What is life as a midnight shift nurse like?

behensley · Jun 4, 2008

While things are pretty hectic at the beginning of your shift, getting your assessments done, chem stix, dealing with family and the pt needs, etc... Usually after midnight, on a good night when the ED is slow, things calm down and you get to catch up on all the stuff that you need to do. Also, working nights you get more cleaning assignments to do, but not so much that it is undoable if you have a good nurse mgr. Things usually begin to pick up again around 5 am, then it is time to give report. I enjoy it, you don't have all the administration to deal with. Just be sure it is an absolute necessity before you call the Dr. in the middle of the night and have all the information that the Dr. will want. :)

diveRN · Jun 4, 2008

Ok, here's how I do it.

I work 19-07 in a level 1 ICU Tuesday night through Monday morning ... 6 days on. Our pay weeks go from Friday to Thursday so I get three shifts in one week and three in the next. After that, I take 8 days off. I'll often pick up extra shifts during my 8 "off" days. I'm in an off week right now.

To prepare for my 'on' weeks, I'll stay up pretty late Monday nights (0200 or so) and sleep until about 0730 on Tuesday. Then I nap from 1300 to 1700 and get up to go to work.

Weds and the rest of my work week, I'm in bed by 0830 and sleep to 1600-ish. Sometimes later, sometimes earlier. I wake my 3YO son when I get some, spend a little time with he and my wife and then off to bed. He's in preschool Tuesday though Friday 09 to 1500 so when he gets home, I'm about ready to get up. He and my wife will spend most of the day Sat and Sun running errands, visiting grandparents/cousins, playing out front, etc.. anything to keep him out of the house when I'm sleeping. Been doing this for over a year and so far it's working for me. My wife works from home, so it's easier on us.

As for sleep schedules, I take 5mg Melatonin, 50mg benedryl and a B complex vitamin each of my work mornings before bed. I also have blackouts on all the windows and French doors in my bedroom. It's pitch black in my room even on the brightest of days. The only real issue I have is that if I've been consuming a lot of Diet Pepsi in the previous shift, I'll often have to get up to pee around noon, but I can minimize it by cutting out the drinks at work after 0300. Our bedroom is also in the very back of the house and I can close it off with pocket doors... so neighborhood noise isn't a problem for me.

As for flipping back to a regular schedule, on Monday morning when I start my 8 days off, I'll come home and sleep to 1100 or so. Then I'll get up and do some light house work or pay bills, etc, nothing too heavy. I'll then go to bed that night around 2300 and sleep to 08 or so the next morning, which pretty much gets me back to a regular night sleeping pattern.

I do take 5mg melatonin, the B complex, and 25mg of Benedryl on Monday nights when I get off. Even with three hours sleep, my body is just used to being up at night after 6 days of a noc schedule. Tuesday night is pretty easy, sometimes I'll take the melatonin if I'm restless, otherwise it's just the B vite... which I take every day, working or not.

Not gonna kid you, some days I'm pretty wiped out but not so much that I can't function. I just get some extra sleep at night or spend one of my afternoon days off sitting on the couch with a book and napping.

Hope this helps.

racing-mom4, BSN, RN · Jun 4, 2008

I work every Sat/Sun and then Weds. That sched works best for me and my family--I have Friday nights and Sat morning off to attends the kids sporting events. I dont get any sleep Saturday day, I may sleep in a little like till 9am if nothing is going on, So when I get off work Sunday at 0730 I have been up almost 24hours, so that makes sleeping on Sunday pretty easy, I go to bed as soon as I hit the door, and sleep till about 3pm, get uo and just lounge, maybe make supper and do some laundry, I then get in the shower at 5;30pm and get ready for my 2nd night. Monday I come home and take a power nap. maybe 8-11, then I go to be normal that night. Same thing Weds to Thursday, I just take a power nap Thursday am.

As far as what is life like in the middle of the night, the night staff I think works pretty well together, lots of team work. Some nights are crazy busy, some nights are relaxed. We typically dont get as many admits in the night as they do in days, and we rarely dismiss after 7pm so we dont have that to deal with. Unless it is to the morgue!!

Eat light, I try to eat cut veggies or raisin bran at night, working 3rds will mess with your GI tract. I drink lots and lots of water even if I find my self in the bathroom every few hours, so be it, the water keeps me hydrated. 0300 is my sleepy time--this is the time of night where I would literally pay some one 100.00 to come in and work for me. So this is when I make a pot of coffee, I only drink a few cups, maybe till 0500 or so as I dont want the caffeine to effect me when I get home.

Once I am back in the day world If I cant sleep at night, I will take a tylenol PM. That is enough for me. A glass of wine doesnt hurt either!!

RN1982 · Jun 4, 2008

I honestly hate working nights because I feel so wiped out after I get off work. I rotate and my schedule is 2 months of days and a month of nights. If I work a few night shifts in a row, I come home after work, take my shower and go to bed as soon as I can. If I know I'm gonna be off for one day, I keep my midnight routine so I don't have to constantly readjust. If i'm gonna be off for more than two days, I sleep for a couple hours when I get home then make myself get up and drink some coffee and try to go to bed around 10pm

StrwbryblndRN · Jun 4, 2008

There have been many threads started on this same issue. So you may want to do a search.

But here is the skinny for me.

I work fri-sun 7p-7a Med Surg and love it. I am a SAHM for the rest of the week.

There are a few other nurses who do it too. My little ones are 4 and 6. The only hard day is Monday. I call it my dumb day but I get through it and feel

ok that I am lazy on the couch.

Luckily for me my husband takes control over the weekend and no baby sitters are needed.

I do not adhere to a rigid schedule with my kids but we do have a nice routine and my kids are great with the whole "mommy has to sleep and is not home at night sometimes" thing.

It may or may not work for you but all you can do is try if you think you will like it. If not you can always change again.

RNDave · Jun 5, 2008

Thanks for the detailed responses. Some creative strategies mentioned. I would make the change mostly to have some extra time off. I thought 8 hour afternoons would be easy, but it turns out there is little to no time to have a life outside of work. I have to get my family onboard first.

Dave

MrsMommaRN · Jun 9, 2008

night shifter here. i love nights. i am a night owl by nature so my natural choice was nights.

as for sleep i get home around 0800 and will stay up for awhile 1100 at the latest and go to sleep. i keep my room very dark and cool. i will also sometimes opt to wear a sleep mask.

what's hard is weekends. if i work a friday shift i tend to sleep most of my saturday away.

i really like the fact that tptb are not around breathing down your neck. as well as the other madness that day shift will bring. we tend to have busy times on nights with a lull around 0200-0300. great time to check mars and catch up on charting.

good luck to you i hope you choose nights.

RNDave · Jun 10, 2008

Another thing about nights, at least where I work: midnight RN's have at least 7 patients and usually 8. I know they're sleeping, or should be, but having a steady diet of that many patients scares me. Is that an issue for any of you?

Dave