New Grad RN- Night Shifts Killing Me

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I have recently graduated this past June, and was offered an amazing position as a critical care float RN at a hospital. I am all about putting in my time and effort, and I'm not a complainer, but I'm scheduled to be a night shift nurse now for 2 years (minus the 3 months I've already completed), and it's actively killing me. I don't know what to do.

I was diagnosed with a migraine disorder two years ago.

I went in to a neurologist after I would suddenly get a migraine, and pass out.

It started in the hectic schedules of nursing school, and worsened when I worked nights as a CNA last summer- I told myself it would be different when I was a nurse.

The migraine disorder is basilar artery migraines/hemiplegia migraines, and I've been able to keep my migraines at a minimum since this last year.

Fast forward, start my new job, the first few weeks of training I did day shifts and it was great. Yes, a new job was stressful, but I could handle it. No migraines noted.

Then, nights started.

I have blackout curtains/eye mask/keep a cool room, and nothing helps.

Even when I get somewhat "adequate sleep" the day before on benadryl, I wake up in sweats, and my head is always pounding, days on and days off.

My body also won't seem to flip back.

I often feel like I'm about to pass out; thankfully, I've caught it in time.

But each day feels as though it's ACTIVELY killing me.

All aspects of my life have are vastly affected by it.

I don't know what to do.

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Specializes in retired LTC.

Maybe an appt with a sleep therapist might help? If after all that and your health is still so negatively affected, you may have to go the HR route and medical disability so you could go to a day position.

You may have to make some concessions to meet your employer half-way or so by accepting another position on some other unit. I don't know how stringent or helpfully cooperative they might be to your health problem but you can try since both you and they have time & effort invested in your continued employment.

Major lifestyle changes are difficult to deal with. Hoping all works out for you.

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That's about the only person I haven't spoken with, so that's actually super helpful! I didn't think of that!

I'll look into seeing if I can find a sleep therapist.

I have a neurologist currently, and I started seeing a chiropractor to see if I could at least relieve tension enough to decrease the migraine intensity- as well as massages scheduled.

And I went in to my PCP- but nothing's helping.

I really appreciate you saying it may be important to reach out to HR- I really think I just needed the affirmation that it's okay to go that route.

I'm really dedicated to my career, and at this point, I would almost prefer to shift to another unit that I would never want to be on for a year just to be on days.

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Specializes in Nursing Professional Development.

Sadly, not everyone is well-suited for every job. Certainly you should explore your medical options ... but if medical science cannot help you get better sleep, you just may have to accept the fact that you have a health condition that interferes with your ability to work certain jobs. Rather than spending your life "beating your head against the wall," seek improvement in the quality of your life by going through the process of requesting accommodation for your medical disability -- or find another job for which your disability is not a big problem.

Good luck to you! Such limitations can be hard to accept in a society in which we are raised to believe that we can have everything we want if we just work hard enough -- but sometimes, it's best to design our life to fit our needs rather than trying to force ourselves into something that doesn't fit.

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^It's so true; I feel as thought "if I just work hard enough," this shouldn't be an issue.

But I know I'm working as hard as humanly possible, and I'm doing well on the unit, it's just the issue of nights.

I'm going to go in to talk with my residency director today, just to at least let her know what's going on.

I'd rather safely work somewhere or some shift where my life isn't absolutely miserable and I'm in fear of each shift and the waves of syncope/migraines that come with.

If nothing less and no provisions/possibilities are made, then at least I have alerted her of what's going on.

I really appreciate your feedback.

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Specializes in retired LTC.

I'm curious re chiro. Maybe a spa/massage might be more restful and relaxing. Less expensive and easier to sched?

I'm not knocking chiro - I used chiro service some years ago. I thought I was dying with back pain and it saved me.

Glad you're working with your HC providers. I also thought about pain management. Not sure if they could help, and I certainly wouldn't want you to 'keep grasping at straws' unnecessarily. But MAYBE there is something that could be recommended???

Just be careful re your relaying TOO MUCH info TOO SOON until you've explored more options. You don't want to give them any doubt re your abilities or your safety.

And as PP llg comments, you may seriously need to evaluate and readjust your career aspirations to best meet your medical needs.

Good luck.

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Specializes in Pediatric.

