new nurse, chronic insomnia, any suggestions?

peaceful · Jan 8, 2005

You need to apply to day positions only. I have the same problem, so can relate. I HATE nights, tried it, and still walked around like a zombie after 3 months. I could never catch up on the day/night sleep cycle so even on my days off felt horrible. I could not live that way so quit and found a day position. I have always had the bio-rhythms of a day person, up early, bed early is my cycle. I also struggle with insomnia not to the extent you do. For me comes in cycles, not all the time. Insomnia is a real disorder that must be managed on a daily basis. I am sorry to say that HR and new co workers will not be understanding about not working nights. There is that mentality that new grads must pay their dues. Have you already told your work that you can not work nights? Congratulations on your new grad job contract!

QUOTE=NP2BE]Hello everyone,

I am grauating BSN in may, and have signed a 2 year contract with a local hospital. I have had for many years a medically managed chronic insomnia problem that involves seroquel, topamax,clonidine,neurontin and a breathease strip and even then i wake up several times a night. I have been to several specialists and this is the best it gets. I may try a CPAP machine but nasal obstruction is only part of it. Anyways I understand new grads are usually put on the night shift, wich wouldn't bother me but a rigorous sleep schedule is important and simply not possible until (unless) my insomnia improves. And certainly flipping schedules around is also not possible as I can't just flip my meds back and forth like that. Is this going to cause a lot of hostility with my new co-workers? I will work every weekend if I have to just not 7p-7a. Last summer I did an externship in ICU (where I want to work) and had issues with my preceptor, I suspect it had something to do with this, the hospital was okay with the situation but I detected hostility from the nurses on the unit. I got switched into amb-surge and had a great summer, and got along very well with my new prectptor and coworkers. But ICU is where I want to work for several reasons. So My question is, would you be hostile to a new grad who would not be able to work nights? Does anyone have any suggestions? Thanks!

NP2BE

aireton · Jan 8, 2005

insomnia

Hello everyone,
I am grauating BSN in may, and have signed a 2 year contract with a local hospital. I have had for many years a medically managed chronic insomnia problem that involves seroquel, topamax,clonidine,neurontin and a breathease strip and even then i wake up several times a night. I have been to several specialists and this is the best it gets. I may try a CPAP machine but nasal obstruction is only part of it. Anyways I understand new grads are usually put on the night shift, wich wouldn't bother me but a rigorous sleep schedule is important and simply not possible until (unless) my insomnia improves. And certainly flipping schedules around is also not possible as I can't just flip my meds back and forth like that. Is this going to cause a lot of hostility with my new co-workers? I will work every weekend if I have to just not 7p-7a. Last summer I did an externship in ICU (where I want to work) and had issues with my preceptor, I suspect it had something to do with this, the hospital was okay with the situation but I detected hostility from the nurses on the unit. I got switched into amb-surge and had a great summer, and got along very well with my new prectptor and coworkers. But ICU is where I want to work for several reasons. So My question is, would you be hostile to a new grad who would not be able to work nights? Does anyone have any suggestions? Thanks!
NP2BE

aireton · Jan 8, 2005

I am a nursing supervisor in a geratic setting and insomnia is common especially in dealing with dealth and dying. I have found Guided Imagiery has helped. What I do is asked them where they have gone on vac/or on a trip that they had a good time then I help them think about plan and pak i tell them to only think of this this distracts their mind from whatever troubles them and they fall asleep it works better than meds. Hope it helps you . You need to distract your mind from whatever it is thats keeping you alert. Amy

aireton · Jan 8, 2005

I am a nursing supervisor in a geratic setting and insomnia is common especially in dealing with dealth and dying. I have found Guided Imagiery has helped. What I do is asked them where they have gone on vac/or on a trip that they had a good time then I help them think about plan and pak i tell them to only think of this this distracts their mind from whatever troubles them and they fall asleep it works better than meds. Hope it helps you . You need to distract your mind from whatever it is thats keeping you alert. Amy

NP2BE · Jan 8, 2005

I am a nursing supervisor in a geratic setting and insomnia is common especially in dealing with dealth and dying. I have found Guided Imagiery has helped. What I do is asked them where they have gone on vac/or on a trip that they had a good time then I help them think about plan and pak i tell them to only think of this this distracts their mind from whatever troubles them and they fall asleep it works better than meds. Hope it helps you . You need to distract your mind from whatever it is thats keeping you alert. Amy

While I appreciate the advice, Its a long standing problem and I am not going to list everything I have tried, But I would appreciate more any advice on how to deal with my limitations as they relate to the work environment rather than advice on how to deal with insomnia.

Thanks!

NP

peaceful · Jan 8, 2005

I totally understand your post! I hate it when someone tries to give me advice on insomnia. I already have tired for long periods hypnosis, guided imagery, medication, diet change, time of day of exercise, herbal teas, natural remedy such as kava (do not recommend b/c associated w/liver problems), on and on. Insomnia many times is NOT a disorder that can simply treated with guided imagery! Very misunderstood disorder and too many times not taken seriously.

