Shift Work Disorder is Eating My Brain

[A.M. Wolf, CNA]

Greetings friends & colleagues,

I work as a CNA on a dayshift / eveningshift line. My goal is to sleep at least 7 to 8 hours every night. Lately, I am frequently tired, irritable, anxious, and depressed. I think shift work disorder is eating my brain.

What are your best practices for getting good sleep on a rotating shift schedule? What are your strategies for coping in the best way possible? Could you recommend any online resources or publications? Could you recommend any OTC medications?

Thank you!

[Been there,done that, ASN, RN]

Are going to day shift to afternoons.. or midnights? How often are you required to change your rotation?

[Davey Do]

On 6/29/2020 at 9:15 PM, A.M. Wolf said:

What are your strategies for coping in the best way possible?

There are lots of discussions on the topic of sleep here on allnurses,A.M. Wolf and I encourage you do do a search.

Here's a portion from a post of mine I copied:

"I deep breathe, focus on phosphenes (the blurbs of light you see when you close your eyes) and a mantra, my favorite being the Lord's Prayer. No thoughts- I don't allow thoughts whether good or bad because one thought will lead to another and another and I will end up having insomnia.

This method works for me with a very high success rate. Of course, I do other things like exercise. I exercise at least 20 minutes every day. On days I work, I do ten minutes of weight lifting and ten minutes of aerobic, e.g. an elliptical before leaving for work. This exercise also prepares my body for what it's got to deal with during a shift."

Good luck!

[A.M. Wolf, CNA]

On 6/30/2020 at 7:42 PM, Been there,done that said:

Are going to day shift to afternoons.. or midnights? How often are you required to change your rotation?

I'm going from dayshift to eveningshift. Usually 2 to 3 days followed by 2 to 3 evenings. My problem is that when I go from days to evenings, my nights sleeping after evenings I still wake up at 4 am and can't get back to sleep again.

[A.M. Wolf, CNA]

22 hours ago, Davey Do said:

There are lots of discussions on the topic of sleep here on allnurses,A.M. Wolf and I encourage you do do a search.

Here's a portion from a post of mine I copied:

"I deep breathe, focus on phosphenes (the blurbs of light you see when you close your eyes) and a mantra, my favorite being the Lord's Prayer. No thoughts- I don't allow thoughts whether good or bad because one thought will lead to another and another and I will end up having insomnia.

This method works for me with a very high success rate. Of course, I do other things like exercise. I exercise at least 20 minutes every day. On days I work, I do ten minutes of weight lifting and ten minutes of aerobic, e.g. an elliptical before leaving for work. This exercise also prepares my body for what it's got to deal with during a shift."

Good luck!

I did do a search but could not locate anything that I found useful, but perhaps I just wasn't looking right. My problem is that even on eveningshift my body is still on dayshift sleep schedule and I lie awake at 4 am as though I had to get up for a dayshift.

[caliotter3]

Many years ago I read a study that concluded that rotating shifts should be avoided. but if necessary, the rotation schedule should be counterclockwise, I.e. day shift to night shift to evening shift, back to day shift. As a minimum each rotation should be three weeks long. I mentioned this to our manager (shift work in another line of work), he laughed at me, and essentially blew me off. Of course, you only saw him around during the day, and not necessarily the entire work day either.

[amoLucia]

Quote

cali - I think that study must have been super interesting. I'm trying to figure out what the rationale might have been. I am intrigued!! Maybe time to do some googling.

Throughout my career, I worked all 3 shifts. Only truly 'rotated' as a new grad for a brief time. Did NOT like rotating. But I never really minded the 2nd & 3rd shifts whenever I worked them. It all depended on whichever position I was filling at the time.

I believe I read about a REAL kind of Shift Work Disorder. A dysrhythmic disruption of some body systems. Guess I'll add that to the Google list.

[amoLucia]

caliotter3 - just to say, I did try some quickie googling. What I read was that clockwise rotation was most definitely preferred. In fact, the CCW (counterclockwise; learned that & CW from my readings), was SERIOUSLY DISCOURAGED.

The studies seemed to predominately focus on sleep quantity & quality, and the subsequent effect of quality of life/social issues. There were some EKG studies also (WAY TOO advanced for me!).

Much of the research does mention nsg as AT RISK, but studies seem to have been focused on others, ie factory workers and police. (Altho there was 1 study of 100 Italian nurses.)

Still want to do more reading re diurnal/cortisol levels etc.

Bottom line - clockwise was preferred.

[CommunityRNBSN, BSN, RN]

I can’t believe that rotating shifts is a thing. When I first graduated, I wanted to work in our city’s psychiatric hospital. I applied, and they called me to set up an interview. She said it was for a rotating days/nights schedule. I honestly didn’t think I could do that, physically (and I’m a healthy 30-something) so I declined the interview. I know some people are more resilient than me, but it’s just so unnatural to mess with your sleep like that.

[LibraSunCNM, BSN, MSN, CNM]

21 minutes ago, CommunityRNBSN said:

I can’t believe that rotating shifts is a thing. When I first graduated, I wanted to work in our city’s psychiatric hospital. I applied, and they called me to set up an interview. She said it was for a rotating days/nights schedule. I honestly didn’t think I could do that, physically (and I’m a healthy 30-something) so I declined the interview. I know some people are more resilient than me, but it’s just so unnatural to mess with your sleep like that.

Agreed! I have no idea how anyone does that and why hospitals think it's necessary and/or a good idea.

[caliotter3]

21 hours ago, amoLucia said:

caliotter3 - just to say, I did try some quickie googling. What I read was that clockwise rotation was most definitely preferred. In fact, the CCW (counterclockwise; learned that & CW from my readings), was SERIOUSLY DISCOURAGED.

The studies seemed to predominately focus on sleep quantity & quality, and the subsequent effect of quality of life/social issues. There were some EKG studies also (WAY TOO advanced for me!).

Much of the research does mention nsg as AT RISK, but studies seem to have been focused on others, ie factory workers and police. (Altho there was 1 study of 100 Italian nurses.)

Still want to do more reading re diurnal/cortisol levels etc.

Bottom line - clockwise was preferred.

I posted what I read in the study, one study, when I read it. The salient point was that the manager didn’t give a rat’s posterior about those who had to do the shift rotations.

[simba and mufasa]

Rotating shifts is a bad idea. Your body's circadian rhythm is constantly messed up, maybe, its time to change or stick to one shift. This is not natural, your body is your temple, protect it, do whats best for you, not your manager, you have a long way to go.

Good Luck

Dr Madenya