Wake Up! It's Your Day Off.

[Joe V]

Tired. Just tired. Are you getting enough sleep? Many are not. Look around you: the coworker who just walked into the door she's not getting enough sleep. I don't care how many cups of coffee she drinks - she needs sleep. How has sleep affected your work (or a coworker)? Please share your stories...

[JBMmom, MSN, NP]

I've had two overtired/dream/sleepwalking stories that make me chuckle sometimes. Once during the Summer I was home sleeping during the day and my kids were hanging around the house. I woke up in the middle of my nap and ran downstairs to the kitchen. I was turning nobs on the stove and pushing buttons and my kids came in the kitchen to ask what I was doing. I don't specifically remember my response but they paraphrased later for me that I was saying "the suction on this code cart isn't working and I can't figure out why". They reminded me I was in the kitchen and not at work, I went back to bed.

When I was on my med-surg unit I would nap on my break. I had 27 minutes between punching out and getting back to punch back in, and that was a perfect amount of napping, or so I thought. One night while on my break I awoke sort of panicked and ran down the hall into the room of one of my patients. He'd been there a few weeks and at the time was working 12 on 2 off, so I had been his nurse most nights. Fortunately he almost never slept at night so when I barged into his room he was awake and looked at me amused asking "what's up?". I started talking and said something like "I thought that you had fallen. But now I realize I was asleep because it was on my kitchen floor and you're not on my kitchen floor and now I feel sort of dumb so I'm just gonna leave now..." He was laughing really hard as I backed out of the room. 

Sometimes now I just hope I don't get pulled over on my way home because I'm pretty sure I'd fail a field sobriety test in the middle of the day. Thanks to 16 hour mandates some days have been rough...

[LibraNurse27, BSN, RN]

2 hours ago, JBMmom said:

12 on 2 off

Does that mean 12 shifts in a row???

[SilverBells, BSN]

I would say a lack of sleep has made me more irritable and not as willing to help out as I once was.  I've mishandled a few situations lately because I've been tired and unmotivated. 

[JBMmom, MSN, NP]

5 hours ago, LibraNurse27 said:

Does that mean 12 shifts in a row???

Yes, when I got off orientation at the hospital I took off every other weekend and that was about all for while. I had been working two jobs for a couple years before that so it wasn't much of a change. Fortunately I don't have to do that for financial reasons anymore. 

[LibraNurse27, BSN, RN]

wow! 12 shifts in a row sounds soooo tough! I'm glad you're not doing that anymore.

[NurseSpeedy, ADN, LPN, RN]

23 hours ago, JBMmom said:

I've had two overtired/dream/sleepwalking stories that make me chuckle sometimes. Once during the Summer I was home sleeping during the day and my kids were hanging around the house. I woke up in the middle of my nap and ran downstairs to the kitchen. I was turning nobs on the stove and pushing buttons and my kids came in the kitchen to ask what I was doing. I don't specifically remember my response but they paraphrased later for me that I was saying "the suction on this code cart isn't working and I can't figure out why". They reminded me I was in the kitchen and not at work, I went back to bed.

When I was on my med-surg unit I would nap on my break. I had 27 minutes between punching out and getting back to punch back in, and that was a perfect amount of napping, or so I thought. One night while on my break I awoke sort of panicked and ran down the hall into the room of one of my patients. He'd been there a few weeks and at the time was working 12 on 2 off, so I had been his nurse most nights. Fortunately he almost never slept at night so when I barged into his room he was awake and looked at me amused asking "what's up?". I started talking and said something like "I thought that you had fallen. But now I realize I was asleep because it was on my kitchen floor and you're not on my kitchen floor and now I feel sort of dumb so I'm just gonna leave now..." He was laughing really hard as I backed out of the room. 

Sometimes now I just hope I don't get pulled over on my way home because I'm pretty sure I'd fail a field sobriety test in the middle of the day. Thanks to 16 hour mandates some days have been rough...

I remember those days. Got pulled over one day because I actually was driving faster than I realized on my way to work. Officer noticed my scrubs, said he had a lot of coworkers who had to go there with inmates so he wasn’t going to do anything, just make sure I had no warrants. He came back, told me I needed some sleep, and was free to go…..I couldn’t sleep for another 14+ hours. I got home, too tired to eat. The bed won. Skipped the food.

