Working in a hospital (or other healthcare facility) often requires staff to be there 24 hours a day, 7 days a week, 365 days a year. They say healthcare is the industry that never sleeps. Some workers choose the night shift as their preference, and some don’t really have a choice. Oftentimes, people take this night shift as a way to get their foot in the door at the facility, until a day shift opens up. Or maybe they have kids they need to be home with during the day. Others who may call themselves “night owls” prefer to work overnight for several different reasons.
The advantages of night shift:
- Less people on staff, making it seem like things are “quieter”
- Less management in the building, so there are minimal training exercises, audits…etc going on
- Less family members at the bedside
- Less instances of patients going off the unit for testing / surgeries or having bedside procedures/consults done
- Minimal physicians rounding
- Different medications to be passed
Disadvantages of night shift:
- Less team members on staff can create some chaotic feeling shifts
- Less resources for patients often causing them to wait until morning for certain things (physical therapy, hot food, caseworker or chaplain consults…etc)
- More physically demanding due to lack of adequate sleep for many nightshifters
- “Sundowner” patients get more agitated/confused during the nighttime hours
- Lack of staff resources (cafeteria, coffee shop, unit directors..etc)
- Often times meetings/trainings happen during day shift hours, making the nightshifters attend these during hours they would be typically sleeping.
Making night shift work for you
Get enough sleep during the day
- Let your family and friends know that you work nights and what hours you will typically be asleep. Remind them to save non urgent matters for times when you are not sleeping or working.
- Place your phone on “Do not disturb” or “twilight” while you are sleeping so that only urgent calls come through, or approved contacts.
- Consider a sitter for your kids (or even pets!) during your sleeping hours. A lot of parents think they can just “nap” while the kids watch a movie or something. This does not allow you to get much needed sleep.
- Keep your sleeping quarters cool, dark and quiet. You want your body to think that it is night time.
- Place a “Do Not Disturb, night shifter asleep.” sign on your front door, to dissuade people from knocking on your door.
Take your vitamins
- Make sure that you are keeping yourself healthy as working the night shift can put an extra strain on your body. Focus on eating a healthy diet and getting enough physical exercise.
- Vitamin D is needed for the lack of sunlight you would normally be absorbing during the daylight hours (while you are sleeping)
- Over the counter medications and/or Melatonin can be used as a supplement to help you sleep both on your days on and off.
- Talk to your doctor about possibly getting medication to help you sleep if you are not able to on your own and over the counter medications are not working.
Take time for yourself
- Make sure that you are taking steps to ensure that your mental health is well. Not getting enough sleep, sunshine or food can start to wear on your body and mind.
- Practice techniques to destress like yoga or meditation.
- Treat yourself! Get that mani/pedi that you want every few weeks, or a massage. Self care is great for mental health as well as your confidence.
- Make sure that you don’t get into the “work, eat, sleep, repeat” routine. Get out of the house and do something fun. (more on that later)
Bunch your tasks
Use your time off wisely. Plan to get your chores done, so that you can bunch them together. If you typically wake up at 3pm, plan to pay your bills, hit the bank, go to the grocery store…etc from 3-5pm (or later). Have a game plan so that you can get everything done at the same time, and it will be out of the way! Tasks that could take an undisclosed or unpredictable amount of time (like going to a doctor’s appointment or the DMV) should be done in the morning. So that once you are done, you can go home and go to sleep, as opposed to stressing out if the task takes longer than expected and may make you late for work. You don’t want to have to do all of your chores/errands on your days off, because that doesn’t leave you any downtime to relax, unwind and have some fun.
Sleeping on your days off
You want to try to keep *kind of* the same sleep schedule on your days off as when you are working (especially if you work 5 nights a week)…but that can be challenging when you want to also do day time things on your days off. It is best to plan for a short nap (a few hours or less) when you get home in the morning, and then go about your day. Then you should be adequately tired to be able to sleep that night (since you are off.) This works well if you work 3 twelves a week. That way you are semi-normal for most of your 4 days off. If you take something to help you sleep, or practice certain techniques or rituals…save those for your nighttime sleep…rather than your morning nap on these days. Try to let your family and friends know that on your days off, you will be sleeping at night too…so they know not to call you in the middle of the night!
Staying awake during your night shift
Staying awake can be a struggle, even for the most seasoned nightshifter, who vows that they need zero sleep to survive. Our bodies are built with a circadian rhythm, dictating when we are *supposed* to sleep. So going against that biology does pose some challenges. Here are a few tips to trick your body into staying awake:
- Don’t be afraid to use some caffeine. (as long as your healthcare practitioner or body doesn’t have an issue with it.) You don’t have to chug a pot of coffee every hour or have the world’s strongest cuban coffee ever created. You can micro-dose caffeine, just to get your umph back when you need it.
- Figure out your “bewitching hour”. The hour when your body feels like it’s going to drop and your eyelids are heavy as boulders. Mine was around 3am. Plan to have your cup of joe then. Or take a run up and down the stairwell a few times. Physical activity during this time can cause some endorphins to lift you out of your funk. Avoid becoming complacent with just being tired at this time. Distracting yourself with a treat or some physical activity also helps you to stop watching the clock.
- Sometimes you just need a bit of a sugary (or healthy) snack to help perk you up. Save a special treat for this time as something to look forward to. Try not to save daunting tasks, like charting, for these times…as it wont stimulate you.
They say that undersleeping can cause the same effects as being drunk. This can be in your work, driving, watching your children…etc. Mistakes can happen when you haven’t slept enough and your brain (and body) are tired. Make sure to consider this and watch for these signs of exhaustion, to keep you, your patients and your loved ones safe.
- Difficulty making decisions or concentrating on a task at hand
- Blurred or slowed vision
- Delayed reaction times
- Nodding off or falling asleep at inappropriate times
- Low blood sugar
- Extreme feeling of fatigue
- Exacerbation of symptoms of medical conditions (Increased heart rate, BP, blood sugar…etc)
If you are noticing these (or any other signs) of lack of sleep / exhaustion, let your manager know that you need a break. Work on trying to get your sleep habits in a better place using the above mentioned tips and tricks. If you are unable to over time, you may need to consider the fact that night shift may not be something for you. And that is perfectly OK! There are many people whos body and mental health just can not tolerate working over nights. Speak to your manager about how and when you can transition to a day shift position ASAP.