Shift work help.

World Canada

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I am a fairly new grad RN with a year and a half of experience on a medical unit. In my first year, I focused on shaping my critical thinking skills and communication skills with patients, families, and the interdisciplinary team. I would say I am fairly comfortable working as an RN now. For the past half year, I find myself less concerned about my skills set (still embracing learning opportunities though) and more anxious about shift work itself. I find myself less and less able to recover on my days off in between sets of shifts (tired even after I sleep for eight hours). I was able to schedule in some exercise time during my vacation but has stopped since work resumed. I have friends and coworkers who work overtime lots. I don't understand how they do it. I have thought about cutting back on the hours but I do need the full-time hours. But for my health (physically and mentally), I think it's best if I leave shift work latest by beginning of next year. While I am interested in specializing in critical care/icu, I understand that it will still be shift work. The other option (or rather, the only option) is dialysis. I know there is the option of ambulatory care/MI but I don't feel that I qualify for those positions based on the job description/qualifications and maybe it a bit to do with personality as well.

As an experienced nurse, what are your recommendations/advice for me? Should I stay another year on my unit to gain more experience? I find myself shying away from hanging out with my friends too just so I can have more time to myself. I am aware of signs of depression and will talk to my gp about it. Thanks for your comments!

Specializes in geriatrics.

I find I have the same issues with shift work. I've tried changing my diet, increasing my exercise, and not picking up shifts. I'm still exhausted most of the time. This week, I'm going to make an appointment to see my NP, but I think over the next 6-8 months, I will request to reduce my FTE. This just isn't worth it. The time I do have off, I'm finding it takes me at least 3 days to recover, then I'm preparing to return to work again.

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Some folks just can't adapt to night shift...I'm one of them. I felt physically ill most of the time during the years I worked night shift. I think research is showing what my body already knew. I have read where facilities are actually implementing nap times and such related to the new research. Hopefully this will become the norm. Remember...your health is most important.

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I've heard no rumours that AHS or any other Canadian health authority is even considering this.

They don't mind us napping on our breaks. I know people who go out to their cars and nap in the parkade!

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Specializes in NICU, PICU, PCVICU and peds oncology.

I'm not sure why we're dredging up a 2 year-old thread...

It frustrates me that so many newly graduated and employed nurses immediately start complaining about working nights. It's as if they just discovered that patients don't magically recover at 1600 and take themselves home in time for supper. I went into this profession with my eyes open, knowing that it meant working days, nights, weekends and holidays - whatever my schedule required - and that I'd be doing that for a LONG time. I don't understand how someone can choose nursing and not know that's how it is. Of course my body doesn't like nights... we're not built to be awake at night. But it's part of my job description so I do it.

As for Fiona59's comment that people nap on their breaks and management looks the other way, it's my experience (20 years of it) that those who nap are very slow to return to their required level of function because they sleep too long. A nap should be no more than 20 minutes to prevent the onset of Stages III and IV of sleep, not an hour. When alertness is an essential part of your work, that 40 minutes or so of recovery time creates a significant hazard for patients and coworkers alike. And what do we do about the people who don't wake up from their naps and return to their unit when their breaks are over? One night we spent more than an hour trying to find someone who had gone to her car to sleep. She returned to the unit at 0705... at the very end of the shift after having been gone since 0400. Nap if you must, but be responsible.

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Specializes in NICU, PICU, PCVICU and peds oncology.

From the first article:

"One potential solution to safety issues associated with sleep deprivation is to encourage nurses to use their break times to take brief naps. Often known as restorative napping, these short breaks have the potential to boost performance and accuracy, reduce fatigue and improve mood for nurses working extended hours or the night shift.

Even a short 20 minute nap was viewed by some nurses as restorative." (emphasis is mine)

From the second article:

"The good news is that there is a great deal of recent research on what has been termed “power napping” and its relationship to work performance. Studies, both controlled and anecdotal, have been published showing an increase in employee efficiency and productivity after a 15- to 20-minute nap."

Recommendations from Dr Sara C Mednick, Harvard psychologist and sleep expert:

" Human circadian rhythms make late afternoons (and early mornings) a more likely time to fall into deep (slow-wave) sleep, which will leave you groggy. Once you are relaxed and in position to fall asleep, set your alarm for the desired duration—20 minutes is ideal. "

Funny how that's pretty much what I said in my last post. I've attended a number of workshops presented by sleep experts (ever heard of Meir Kryger, Yale University professor and editor of Principles and Practices of Sleep Medicine?) that provided solid education on staying healthy while working shift work, including sleep hygiene and how to nap.

"The circadian rhythm dips and rises at different times of the day, so adults' strongest sleep drive generally occurs between 2:00-4:00 am and in the afternoon between 1:00-3:00 pm." The National Sleep Foundation.

So taken all together, power naps - by definition - should be SHORT and should not result in slow-wave sleep, which impairs ability to function.

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Specializes in Acute Care, Rehab, Palliative.

Night shifts at my work we all nap on our breaks.

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Specializes in Palliative.

One of my reasons for going in to health care was so that I could work nights. I have never slept at night and I'm really sensitive to sleep deprivation. I have a lot of difficulty functioning both physically and cognitively on day shifts and I spend a fair bit of time vomiting or trying not to vomit. And no naps for days. I have been caught (and laughed at) many times having fallen asleep while charting.

Anyway there are a lot of people who prefer nights. You just need to work out trades (as long as your manager is agreeable--my former manager was very determined not to let me work all nights, or even majority nights). I try to trade or give away all but two or three days a month. As an aside, our schedule is awful but fortunately our contract allows a great deal of leeway with trades and scheduling. Nights is the only shift you can work exclusively without a medical reason, but trades and LOAs (giving away a shift) do not count toward OT or interfere with weekend obligations because you traded your day off or gave the shift away by choice.

That said, in my experience the younger staff we have now prefer nights because they are overwhelmed by days. It's much harder to get rid of them when you have newer and younger co-workers. Also WAY more sick calls for days, especially the weekend.

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I've had co-workers like you who preferred nights for some of the same reasons you stated. For whatever reasons they were able to adjust their life and their body to function on night shift...something i was never able to do.

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