[Ele_phant]

When I first started my training and the 12 hour shifts were a shock to the system I woke up kneeling on the floor face down on my bed, panicked, ran into the kitchen I shared with housemates I'd known one week and shouted at them 'has anyone fed that woman in my bed'. They burst out laughing and I just backed out the room 

[Davey Do]

On 9/21/2021 at 10:16 AM, Joe V said:

 Are you getting enough sleep?

My wake up routine while drinking coffee is drawing & writing. I write & draw whatever's on my mind at the time. Before work, my sleep status was regularly chronicled and the drawings generally looked like one of these two characters:

[angeloublue22, BSN, RN]

I work in mental health and the amount of people with schizophrenia or other psychotic issues that use meth, which, of course makes them worse and they keep landing is psych hospitals on holds or in jail. I guess I was having a snarky day. We had frequent flyer that the above is his MO. When he told me he was using meth again I said, "Of course you were because we all know meth is a great treatment for meth and much better than your psych meds for schizophrenia." The pt actually replied, "You're right, I need to focus on my psych meds."

Another one who had made suicide gestures then denied any issues and blamed everyone else for blowing it out of proportion. I said, "People don't just trip and land in a psych hospital when nothing is wrong." He opened up after that. 

Last one, was using heroin and was angry that his dealer gave him a contaminated batch that he had a bad reaction to. I said, "Dang it, isn't it annoying that drug dealers have no quality control." His response, he laughed and said, "Damn it you're right!"

Oddly enough I think they all needed to hear it but it was totally by accidental. I think I'm a little over it. I'm too old to let people live in there own flawed thinking. 

[autumn_blue]

No, I'm not. I've only been a nurse for a little less than a year, but when I first started, I was sleeping terribly and having work dreams all night that blended with reality in weird ways ... I would half-wake next to my boyfriend and worry about whether anyone had turned and repositioned him recently and I'd panic realizing I was sleeping and no one was taking care of my patients or doing the med pass I was dreaming about. Eventually my brain learned to separate the times I AM responsible for the well-being of four to five different people from the times I am NOT ... sort of.

I do make mistakes at work, partly because I'm overwhelmed and new and partly because I am so tired and burned out. I obviously care about not letting patients get hurt, but beyond that, I care way more about not being held culpable for any particular mistake than not making the mistake in the first place -- everyone makes mistakes, but I'm afraid that from my manager's point of view I make too many (2-3 she knows about in my year on the unit) and I am worried that I'm not a good nurse. Yesterday my patient fell, and I'm worried that I could have prevented it, but she wasn't hurt at all and we are pretty sure a med caused it and won't give that med anymore so my worry has shifted to myself. The paperwork when someone falls is overwhelming at my facility, over an hour of redundant documentation. We are bipeds! We fall down! I didn't sleep well last night and I won't sleep well tonight because I am worried I didn't do enough fall paperwork and my APSM will be mad at me. I don't really know why I care if she is. Sorry to vent, I guess this is only tangentially related, but long story short, it's my day off and usually I leave work at work but clearly not today ...

[Davey Do]

I empathize with you, autumn blue. We are our own worst critics.

Sleep is so very important and I've always made it a priority. I learned that I could think of NOTHING about work if I wanted to sleep. Awaking halfway through my sleep session was the worst. EVERYTHING that I thought about could and would bother me.

It is theorized that our serotonin levels drop during our sleep sessions, and that's a reason why we're so easily disturbed. Working MNs and changing my sleep schedule was hell for me.

I dealt with keeping my mind off of work- or anything else for that matter- and the negative waking sessions through a meditation process that I tailored for myself.

First, I did deep breathing to a count of 8-12. Once my breathing was regular, I recited a mantra, my favorite being an extended version of the Lord's Prayer over and over again.

Then, for visual distraction, I focused on phosphenes, those blurbs of light we see when we close our eyes. They are random firings of the optic nerve because our brains refuse to see total darkness.

I found that if I focused on the phosphenes, I could make pictures out of them. I believe my brain interprets this process as a twilight sleep and responds accordingly, and I fall to sleep.

In all my final years of having to deal with stressors and working a MN shift, I have never not been able to fall asleep or back to sleep if I use this technique.

This technique of deep breathing, mantra, and focusing on phosphenes takes devotion and practice, but it works!

Good luck and the best to you, autumn blue!