Wednesday, February 24, 2010

A Beginner's Guide To Working Nights

(In that I am a beginner at working nights)

So: you just got your first assignment as a nurse, to work nights. Holy crapping monkeys, you say, what the hell am I gonna *do*? How will I live opposite the rest of the known world? What if I can't sleep? Auntie Jo is here for you.

Understand that some people are natural night shift workers, some can never adjust, and others can adjust fine but still hate working in the dark (I'm one of those last). If your preferred living schedule has you getting up at noon and staying up until four am, you're golden: nothing here will apply to you, and you can look forward to a long career of greater autonomy, bigger paychecks, and reverse commutes.

If you hate working nights and can't adjust, well, there's not a lot I can do for you either. Some people just can't do it; no shame in that. I have a number of colleagues who did their requisite two-to-eight months on night shift and were miserable the entire time. Some people just never do feel better about staying up until the wee hours.

But if you're determined to Make It Work, or if you're like me and can do nights with a little encouragement, here are some ideas:

1. Snacking is key. Seriously. Your metabolism is so whacked-out by going against your circadian clock that you'll probably pendulum between ravenously hungry and nauseated all night long. Don't expect to eat big meals; instead, take a variety of small, protein-rich, healthy snacks to work with you and munch. It'll help keep you awake, fast on your feet, and (if you choose beans rather than Bugles), keep you from gaining the dreaded Nursing Forty.

2. Sleeping is also key. Whatever it takes to get you to sleep during the day is fair game. For me, blackout curtains and a single beer put me down from nine a.m. to four p.m. Other people might need to add earplugs, white noise machines, or even prescription sleep medication: again, no shame. Do what you need to do to sleep.

3. Manage your expectations. A lot of new nightshifters try to "flip" on the days they're off--that means they try to maintain a normal daytime schedule after working nights. Most of them can't, and end up crashing around lunchtime. Keeping a regular schedule is important, especially if you get only a day off between shifts.

4. Get out in the sun when you can. I know this seems contrary to the previous piece of advice, but it's true: getting some natural light (not even sunlight, but natural, from-the-sky light) can do wonders for keeping you from getting depressed and frustrated.

5. That old saw about a fifteen-minute shower being equal to eight hours' sleep? Is true. Don't make any decisions about anything until you've poured a substantial quantity of hot water over your head. This goes whether you're working that night or not. It's amazing how far a little soap will go to make you feel Almost Human.

I'll be honest: I hate, hate, hate, hate, hate, loathe, and despise working at night. I have to, though, until a day-shift spot comes open. For me, the worst thing about it is the feeling that the crushing depression I've had to deal with in the past is just on the edge of returning. I'm snappish, bloated, grouchy, and weepy (Wow! Four dwarves at once!). I resent intensely having to be opposite everybody I know and miss out on stuff. I worry that my dog hates it, too.

Plus, it affects my brain badly, and thus affects my writing, and we can't have that. (The memory loss is a little unnerving. I hope it goes away as I get more used to this.)

But I'm doin' it. I'm doin' it by taking advantage of the small bursts of energy I *do* have. I'm managing to sleep all day, nap when I can*, and stay awake the rest of the time with B vitamins and caffeine. However long it takes, so long as it's not more than a year, I can manage. I may not like it, but I can manage.

I'll put it this way: working nights is less of a pain in the ass and frustration than having a sprained knee has been.

*The other night I had to go down to Radiology with a patient. The patient was getting an MRI that was scheduled to last 90 minutes. After the first half-hour, the MRI nurse (yes, we have one down there all the time) took pity on me and sent me off to the CT sled with a pillow and some blankets. I had an hour of blissful, lovely sleep while she watched the monitors for me. Thank you, thank you Emily, for that nap.


Crazed Nitwit said...

extra doses of vitamin D might help the depression. I've applied for a regular 8-5 job and I can't imagine going to bed by 11. All those night nurses openings in SNF's did not want me because I was a stay at home mom before I went back to school and they fear my lack of experience.....c'est la vie.

Great to hear you got a nap!!!

'Drea said...

LOL about the four dwarves.

Hope a morning shift heads your way soon or that you'll continue to encounter the kindness of an Emily or two...

beadnik said...

Hey Jo, as someone who did 25 years of night shift, I can totally agree with all of the above. Also, if you're not on any anti-depressant, get yourself some nice OTC St. John's wort and take a couple a day before going to work, and then decrease to 1/day when on days off. My husband wouldn't let me run out of the stuff!

Flea said...

Another thing that helps me a ton is to remember to turn off the phone ringer. Nothing ruins a good morning of zee's like the insistent call of your mother-in-law who just wants to "chat" and "forgot" you have to sleep after working 12.5 hours. Neveryoumind that you've been working this schedule for the last 2.5 years. That and telemarketers. Those guys have no idea the wrath from which I protect them merely by shutting off all ringing within range of my bed.

Not Nurse Ratched said...

I'm the opposite with the snacking. Through much trial and error, I've found that eating at night makes me sleepy and sluggish. I eat a GIANT healthy meal before I go to work and then usually just eat a carton of yogurt and some crackers during my shift, and then when I get home I make myself eat breakfast even though I'm usually feeling like crashing. This works for me, but I'm willing to believe I have a strange metabolism.

coulrophobic agnostic said...

I'm laughing SO HARD at the image of someone napping in the CT machine. Really, they're very comfortable.

As a natural night person, all I want to know is where do I sign up??

Halie said...

Great tips! And I've learned there are definite benefits to nightshift nursing but one should definitely be a night owl to enjoy them!

Maha said...

I've always been a bit of night hawk but I find the most grueling hours are from 4-7. I'm running nearly on empty. My eyes are on fire, the nausea/ravenous hunger is in full force, I can barely string together a sentence and thus, I'm nurse grouchy at those hours. I'm sure most of the complaints against me have come from patients who came to the ER between 4-7. Day shifts are a real downer for me because I hate waking up earlier than 1200!

And I lived vicariously through your nap :D

One last thing - the confirmation work is sucki. I think it speaks for itself!