Starting night shift - need advice/tips from night shifters!

[Irock]

I graduated from nursing school 6 mos ago, and I got hired in Jan at one of my top 2 hospitals of choice! However, I applied for days, and they offered me nights, which I accepted, just b/c I wanted this job so badly. I've never worked nights in my life, and I have a feeling it's going to be a difficult adjustment. I am finishing up orientation on day shift, and next week I start 3-4 weeks of orientation on nights, before I go totally on my own on night shift. The other day, someone told me that they know a night shift nurse who takes Tylenol PM in the morning when she gets off work, so she can sleep all day. Not sure if this is something that a lot of night shift people do, and I hesitate to do this.

Can you night shift nurses please tell me what YOU do to make the switch to staying up all night? Obviously, I need to keep my room dark and sleep during the day, but any other advice would be great. Thanks!

[brownbook]

You will hear and read, a lot of advice about working nights. You will need to find what works for you. Your sleep "routine," or "sleep hygiene," is about as personal and individual as any body function can get. What one night shift worker just "has to do" may not work for you.

I was younger when I worked nights (for 17 years) and didn't have any major problems. Focus on how you feel not how many hours you slept. You can feel great, function fine, on 4 hours sleep, and you can feel slow and groggy after 8 solid hours of sleep.

[Chin up]

Before you take Tylenol PM, ( which I think is dangerous, and personally don't keep it in my home) see how you feel naturally. It is important to get 7-8 hours of uninterrupted sleep, some do it easily, others like me, had a hard time. I could not sleep when I got home and tried the room darkening shades, sound machine, food, etc. None worked. I finally let my own clock regulate my sleep. Going to sleep at 1pm, after errands, gym etc worked well for me. I had a girlfriend who would pass out as soon as she got home. The trick was to get to sleep before 9:30am. She slept 8 solid hours. Another friend did the 12noon - 8pm and swore by it. You need to see how your body responds and go from there. Give your body time to adjust and then listen to it. Good luck and congrats on your new position!

[TheCareerStudent]

I was night shift in the military and here are the tips that worked for me:

Try to adjust to the schedule as many days ahead as possible.

Black out curtains.

Eat your meals the way you would during the day, like eat breakfast when you wake up. Some of the people I worked with ate breakfast at the end of the day when normal people did, my body liked sticking to my normal routine.

One of those peaceful sound noise makers. I got a great one for $20 at Walmart.

Go to the gym, it helps you sleep.

Hope this helps, it got me through 5 years.

[j621d]

Try not to switch back and forth from night shift sleep habits to "day shift" hours on your days off. It's just too stressful and you won't get the rest you need.

When I was a new grad (20+ years ago) I had to work nights, I started staying up later and later to try to get into the grove of night shift. I saw some really great movies (I always liked Fred Astaire, Cary Grant, etc.). It was tough for me as I'm a morning person. At some point there will be a day position that will open - if that's what you really want.

Good luck in your new life style!

[NPinWCH]

I worked nights for almost 15 years, by choice. I liked the night shift. I never took anything to help me sleep, except for melatonin on occasion, because most meds that make me sleepy keep me drowsy for longer than I sleep.

Darkness: I recommend blackout curtains/shades or some other way of keeping it as dark as possible in your room. Light is the enemy and if you roll over, no matter how sleepy you are, and see the pretty sunlight streaming through the curtains your brain will tell you it's time to get up. I also used a sleep mask to block out the stray light.

Quiet: I used earplugs and a box fan/window air conditioner. The earplugs took me a while to get used to, but when people are mowing their lawns, kids are playing, stereos are loud and other people are generally living their lives, you are trying to sleep. Noise is also the enemy. What usually doesn't bother you will when you tired and NEED to sleep. The box fan or air conditioner add white noise to help drown out the things that get through the earplugs.

Routine: Find a routine that works and stick with it. On my first day back on nights after a few off, I would try to take a nap before my shift. I'd get up at a normal time and then do what I needed to do and then nap for a couple hours before my shift. On my last day of nights, knowing I'd have a few days off, I'd go home, usually nap a couple hours then get up and do my normal things and try to go to bed at a normal time.

If you don't have kids/husband or whatever, you might be able to stick to sleeping most of the day and then doing your normal things in the afternoon/evening. I did this before kids and did well sticking mostly to a night shift lifestyle.

Caffeine: It's your friend and your enemy. Be careful how "late" in your shift you drink it. I always hit my wall around 3am (12 hr shifts), I could drink coffee then and be okay by the time I got home and ready for bed around 9am. BUT if I was dragging at 6 or 7am and drank a cup, it kept me awake far longer than I really needed to be.

