Night shift nurse

[Born2BAnurse]

Can anyone give advice on how you make thru your shift. I recently started working night shift and I'm finding it difficult to stay awake even after drinking coffee.  

[JBMmom, MSN, NP]

I've been on night shift almost seven years, getting through your shift is about more than coffee/caffeine, you have to set yourself up for success. First, did you get enough sleep during the daytime? If it's possible, getting in a quick workout or even a short walk before your shift starts can totally help you feel more awake, but it's not always possible if you wake up and come directly to work.

Avoid eating foods that will set you up for a crash. Everyone's body is different, but if you know that breads or sugary foods make you tired, avoid them during your shift. I try to sip on ice water frequently, and now that we can't keep it at the nurses station it takes a quick trip to the breakroom which gets me moving as well. One thing that helped me was just to not sit down. I would take a workstation and stand in the hall near my patient rooms to chart. That way I'm available to answer lights, help the other nurses or techs, and get my charting done. On nights that weren't quite a busy, I gave myself assignments to work on. Look up certain tests or imaging to try to figure why my patient had those tests and what the results mean.  

If you prefer to sit at a nurses station, every hour make yourself get up and move. A walk around the unit, 10 quick squats, anything to get your blood flowing. It can definitely be an adjustment and it's not for everyone, but night shift can be great! Good luck. 

[heron, ASN, RN]

Born2BAnurse said:

Can anyone give advice on how you make thru your shift. I recently started working night shift and I'm finding it difficult to stay awake even after drinking coffee.  

After spending roughly half of my 50 year career on nights, I can say that the sine qua non is sleep. Figure out the sleep schedule that works for you and guard it like Fort Knox.  Nurses' lives are so different, so their sleep schedules are, too. The key is to figure out what works for you.

Avoid empty carbs and limit caffeine intake - don't depend on coffee as your only resource for promoting alertness. The boost they provide is short-lived and they contribute to many of the bling-term health issues affecting shift-workers (weight gain and hypertension, for instance).

Studies have shown that a short (20 minutes) nap is more effective than either caffeine or will power in restoring alertness. Time for a nap is often not available in a work setting, even when unpaid break time is used - but if you can wangle it, it might help. Failing that, stay busy.

Try to maintain the same or similar sleep schedule on your days off. The fact is that shift work is biologically bad for you - it requires you to violate your normal circadian rhythm. Switching back and forth between day and night time wakefulness is the worst.

ETA: also, what JBMmom said - all great strategies!

[heron, ASN, RN]

heron said:

After spending roughly half of my 50 year career on nights, I can say that the sine qua non is sleep. Figure out the sleep schedule that works for you and guard it like Fort Knox.  Nurses' lives are so different, so their sleep schedules are, too. The key is to figure out what works for you.

Avoid empty carbs and limit caffeine intake - don't depend on coffee as your only resource for promoting alertness. The boost they provide is short-lived and they contribute to many of the long-term health issues affecting shift-workers (weight gain and hypertension, for instance).

Studies have shown that a short (20 minutes) nap is more effective than either caffeine or will power in restoring alertness. Time for a nap is often not available in a work setting, even when unpaid break time is used - but if you can wangle it, it might help. Failing that, stay busy.

Try to maintain the same or similar sleep schedule on your days off. The fact is that shift work is biologically bad for you - it requires you to violate your normal circadian rhythm. Switching back and forth between day and night time wakefulness is the worst.

ETA: also, what JBMmom said - all great strategies!

 

[Red Shirt 6, CNA]

I take lunch break before heavy activity times. I found that if I take my lunch break before slower times, during my shift I feel more lethargic however if I take my lunch break before lot of moving and activity like the last part of my shift it is easier to stay alert. 

I also limit coffee caffeine intake, so it is easier to sleep when I need or want to.  

[klone, MSN, RN]

And if none of those things help, ask your PCP about a prescription for modafinil/Provigil. My thoughts are with you - night shift just about killed me.

[0.9%NormalSarah, BSN, RN]

I don't have trouble sleeping during the day and get a lot of sleep between shifts, and I'm pretty sure that's why I'm so energetic at night. I think if you can find a way to get lots of sleep before your shifts, you will find it easier. When I'm feeling sleepy on shift, I do some squats and standing stretches. I may look silly, but I do things that get the blood flowing and my heart rate up, plus I get a little strength training in! I do use some coffee occasionally, too.

Also I know this is a little off topic, but @JBMmom you can't even have WATER at your nurse's station and have to keep it all the way in the break room? But ugh, we just can't figure out why we can't keep our nurses, what ever can it be? ?

[JBMmom, MSN, NP]

0.9%NormalSarah said:

Also I know this is a little off topic, but @JBMmom you can't even have WATER at your nurse's station and have to keep it all the way in the break room? But ugh, we just can't figure out why we can't keep our nurses, what ever can it be?

Nope, no food or drink at the station, including water bottles. Each floor has a "hydration station" cart where we can leave drinks for the shift- they're in break rooms or hall corners. Admittedly on night shift we are sometimes non-compliant with this ridiculous rule that was instituted during COVID and then just never de-escalated. 

We can't keep nurses at MY institution because we are constantly short staffed, being mandated regularly, and they are still hiring travelers that make significantly more money than regular staff. The food and water is just a drop in the bucket. I'm thankful at times that I'm only per diem now, but I feel badly for my co-workers relying on the organization for their main or only employment.  

[0.9%NormalSarah, BSN, RN]

JBMmom said:

Nope, no food or drink at the station, including water bottles. Each floor has a "hydration station" cart where we can leave drinks for the shift- they're in break rooms or hall corners. Admittedly on night shift we are sometimes non-compliant with this ridiculous rule that was instituted during COVID and then just never de-escalated. 

We can't keep nurses at MY institution because we are constantly short staffed, being mandated regularly, and they are still hiring travelers that make significantly more money than regular staff. The food and water is just a drop in the bucket. I'm thankful at times that I'm only per diem now, but I feel badly for my co-workers relying on the organization for their main or only employment.  

Wow that's ridiculous. I think I have it pretty good where I work to be honest, but I feel so bad for nurses in that type of environment. Good for you for going per diem. ?

[barcode120x, RN, NP]

I used to never take naps during my lunch break, but my last few years before I left bedside nursing, my 30min power nap was a MUST. I always took my lunch right around 3am. Caffeine is always great, but maybe try spacing it out or taking them at the heart of the night. 3am was always the roughest time from me so that's when I always popped a Monster (yes, I know it's bad, we all do) right after my lunch nap and it always helped me power through the last couple hours of the shift. Eating a big hearty carb meal will definitely contribute to sleepiness so you could look into healthier meals or eating small meals throughout your shift.

Maybe change your daily schedule. When it's my 1st shift, I always try and wake up early in the morning and do a heavy gym session. Do the usual through the day then take a 3 hour nap just before getting of shift. It may take some time for your body to get used to it since you really have to change your routine and daily habits. Night shift isn't meant for some people though, so listen to your body!