New NP to start working 7:30 PM-7:30AM shift...and I've never worked nights before!

Trauma Columnist · Sep 22, 2008

Hi there - our big hospitalist service is hiring for overnights. I worked nights for 15 years and here's what worked for me:

1. I always bundled my three 12's together in a row.

2. First day took a 3-4 hour nap.

3. Slept 7-8 hours after each shift. Turned off cell phone (had emergency phone on only and number only given to immediate family members with threats of dire consequences if they called and someone wasn't dead or bleeding!!), kept room dark, quiet worked for me though some people like white noise.

4. After last shift, slept for 4-5 hours, stayed up late and went back to sleeping at night.

5. Refused to go to ANY meetings unless they were at 7:30am and lasted 1 hour, accepted no phone calls at all while I slept.

Good luck...I enjoyed night shift.

Advanced Practice Columnist / Guide · Sep 22, 2008

Since I have never worked past midnight before, and I will be working 12 hr overnight shifts (starting tomorrow night), I am worried how I will do with staying awake and not feeing out of it. When should I sleep before work? Thanks for any advice.

I too work in a setting where 24-hour coverage is necessary. All but one of the NP's want straight MN so we decided to rotate shifts so everyone gets a chance to work the dreaded graveyard shift. When I became a nurse practitioner, I have been a nurse for a long time so I too have not worked nights for years.

However, as a nurse practitioner I found that working nights is not really that bad compared to working nights as an RN. An RN has to stay on top of each patient throughout the night because there are specific routines that need to be done - baths, vital signs, charting, meds. As a nurse practitioner, you do not need to be physically around your patient's rooms the entire time you are working. You do your initial assessment, check labs and x-rays, confirm the plan, and do your notes. Throughout the night you get called for patients issues, admits, and occasional emergencies. You have time to sit down and rest . In fact, we have a call room at work with a desk and a computer. We can stay there and monitor the V/S flowsheets, labs, and x-rays online for each patient. There are bunk beds there we can lay on (not very comfortable but it's a bed).

Now how do I stay awake at night? COFFEE. I must say I drink a cup from time to time to stay awake. I ease off from the coffee at around 3 AM so that I don't still have high blood levels by the time I'm ready to fall asleep when I get home in the morning. I tried those Red Bull's and similar drinks and do not recommend them. They give you a rush and then all of a sudden, a low. During the day, I try to sleep between 6-8 hours and keep noise to a minimum by turning the phone off while I leave the beeper on. I also darken my room by closing the blinds. My dog sleeps on the floor by the side of the bed and if I don't let him do that, he barks at everything and wakes me up.

But that's basically how I survive my run of nightshift and we usually get a week of it (3 12-hour shift) every 6 weeks. That's not really bad at all. I actually like the pace on nights - slow and laid back at times but it can get crazy when it's busy. The only thing preventing me from doing straight nights is that I'll miss out on multidisciplinary rounds with attendings in the morning and that to me is a huge educational opportunity I won't get if I work straight nights. Anyway, Chris, good luck to you, I'm sure you'll do fine.

christvs, DNP, RN, NP · Sep 22, 2008

Thanks Trauma & Pinoy. I really appreciate it. Did you guys ever have to deal with day/night rotation too? Pinoy-you mostly work days, right-and occasional nights? We are going to be doing some day shifts too pretty soon. I love this job, but wish we could stick to one set shift-whatever that may be.

Advanced Practice Columnist / Guide · Sep 22, 2008

Thanks Trauma & Pinoy. I really appreciate it. Did you guys ever have to deal with day/night rotation too? Pinoy-you mostly work days, right-and occasional nights? We are going to be doing some day shifts too pretty soon. I love this job, but wish we could stick to one set shift-whatever that may be.

Your group should decide and pick how you will do the shifts. In our case, all but one NP prefers a straight MN shift and all the others are OK with rotating shifts. There are 7 NP's on our team and we are very flexible with scheduling. Our Lead NP does the schedule and is very accommodating of requests. The schedule can be a huge headache but it has not come to a point where there are huge disputes between NP's. Your group may decide to assign certain NP's to work straight days or straight nights but I think you will have difficulty finding NP's who will do straight nights.

LisaFNP · Sep 22, 2008

As a nurse I started working nights, that was 1992. I did 8 hour shifts, much prefer 12 hour shift.

When I worked ICU we had to do 6 day shifts and 6 night shifts a month. that was tough, but I didn't have kids then and staying up all night was not too bad. I did that for 5 years.

When I went to work in an ER, we worked 1 month of days and then 1 month of nights. (Days was 7-7p, 10-10p, 11-11p, 12-12p, 1-1a) and nights was (3-3a, or 7-7a). You got to sign up for the shift but seniority got dibs on 7a shifts. Rotating shifts can be tough. There were mornings that I got off of work and didn't know if I should eat, pee, puke or sleep.

Good luck, you will be fine. I always had more fun on nights :coollook:

emtneel · Sep 22, 2008

Try PROVIGIL.

There was a drug rep at one of my clinical sites that recommended it and i've been using it since. It is recommended for night shift workers. It is pricy but you can get 200mg pills for $10/pill and cut in half, just take 100mg at one time.

When i take provigil, it is like caffeine but NO side effects and you can go to sleep right away after taking it if you need to. It is a really cool drug. Mainly for narcoleptics to stay awake but very safe and approved for elderly as well. you don't get jittery or anything, you just feel awake!

I would take one half or 100mg on my first night shift, and it would help me stay awake pretty much for a 12 hour shift, and i did not crave caffeine like i normally do. i usually just take it the first night then you are pretty adjusted for the other nights.

i can only recommend it!