I am a new grad and have been working on a psych unit for 4 months. I like what i have been doing and I am actually pretty good at it, but night shift is destroying me. It began insidiously. First my mood started to get a little labile (i have bipolar disorder that 'was' fairly well controlled). Then I developed a mysterious stomach condition in which I was very nauseas for the first half of my day and would sometimes vomit and i lost most of my appetite. I lost about 10 lbs in a month with this. Then i started having trouble with tachycardia.. my heart rate currently rarely falls below 90, even when resting. I have chronic insomnia and have been using ambien for a long time before this job.. but i started needing 3x the dose i was used to taking. That eventually failed too and I now take seroquel and ambien. I had lab work done and my TSH is well above normal range. I started taking Prilosec for my stomach, which mostly alleviated the problem (although ive never had an acid reflux problem in my life except if i ate greasy foods like sausage). I did manage to gain most of the weight back (im generally low in my weight range so weight loss isn't healthy). My moods became more and more labile.. until it finally broke....
i called my nurse manager today to discuss day shift options.. and well..there are none. My unit is small and already smarting from the recent loss of another psych RN. I told her that i was growing depressed and that my physical health was declining. I tried to tell her that I understood her situation and cared about the unit. She cut me off and told me that i wasn't a good fit for the unit.
now, the dilemma:
Financially, I can technically afford not to work for about 6months (although i wouldnt do it). I am very destabilized to the point of suicidal ideation (i have no plans and know better) and having rage attacks.. i sleep for 12 hours..can barely get out of bed..cant clean..my appetite is low.. and i barely have the energy to feed and bathe myself. and im on the verge of tears most of the day. My psych team tried to petition me this weekend, but i did manage to squeeze past that one. so..not very prepared to go psych nursing! My psych doc said he would sign any papers i needed to document how emotionally inept i am =P. In actuality, my nursing judgment is intact; i am very rational, even though my emotion regulation is well..broken. technically, i could go back to work...but the stress might worsen my mental state.. but i feel like ill be practically unemployable and leave a unit i care about in dire straights if i leave.. but i might have already burned that bridge anyway.
Have you tried getting a letter from your treating psychiatrist or other MD for your job stating that for health reasons you cannot work nights? You seem to have pretty serious reasons for not being able to do it. Maybe the facility will have to place you in another job if you have an MD's statement.
Our overnight pharmacists work seven 10-hour shifts in a row, and then have a week off. A few years ago, one of our overnighters left and a man who's about 40 with a wife and three kids decided to do it. He worked overnights while he was in school and could handle it, and good heavens, 26 weeks of paid vacation a year? Sure, there would be adjustments, and he didn't plan to do it forever, but how hard could that be?
The first few months, the kids loved it because as far as they were concerned, he was always home, but eventually the day/night switching started to take a huge toll on him. He's a totally laid-back kind of guy, and he turned into someone who was throwing things, using profanity, and people would come in and say "Hi" to him and he would give them a look that would bore holes in concrete......he did his best not to bring it home. He reached a point where he needed Ambien to sleep during the day, and the kids weren't allowed in the basement den when he was asleep but one day they sneaked down there to play some video games and his wife caught them. They were blowing up planets and making a lot of noise, and he was sleeping right through it which terrified him. What if the smoke alarm went off and he was home alone and didn't hear it? We were also worried that he might get fed up and walk out on the job, or worse, that he would get really sick; not only would that leave us in a huge lurch, but we sure didn't want to lose him.
Enough people told him he needed to give this up that he finally told our supervisor that he would finish out the schedule that month, and go back to day/evening rotations. I worked an overlapping shift with him the last few days, and as the light at the end of the tunnel got closer and closer, he became more and more himself which was good to see.
Edit: When he started this, he looked much younger than his age but he must have aged 10 years in those six months. That was hard to see too.
Another pharmacist took over for a while, a single guy who will come in on very short notice if one of the overnighters is sick, and he just couldn't handle seven 10-hour shifts in a row.
I learned around age 20 while waitressing that I CANNOT do overnights. I just can't. If I worked that shift, I was always sick for several days afterwards. My employer knows this, and does not call me although I would do a split night if needed; others have done this.