While I appreciate the advice, Its a long standing problem and I am not going to list everything I have tried, But I would appreciate more any advice on how to deal with my limitations as they relate to the work environment rather than advice on how to deal with insomnia.
Thanks!
NP

NP2BE · Jan 8, 2005

I totally understand your post! I hate it when someone tries to give me advice on insomnia. I already have tired for long periods hypnosis, guided imagery, medication, diet change, time of day of exercise, herbal teas, natural remedy such as kava (do not recommend b/c associated w/liver problems), on and on. Insomnia many times is NOT a disorder that can simply treated with guided imagery! Very misunderstood disorder and too many times not taken seriously.

Thanks peaceful, it is definitely something that can take over your life in ways only someone who experiences it can know. And I appreciate both your posts. I am considering turning down the job I have and taking a job at another local hospital that is far more desparate for nurses , where I may be able to get the schedule that i want. I graduate in May. My other consideation is to take a job as a PACU nurse which would be mostly days except for call, and do that for a year, than switch to ICU and I will not be a new nurse any more so I would hope to get a better chance at getting that day schedule in ICU. I want to CRNA school so I need ICU exp, and PACU is not really the best course of action for anyone going to CRNA school (as far as I can tell), but I expect to work for several years before moving on to grad school

Thanks!

GingerSue · Jan 8, 2005

Clarify with your employer about the shift expectations - that has to be clearly established. That way there won't be misunderstandings later.

Other staff might want also clearly established expectations - they might want to know how their work schedules would be affected. Some people prefer to work nights - you never know until you ask.

palesarah · Jan 8, 2005

I also have chronic insomnia, which I am able to manage with Ativan and Ambien. I have learned that everyone has their 2 cents worth of advice when it comes to insomnia and I take it with a grain of salt and the good will it's offered with. ("Thank you, tried that, doesn't help")

Part of my problem is I'm naturally a "night owl"- when I'm able to sleep, my natural sleep cycle is from about 3am to noon. So I choose to work nights, and it is working out very well for me. I had to do some of my orientation on 7-7 days and it killed me! I was offered a day position after but I just couldn't do it.

To get back to the OPs question- in my hospital and especially my unit, many new grads have been hired into day positions. Even on a great floor like mine though (very supportive experienced nurses, no one eating their young so to speak) there's a little "talk" about how did THEY get day positions right away? The truth is no one on nights really wants to leave, and there were day positions that needed filling.

It sounds like you've already experienced hostility in the ICU you want to work in. Is that unit your only choice? I see you have a contract with that hospital so that does limit you somewhat.

NP2BE · Jan 8, 2005

I also have chronic insomnia, which I am able to manage with Ativan and Ambien. I have learned that everyone has their 2 cents worth of advice when it comes to insomnia and I take it with a grain of salt and the good will it's offered with. ("Thank you, tried that, doesn't help")
Part of my problem is I'm naturally a "night owl"- when I'm able to sleep, my natural sleep cycle is from about 3am to noon. So I choose to work nights, and it is working out very well for me. I had to do some of my orientation on 7-7 days and it killed me! I was offered a day position after but I just couldn't do it.
To get back to the OPs question- in my hospital and especially my unit, many new grads have been hired into day positions. Even on a great floor like mine though (very supportive experienced nurses, no one eating their young so to speak) there's a little "talk" about how did THEY get day positions right away? The truth is no one on nights really wants to leave, and there were day positions that needed filling.
It sounds like you've already experienced hostility in the ICU you want to work in. Is that unit your only choice? I see you have a contract with that hospital so that does limit you somewhat.

Thanks sarah,

Their are several ICU's in the hospital I have a contract with, That was only the CVICU, I would be glad to work in the SI or MI or neuro ICU. But in my area, the other hospital will typically buy your contract out with no problem so it does not really limit me. That would be great if I wound up on a unit like yours. The CVICU nurses at the hospital I signed on with have a reputatiion for not being the nicest, and I have witnessed it firsthand. So perhaps, One of the other ICU's would be better. I prefer CVICU but I realize that with my need to work days, I may have to take what I can as far as ICU work is concerned, and that is fine with me because I am glad to learn as much as I can in any ICU. Really I am just greatful to be having a chance to start my career, I am so excited to go into nursing and even more excited to maybe get to CRNA school. I must be twisted because I just love to be in and around hospitals!

Dixielee, BSN, RN · Jan 8, 2005

I work ER where we have a variety of shift options. Maybe other areas do as well. We have folks working 11 am to 11 pm, 1 pm to 1 am, 3-3, etc. as well as typical 7-7 shifts. One of those might work for you. I have worked 11-11 before and loved it because I am not an early morning person, and was still able to get to bed at a reasonable time. Maybe your employer would consider such a shift. Good luck. It is tough constantly switching your sleep schedule even when you do not have insomnia.