Also, remind your friends/family that just because you are home doesn't mean you are available. If you need to turn off the phone, hang a sign on the door, do it. In fact do whatever it takes to get the sleep you need. Studies show being sleepy actually riskier than driving while intoxicated. So, it can't be good to be working while chronically sleepy either.

Listen to your body. If you are always tired at work, you need to find a way to get more sleep. Melatonin works for a lot of people, check with your doctor before using it though. Don't let friend guilt you into meeting them for lunch or shopping or whatever. I used to tell them that if they called me one more time at 2pm, I was going to be calling them at 2am to see if they wanted to meet me at the 24hr coffee shop.

Good luck on your new job and take sleep seriously. It's how I survived and thrived on nights!

[bubblymom373]

Definitely no phone in the bedroom unless absolutely necessary. Ear plugs are also a good investment. I swear by these two things. This way my family can do their thing without worrying about waking me. Like other posters stated your body will tell you when it it time to sleep during the day. I sleep after I am home for about 2 hours others I work with don't sleep until noon or later.

[gigglymo]

- Establish a morning routine. I get home from work about 8 a.m., drink a cup of sleepytime tea, take some melatonin, and then read or watch TV until I'm tired.

- Remember that when something happens in the afternoon, your body thinks it's the middle of the night. I used to feel guilty when I would wake up at 3 p.m. and not use the "extra" time before work to go to the grocery store, grab lunch with a friend, etc. Now my logic is - if I wouldn't do it at 3 a.m. before a daytime shift, I'm not doing it now.

- Put your phone on silent. If you're worried about a family member not being able to get a hold of you in an emergency, buy a "go-phone" where you only pay per use and give the number out to very select people.

- I found that eating mostly protein during the night and having a light snack a couple hours before the end of the shift really helped me sleep better. It also helped quell what I called "night shift stomach" - a stomach ache that always hit around 3 a.m.

- I worked both nights and days initially, and as a new nurse, I really prefer nights. There's a sense of camaraderie on the night shift that I didn't see as much on days. Because there aren't new orders constantly coming in, family members needing to speak with you, patients going to procedures, etc. etc., you have more time to focus on learning the flow of the floor really well.

Eventually you'll figure out what works for you. You're going to do great - congrats on your new job!

[hipaacrates]

I'm a 12 hour day/night rotator and agree with most of the advice already shared. I try to schedule my weeks of nights consecutively so I'm not constantly confusing my diurnal/circadian rhythm. The weeks I'm on nights, I try work my shifts back-to-back or with minimal breaks between them to make it easier on my body.

After a night shift, I try leave work by 8am and get home, showered, and in the bed ASAP. I use blackout curtains regardless of which shift I'm on, as they help me sleep better. I sometimes use my fan to generate white noise. I avoid taking medications, as they completely knock me out and make me feel groggy if I'm not able to get 6+ hours of rest. However, if you are inclined to take something, avoid Tylenol PM! It's the diphenhydramine (aka Benadryl) that helps you sleep, not the liver failure-inducing acetaminophen. When I flip back to days, I sometimes take melatonin to help "reset" my pineal gland.

Ideally, I'm in bed by 9 or 10am and may wake up early in the afternoon for a quick snack before going back to sleep. I'm usually up for good by 5:30pm. I try to eat a healthy dinner before grabbing some tea or coffee and heading to work. I typically bring another small meal with me (I love Amy's frozen meals!) as well as healthy snacks (nuts, yogurt, fruit). I cut myself off from caffeine around midnight, when I sit to start my chart checks. I drink water for the rest of the shift to stay as hydrated as possible.

Perhaps the thing that's helped me most when I work nights is getting to work about 30 minutes early, grabbing my charts, and checking orders from day shift so that I have a jump on my chart checks if the shift gets crazy or I get a difficult admission. This also helps when I'm getting report, as I'm able to follow up on any outstanding orders / meds / diagnostics / treatments and hopefully resolve any issues at the beginning of the shift instead of discovering a surprise at when I open the chart at 2am!

After spending almost 2 years rotating, I've come to prefer nights over days despite the inconvenience. I tend to feel less hurried on nights and and am often able to eat and catch up with my co-workers, which can be very difficult during day shift. Nights are also a good time to learn more about your patients and their medical issues, as there is often more time to read their H&P / progress notes and look up things you don't know online. I also was able to get more set in my "routine" by working nights.

Best of luck to you and congratulations on your new job!

[clarkbar72]

It will be hard at first, but once you adjust, you may like nights a lot. Give it a few months, your body needs time to really adjust because it is different than sleeping at night. The best advise I can give is get some dark curtains and create a quiet noise to drown out those people who like to mow their grass at 11 a.m...I worked nights for 8 years and loved it after I got used to it.

[Ruby Vee, BSN]

there are a lot of threads about working night shift -- do a brief search and you'll find hundreds of ideas. try the "nightshift for newbies" thread to get you started.