Thanks so much guys!! I'm getting a lot of ideas and not feeling quite as bad about myself. While I don't like to hear that others have suffered too, it makes me feel like less of a doof =P
Getting a letter from my psych doc is a great idea! I don't even know how i would go about disability stuff. Tomorrow, i could call my local NAMI and ask. At the very least, a letter should show that im not lying =P I had always hoped that i would never have to deal with the disability issue and im just recently faced with my bipolar being a disability.
as for my mental state, im feeling a little better everyday. I managed to get out of bed after 10 hours. I actually prepared hot food. I'm not feeling suicidal. I called my docs office without getting in a rage, just a little righteous irritation =P. I think i'll be ready to go back to work for at least a few weeks *hoping hoping hoping*in preparation to leave.
Specializes in telemetry, med-surg, home health, psych.
oldiebutgoodie---I do believe you are correct in the fact that we have a real need for psych RN's.....we have had ads in the paper and even had a job fair at my facility and still came up empty handed...either there are NO psych RN's in my area or we are not paying enough, I don't know which, probably a little of both !!
Specializes in telemetry, med-surg, home health, psych.
BlueRidgeHomeRN--you are soooooo right, our biological clocks are just not suited for the night shift.....I have never even attempted it, I know I could not do it....I would be asleep before 1 AM on the floor !!
I give credit to all who do work nights....they deserve the extra pay and then some.....and I know it sure does get crazy on the floor in a psych hospital at night, too.........I hear all the stories in AM report....
Specializes in telemetry, med-surg, home health, psych.
inthesky----have you given them an ultimatum??? let them know that you will be leaving if they can't find a spot for you on days, see what happens....good luck to you, I sure can understand your situation and feel for you....
I feel the same exact way about night shift. I can NOT sleep during the day. I only manage to get about 4 hours of sleep. On my nights off, I sleep like a baby, like I died and went to heaven.
I suffer sever headaches, have bouts of crying, etc... on the days I have to go in. I am absoutely miserable!!! I am not a nice person because of it and I don't like how I am treating people, those close to me. I am normally a happy go lucky type of lady.
I have asked if I could be switched to days, but I don't know if that will happen. I am very close to looking for a Mon-Fri day job just so I can get my life back. I want 3-12's, but I will settle for 5-8's just so I can sleep and live like normal people. I have been looking around for other jobs, I will be keeping my eyes open.
unfortunately, there is absolutely no day shift available, so i am definitely leaving.. im just figuring out how long i'll muddle through this to help them out. From reading your posts, i wouldnt work where you are working =P too stressful and dangerous!! i admire your dedication even in very poor working conditions.
2b,
It sounds like it is time to get off nights.. not ..sometime.. but ASAP. Depression is a horrible illness which you dont need to have. this is not you being weak or being unreasonable. maybe your co-workers are 'ok', but you aren't. You hoped it would get better, but it didn't. For me, im pretty much being forced off nights in a dramatic way, but that doesnt mean you should suffer longer than you have to. I'm leaving mostly for emotional issues, but im having physical illness as well. Im 24 years old and healthy, why do i need a pill to eat? and why is my thyroid under-functioning? thats crap!
It sounds like you have casually asked, its time to be more forceful. I'm sure more experienced nurses here could give you some good advice. If you work trauma, could you deal with working on another unit days until there is a day trauma opening? or being day float pool? its time to take your life back
Specializes in telemetry, med-surg, home health, psych.
inthesky----it's not so much dedication as it is survival....I have to work and know that I could never go back to a med-surg unit....Some days are highly stressful, others OK.....but those are few and far between.....I really do feel that I make a difference and am helping some of my pts. so it makes it all worth while...
Are you covered by a short-term disability benefit at work? It sounds like your doctor would say you are temporarily disabled right now.
Maybe if you had a couple weeks off, you could recover a bit and find a day-shift job at another hospital. Even if you need to switch specialties to get on days, I would think it would be worth it.
OP, I hope everything works out for you. IMO, when you are experiencing symptoms like yours, that's a sign that you need to find another job, STAT. No job is worth your health or sanity. Your NMs reaction is telling..evidently, she is not willing to work with you.
I am so sorry about how you are feeling. Night shift is a tough shift. I have just graduated from NS this May and will not take a job working those hours. I used to work nightshift in a hotel on the weekends and it took a huge toll on me. I also worked first shift on a Tuesday and 2nd shift on Wed and Thu along with the third shift on the weekends.
I turned into a big B---h and always felt sick and depressed.
I will work at McDonald's before I work that shift again. I know as a new nurse I may not have quite the choice of hours I would like but I will not compromise my health and sanity for the almighty dollar.
Selke
543 Posts
Have you tried getting a letter from your treating psychiatrist or other MD for your job stating that for health reasons you cannot work nights? You seem to have pretty serious reasons for not being able to do it. Maybe the facility will have to place you in another job if you have an MD's statement.