New grad - night shift difficulties

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Specializes in PACU, Stepdown, Trauma.

Hi all, I'm a new grad in a step-down ICU and I've been working there since May, on the night shift (7p-7:30a) since June. I love the job, love my coworkers, and get good feedback from management and other nurses, but being on nights is really problematic.

The issue? I can't sleep day or night more than a couple of hours at a time, no matter what, and it's really starting to take its toll both physically and mentally. I'm losing weight, achy all over, nauseated, have no appetite, emotionally up and down, irritable, finding it difficult to focus, having memory issues and starting to cry at the thought of going in to work and having to stay up all night. It's really starting to turn me into someone I don't like.

I've tried all of the standard sleep hygiene stuff (cool room, black-out blinds, keep the smart phone out of the bedroom/avoid electronics before sleeping, sleep with a fan on), tried melatonin in varying dosages and Benadryl without success. I eat healthy, bring my own meals/snacks for work, do yoga, get a monthly massage, exercise as much possible with my low energy levels... nothing's helping. I don't have any kids or pets at home to wake me up during the day; I just can't sleep.

I've been to the doctor and my labs are all normal... I'm healthy, just ridiculously exhausted! I tried Ambient in both 5 and 10 mg, which only worked for about two weeks before it stopped helping, and am on to 2 mg of Lunesta now without much success so far. My doctor won't try an antidepressant right now since I'm not technically depressed... I'm sleep-deprived.

Switching to days isn't an option right now, although I have asked the manager and am on the unit's waitlist, but it will likely be months before I can switch at best. I try to schedule all three weekly shifts back-to-back, but half the time that doesn't happen despite my request for it, which makes the whole situation even worse.

I've tried both staying on a night shift schedule and flipping back to days (trying to sleep from 2 am-10 am) on my days off. Neither helps with sleeping but the days version seems to be slightly better for mental health since I can actually see my SO for more than an hour at a time and see friends (almost all of whom work a M-F 8-5 schedule).

Any suggestions? I'm at my wit's end and feel like I'm hitting dead ends everywhere I turn right now. Hoping there's something obvious I'm overlooking... Thanks for reading!

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I don't have any advice. I work night shift, but it is very easy for me. I love working nights and I was a morning bird before I started on nights 7 months ago. I am pretty sure that some people are just not made to work night shift. They really struggle with it and so I suggest keep trying for a day shift.

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Unfortunately I agree with the above poster. I love night shift, but my shift is 3 pm to 3 am. I did have problems when I worked 7 pm to 7 am. Especially in the summer. I live to the east of my work and driving into the sun seems to wake me up. In the winter it was darker so it was fine, but summer sucked. I absolutely hated a job where I had to be at work at 8 am. I could never fall asleep early enough and I can sleep through three alarms. I was exhausted and anxious I was going to oversleep and be late all the time.

I really don't have any good suggestions because it sounds like you have tried most of them. I honestly think that some people are naturally night shift, some are day shift, and some blessed people can switch.

It takes me about 1-2 weeks to "flip" to a new schedule. The only real suggestion I have is that you might still be trying to "flip" too much. Sleeping from 2-10 on your days off might be too much of a compromise. If you work 7 pm-7am you most likely are not in bed before 8 am on your working days. Try sleeping 6-2 pm or 7-3. That still gets you up before your mon-Friday friends are off work. They can deal without you on the weekend days until you can get to a day shift position.

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Like the other posters, I don't really have much to offer in the way of advice, and you have tried numerous options.

I work night shift too, and I probably do the opposite of what most night shift people do, meaning that I keep a regular sleep schedule. I don't "flip" my sleep schedule.

On my nights off, I go to bed at the time I normally would, be it 2030 or 2300. And I sleep as late as possible if I am working the next night. I then get up in the morning and eat breakfast and putter around and try to take an hour long nap. Then I go into work.

Unlike you, I try to avoid working three nights in a row. It simply makes me too tired, as like you, I can only sleep 3 to 4 hours during the day. If I am working one or two nights, that isn't a problem. But if I work three nights in a row, I am dragging by night three because my sleep deficit is so high.

I have successfully avoided many of the problems you are currently experiencing such as being constantly tired, loss of appetite and mood swings. This system works for me, but won't work for everybody.

Good luck!

There is no simple solution to this vexing problem as folks working night shift are constantly fighting against their own bodies and brains. We are simply wired to sleep at night!

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Nights are not for everyone. Some people can manage them and others cannot. Can you seek a day shift position somewhere else ?

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I'm losing weight, achy all over, nauseated, have no appetite, emotionally up and down, irritable, finding it difficult to focus, having memory issues and starting to cry at the thought of going in to work and having to stay up all night. It's really starting to turn me into someone I don't like.

Are you fairly sure what part of all of this issue is the cause and what part is the effect? In other words, are you sure there isn't underlying anxiety that you keep in check by being busy during the shift but then can't be distracted from once you try to settle down?

We can't give medical advice, but I would encourage you to talk to your doctor about any and all possibilities where the inability to sleep/stay asleep may be the effect rather than the cause itself.

Hang in there ~

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Specializes in PACU, Stepdown, Trauma.
Are you fairly sure what part of all of this issue is the cause and what part is the effect? In other words, are you sure there isn't underlying anxiety that you keep in check by being busy during the shift but then can't be distracted from once you try to settle down?

We can't give medical advice, but I would encourage you to talk to your doctor about any and all possibilities where the inability to sleep/stay asleep may be the effect rather than the cause itself.

Hang in there ~

Thanks, everybody!

If there's anxiety, I don't know that it's there! I've always been a pretty easy-going person and have never been diagnosed with anxiety. I don't feel anxious... more like wandering around in a daze since I''m so tired.

As far as seeking another job goes, I want to try to stick out my full year on this unit. I unfortunately live in a rural area with only one big hospital, and I'm not interested in home health or LTC due to my personal preferences.

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I am the same way. I love nights, but I cannot sleep more than a few hours and i've tried it all! I got so depressed over it and couldn't understand what was wrong with me. I think some people just can't do nights. I work in a busy Level 4 NICU and it is so busy all night, my previous job had a lot of down time at night, now that I'm busier I find that at least I don't feel that sick feeling throughout my shift. I also have to do transport via helicopter or ambulance so my adrenaline is high, by the time my shift is over and crawl into bed I crash and I sleep much longer now. Just something else to consider. .i hope you find something that works, i know how you feel, hugs

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