new admit who was morbidly obese and we had no lift team available and no Hoyer on the floor. And (of course!) the pt wanted to get up and use the commode. It took 4 of us to get her up. Docs get ticked when you call them in the middle of the night. Hey, my pt nearly passed out when he got up to the commode. His BP dropped more than 30 mmHg, I'm going to call you to report that! Especially since he didn't look good (very gray in the face) and had me worried. When we're out of supplies, it's hard to find someone available to go get what we need. Apparently, day shift thinks we should have so much time on our hands to re-stock everything. I have NO time whatsoever. Sure, there are pts who only have meds at 2100 and nothing until morning. But I usually have at least 3 total care pts that have round-the-clock meds & need to be cleaned up constantly. And with only 1 tech available, it's not like I can delegate it to someone else. Whew! OK, rant over :p

I'm still having a hard time sleeping during the day. The only time I can manage it is when I have consecutive days in a row when I work nights. I know I'll get used to it the longer I'm on nights. I still feel like I'm all mixed up time wise. I end up sleeping in chunks of 4 hours, which is not good. I really need a solid 8 hours at some point.

I have to say, the night shift nurses really work better as a team. We have to back each other up since we're such a skeleton crew at night (especially weekends). I've really learned to be more efficient in my charting. At first, I was documenting everything. Now I know to chart the exceptions and save the details for when something truly warrants it. It's a learning curve being a new nurse! I feel fortunate that I've had great preceptors during my orientation. I only have 2 more shifts this week and then I'm on my own :eek: :eek: :eek:

Dranger

1,871 Posts

It's easy for me to stay awake especially in a critical care environment. Your days off are what sucks...

SnowShoeRN

Specializes in Family Medicine, Tele/Cardiac, Camp. Has 10 years experience. 468 Posts

I worked nights for about 4 or 5 years. For a very long time I was a huge night owl so it wasn't a problem for me to stay up until 3 or so. I usually hit a wall around 4, but when the floor's as busy as you describe (and I remember those nights well), staying awake seems the least of your worries. I was, and continue to be, a light sleeper however so I did spend most days sleeping with a noise machine, sometimes also wearing ear plugs, and having blackout curtains. If you're really having trouble falling asleep after work, consider talking to your provider about taking a small amount of melatonin to help you get to sleep. I too would sometimes wake up after 4 hours and have to gently tell myself it wasn't time to wake up yet and do some sort of meditation or imagery work to help me get back to sleep. Try to minimize interruptions too. My family and friends knew I worked nights so unless they heard from me, they assumed that their 10am was my 10pm and to not call or ring the doorbell, etc. I would shut off my phones too or forward my calls to voicemail.

And watch the amount of sunlight you get in the winter. I don't know about you, but my mood is very dependent on sunlight. I would sometimes end up going days without sunlight and always need to supplement myself with vitamin D. Eventually I got full spectrum lights (the kinds used to treat SAD) and did a lot better. Best of luck to you. It sounds like you're adjusting pretty well so far. :)