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.
appreciate all of the shared thoughts. not much to add except that i am neither bi-polar nor depressed, but nites still almost killed me. i still have [literal] nightmares about being on nights!
similar concerns-nausea, fatigue, anxiety attacks, crying spells, memory problems--and all i ever did on nights off was sleep (day and night)!
some bodies and minds are not suited for night shift. i'm just glad you are taking care of you!
((:redbeathe)) hugs!
i have to say i am totally with you, i was so ill i was convinced i was dying of some dreadful disease. i have just recently been working normal days and then then a midnight finsh on other days and the same feelings returned because it was after 2am i was eventually getting off to sleep then getting up at normal time. i was a walking zombie, so i had to say to my boss sorry but no thanks.
Specializes in OT, Palliative, ICU, NICU, Wound Care,.
hi,
i came across your post as I am about to start my next spell of 3 nights on in the NPICU where i work. I too have been diagnosed with BP around 2 years ago. Nights are totally screwing my head in. I cannot sleep some mornings..wake repeatedly..have vivid dreams..racing thoughts that drive me insane. I was reasonably stable prior to the nights. I actually really like the work on nights..enjoyb eing there..it is just that afterwards I dont cope for at least 3 -4 days. I have to take doubly my dose of sleeping tablets and then add some stronger things to actually fall asleep.
After the racing thoughts settle I end up depressed. Today I finally went to sleep at 5am and slept in chair for 12 hours straight! And I didnt even work a night last night.
I am going to see my doctor tomorrow so have a chat about what is best for me. Your nurse manager (although should care for you) have a primary goal to do what is beset for her unit. So, I dont think you can rely on her to help you make decisions as to what you should do.
IN the last year I have decided that I Will take myself seriously and I will make the decisions for my health and well being. I cannot help how other people may react to these decisions. I am a valued and productive member of my nursing team so they need to value me eve if I cant do nightshift.
LUckily in Australia I can get a doc certificate which will exempt me from nights and my employer will work around that.
You seriously need to take care of YOU..if you dont take your healthj seriously then no one else will. I would go to your doc and see what you can do to help you in the immediate future. Then maybe start looking about for day work.
We are so short staffed in nursing in Australia we have the advantage that we can chose and negotiate our hours.
Goodluck..I do feel for you..it is awful feeling this way..it doesnt matter what other people think - you know what is best for you..go for it
thanks so much for commenting!! our symptoms are so similar! Call in sick for those remaining nights if you have to!!! Bipolar can get really nasty if poked around with >_<.>
UPDATE:
I took some time off and started to feel much better. I had originally wanted to work for a few more weeks to help out the unit. I went back to work and it was a mistake =(. I was really jumpy and my thoughts were racing so much that I could barely concentrate. I broke down and told the other nurse that I felt unsafe to practice and he had to call other supervisors. It was one of the most demoralizing things I have ever had to do, but patient safety is #1. Of course, they didnt have anyone to replace me, so I trudged it out rather well. I was even more manic when I got home and I didn't even try to sleep because it would have taken the whole bottle of sleeping pills!
Verdict is that I cannot work one more night shift ever again. I called in sick for the next one and ended up talking to my manager's boss >_<. i switched my personal schedule to days immediately because this is the worst manic episode ever had and really don want see how bad it has capability of reaching. spent first day nauseas vomiting>_<. stupid stomach.>
I'm getting pretty close to 'normal' right now. I've been able to sleep with my usual sleeping med dose. My psych doc has signed that I am disabled from performing night shift (he was relieved to sign it). My manager is ****** and won't work with me to work on her unit. The hospital is going to work out another unit to work on as mandated by disability law. Psych nursing is my passion so I'm leaving the hospital.
I've been busy applying to another psych hospital and planning on signing onto an agency as backup (reading over contracts very carefully). This has been a bumpy nasty ride =(.
Specializes in OT, Palliative, ICU, NICU, Wound Care,.
Well..I worked one more night (930pm-730am) I felt surreal the whole time (I actually worked in the lower care nursery as it wasnt so high tech). I got home and rang in sick for the next two nights. All my collleagues and manager know I am BP and have no issue with it. Another colleague is also much worse than me with BP and also doesnt do nights.
Weirdly I managed to sleep after the last night and have only just awoke and it is 22 hours later. I have no idea what is going on with that. I am just so relieved I dont have to do any more (no more rostered until next year anyhow)
I also have accompanying anxiety with the hypomania which is just so awful so the whole lead up to nights is also fraught with anxiety and horror which makes me worse.