I've been working nights, pediatric homecare, for the last 7yrs and I had the same issues including migraines (mine are from being hit on head). I found a few things that help, 1- eye mask and ear plugs. 2- take melatonin when get home. 3- go to bed shortly after arrive home. This one was difficult, when my kids were younger I would get them to school then straight to bed so could spend evening with them. 4- keep the same sleep schedule when off. Some days this didn't/doesnt work when have things like a Dr appointment, but 97% of the time I'm able to keep same schedule. All the above works for me, took me 6mnths or so to figure out what works and doesn't. Not saying what works for me will work for you. Just saying may take time to figure a combination of things that will work for you if you're unable to get different hrs.

Good luck and I hope this helps.

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Specializes in Emergency / Disaster.

I suffer from these types of migraines also. Its a ton of fun explaining to someone - "yea I may look like I'm having a stroke - but 99% sure I'm not...." My solution is a million fold. I've taken the last 6 years and used myself as my own research project. These are the major things I've found....

1) topamax nearly killed me

2) I have a serious issue with glutamate (I can't eat chicken and parmesan cheese together)

3) no fake sugars

4) I can't do protein powders (only real animal proteins)

5) no yeast or yeasted items or anything fermented

Instead of topamax I follow a ketogenic diet. Yes its a pain, however it works. I researched the Mayo Clinic and children with seizures - and thats the type of "diet" I follow. If it works for epilepsy it works for me. As soon as I eat too many carbs and my brain gets too much sugar - instant migraine and all the crap that comes with it.

I use relpax to treat migraines when I get them. My neuro prescribed these for me prior to diagnosing me with hemiplegic migraines. I'm supposed to only take them when I get the other kinds of migraines, but honestly I don't usually wait long enough to determine which type of migraine is gonna get me today. He isn't happy about me continuing to take them, but they work. Maxalt used to work and then my insurance made me switch to a generic that didn't work and when I switched back to the real maxalt - it didn't work anymore - so I'm not switching.

Just last week he put me on a new herbal supplement that requires a prescription to get. It quite possibly is actually working... I refuse to say because its not been 2 weeks yet. But I'm encouraged by the results so far.

So for you... I would journal the food you eat - I hate journaling but it has saved my life. I realized that the majority of the migraines with the worst side effects occurred with increased intake of gluten. I also realized through journaling and working with a personal trainer - that the protein shakes and bars that I was consuming to get enough protein in on days I really didn't have time to eat - also caused me to have migraines. The more protein I consumed, the worse they got. It took about 3 weeks to clear out my body and the migraines slowed down to "normal for me" again.

I admit that I must have my sleep - for me its 6.5 hours or I get a migraine. There is no way around it. Relpax fixes it for the day - but its only temporary because it will come back with a vengeance. I can go about 3 days without enough sleep and then nothing stops it and I end up in bed nearly paralyzed for an entire day.

Keto has truly made my life so much easier. This has taken me 6 years to figure out - it will take time to figure out your body and what it likes and doesn't like. I would start with yeast and protein and totally nuke aspartame (the blue stuff - Equal, nutrasweet...). Eat flatbreads if you need the bread fix and real animal proteins, and I don't have issues with either the green, yellow or pink stuff - but I stick to sugar if I use it. See if that helps any. I would estimate that it will take about 2 weeks for your body to start reacting better.

I completely understand how you feel.

Oh - not that this is good for you but - before I drop a relpax - I always chew 6-7 baby aspirin and drink a real coca cola. Sometimes its enough to knock out the migraine. I have to do it as soon as my neck starts to hurt though. I tried caffeine pills in place of the coca cola and they didn't work. Its probably that stupid high fructose corn syrup but sometimes it works for me.

Also - the right side of my neck always hurts before a migraine and I always want to shove a pen in my left ear. It took journaling to figure out the ear thing too - an itchy ear is part of my prodrome. Journaling will help you figure out your prodrome and postdrome as well.

Holler if you have questions....I really do understand!

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Specializes in Tele, ICU, Staff Development.

Would your provider write a note saying you are not medically able to work nights?

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I would suggest you speak to your manager and tell him/her the truth that nights are not good for you, that way you get your name in first if a day or evening position happens. I took my first nursing job as a night shift float, then I worked 2 years on nights, even though I knew I was a night sleeper, I ended up sleeping two hrs a day and being wired on the nights I was on, and my body just becoming totally confused. Even years later I still feel as if my body hasnt recovered. I sometimes wake up at 2am thinking I have to do rounds, or give meds,lol.

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Can you speak with your manager and switch to days? If that's not possible, would you be willing to work a day shift on a critical care unit instead? I know it's tough as a new grad because you don't want to come across as being needy/picky, but you'd be surprised how they may work with you...especially in your situation.

Night shift is a tough shift, it's really hard on the body and some people have a harder time than others. There's no point in torturing yourself.

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