So, it sounds like you are getting things sorted out. Your manager sounds like she shouldnt be working in mental health - no understanding at all. Maybe it is best you do more somewhere else in the hospital to get away form her. Your patients are actually very lucky to have someone who can have empathy and a little understanding of how hard it is to have a MI. The hospital is lucky to have you.
I do not consider myself any 'less' a nurse or member of my team at all because I dont do nights...:heartbeat
Specializes in aged, palliative care, cardiac, agency,.
I am so sorry to hear that people are having problems with rostering and / or their nurse managers. These are the very people who should be advocating for nurses, and taking care of us when we are unable to do it for ourselves, and who should be receptive to our needs.
Can you go to your nursing union?
Definitely get your local GP on board with documentation as to what you can and cannot be expected to do. No way should any of us damage our health or interrupt current treatment in order to go to work. Especially poor when you think there are a number of shifts available every day - why force someone to do a shift which is damaging to their health? Surely this is self defeating. If you damage your staff you cant then be surprised when people resign or leave nursing.
As you can probably tell I speak from some level of personal experience. I ended up leaving my hospital - am now so much happier working elsewhere.
I had difficulty with nights too - not to the same extent.
Go to someone higher than your manager for help, after all if you made an error at work that would have huge knock-on effects!
Look at this period as one of learning - as you said you know you don't do well on nights so that can help you to find a job that is a 'good fit' in the future.
I would also add that you need to work for someone with insight and understanding re your underlying condition!
Arizona doesnt have a nursing union; it is a right to work state. I went to occupational health yesterday to give them my docs note and survive a battery of questions about crazy and inadequate I am. If I wanted a day position in another part of the hospital, I could fill out disability paperwork (it is not very long, but asks in-depth..somewhat insulting questions). An entire committee would have to go over the paperwork and approve it >_<. i cried the rest of day and feel like reached personal crisis what do want to with my life.>
Specializes in aged, palliative care, cardiac, agency,.
I went to occupational health yesterday to give them my docs note and survive a battery of questions about crazy and inadequate I am..... I cried the rest of the day
I feel so sorry to hear this has happened. Please hear what everyone is saying to you on this discussion. This is not your fault. You have not done anything wrong. You are not inadequate or a failure or whatever else they have made you feel about yourself.
Dont know how the American system works but surely there is somewhere else for you to work???
I suffer from severe depression/anxiety and tried working the night shift. I lasted about a month. I was in a horrible mood all the time, no matter how much I slept I was always tired. I hated it.
It seems that finding another job, even one you don't particularly want, would be better than working at a job that is making you sick. I'm working 3-11 now and am so much better off.
My gut feeling is that you will find a day job at another facility. Either way, this is all probably for the best. Your manager sounds like a horrible person, and your hospital doesn't sound very flexible. I would imagine you should be able to find a day job pretty easily.
Don't give up on psych nursing just yet. Frankly, the first year in nursing is really lousy, for me, things didn't turn around until the end of my second year, and now I love what I do.
The last week has been emotional hell, but yet again, i'm pulling on strength I didn't know I had. I've gotten in a 'i hate nursing' phase that my boyfriend keeps telling me is untrue..as i would come home and talk his ear off about my patients (no identities of course!). Ive applied to a day job in another hospital and am undergoing negotiations with an agency (working out contract deals =P) just in case it does not work out. There aren't a whole lot of jobs around here which is frustrating and my boyfriend and I hate Phoenix. There are a lot of med surg jobs and this is what my current hospital would probably work out for me...but psych is my passion..and actually the only type of job I really want in life (i guess it's good to be sure right? =P)
Thanks again for your support; It's really helped me.
Specializes in telemetry, med-surg, home health, psych.
inthesky....how about moving to a different area?? I know that we sure need psych nurses day and night shift !!! We have ads in the paper at present. would you like to live in the sunny south ??? if so, e-mail me and I will tell you where I am...
Glad you are off those horrid nights....you will feel so much better..our biological clocks just do not work well when we change them...I don't know how some of the nurses do nights....but I am glad they do because I could never do it....they deserve the pay diff, for sure....
madwife2002, BSN, RN
26 Articles; 4,777 Posts
i have to say i am totally with you, i was so ill i was convinced i was dying of some dreadful disease. i have just recently been working normal days and then then a midnight finsh on other days and the same feelings returned because it was after 2am i was eventually getting off to sleep then getting up at normal time. i was a walking zombie, so i had to say to my boss sorry but no thanks.