EMERGENCY NURSING WORLD !  

Night Shift Survival Hints

Introduction: It often seems that some staff are "permanent night people" who
always function well; that some are "day people" who are known to "face-plant" on
the desk and function poorly at night; and that some rotate satisfactorily but
markedly prefer one particular shift.

Advantages of night shifts:
Differential pay (where available).
More "interesting" clientele (perhaps).
Pace of shift may be preferable.
Simpler and more personal bureaucracy.
Close-knit working relationships.
High level of self-reliance, cross-training, even increased autonomy among
experienced and successful staff.
Counter-commute traffic and parking.

Disadvantages of night shifts:

Career-Stall as invisibility to daytime administrators and power-brokers increases.

If you are highly effective and actually like nights, you may rise to your highest
level there and stay forever as you become so essential to avoid "daytime" administrative
problems like finding someone who could be forced to take your position!

Loss of Inner Calendrical Rhythm, as years of nights and weekends (unlike the rest
of the world) erase your sense of day, date, and lifestyle, or ultimately the ability
to function happily in a daytime world in the manner of the old phrase "I've been
upside-down so long ---it seems like right-side up to me!"

Tips:

• Sleep well and eat well before the shift. ---Who knows when or if the chance will come again?

• Two Words: Digital Watch! Your key to accurate charting of day, date, time (24 hour International time), and personal orientation.
  How can you check orientation after loss of consciousness without looking up the answers?

• Allow end-of-the-day decompression time before sleeping after work. "Day-time people" relax after work.

• Eat or drink something warm during that chilly lowest ebb of circadian hormonal change.

• Can't stay awake; no matter what? Excuse yourself for a minute, go outside or into the hallway, and SPRINT! for 100 yards.
  ---You'll be wide-awake!

• Rotate shifts in a forward fashion. (Days -to-> Evenings -to-> Nights -to-> Days)  if rotate you must.

• Whether you nap right after work or marathon through your first off day, try to get on your family's cycle as soon as possible. I
  t will feel more natural and help preserve your relationships with your family.

• Live on your day shift income; don't rely on night shift differential pay to make ends meet. Plan your budget upon your basic income
  in case of unexpected changes or disability. Use your differential income for specific short-term purposes: e.g., debt reduction, extra investment,
  vacation funds. It is too easy to become dependent on extra money as essential for house payments, schools, etc.; ---you may never be able to go off nights!

• Use mornings for business. ---While you still have your wits about you and businesses are at their freshest level of service.

• When planning chores, watch out for the "day world's" lunchtime-and-early-afternoon slowdown. Or the early leaving of staff decreases
  efficiency in the afternoons if you're trying to get things done before work.

• When relaxing before naps: avoid time-sucking activities. Choose things that you can put down when the time comes to go to sleep.
  Don't get drawn into the black hole. [N.B. from the Editor: Web-Site management can be particularly bothersome.]

• Have sleep-preparation rituals that promote good sleep hygiene. Regularity of preparations, even the same go-to-sleep music,
  will flip your mindswitch to "I'm going to sleep now ."

• If it takes a sleep-mask, black-out curtains, ear-plugs or "white noise machine", or other sleep aid, even silencing the telephone
  ringer to ensure daytime sleep, ---do it and don't feel silly. You're entitled to the best sleep that you can get!

• Avoid using intoxicants or sleeping pills to get to sleep except in the most unusual circumstances: the sleep architecture is altered
  thus sleep is less restful and you may be hung over with poor performance at work. ---Habit-forming, too!

• Avoid excessive reliance upon caffeine. It may get you past the occasional slump o.k., but it's addicting, disrupts even your own semblance of
  circadian rhythm, and is diuretic!   If possible, take a break, change activities, exercise, get fresh air, find a task where your attentiveness is really needed.

• Don't forget that your family is for whom you do it. Don't lose your connection with family life. Don't put career, the job,
  colleagues, before your family's needs. Don't lose your spouse/significant other.

• Show up, unexpectedly, at your spouse's work with flowers and go out to a special lunch when you can. Let your spouse feel
  envied by coworkers and appreciative of the ways you can be available during hours that conventional workers aren't.

• Make time for regular exercise (especially if you and your partner are on opposite shifts). It's easy, when lifestyle consists of long night shifts and
  revolves around essential functions of work, sleep, and eating, to omit keeping the body in tune.

• Meet teachers, and help with school field trips, or contribute teachers' aide time.

• If you seek career-advancement and consistently work nights, you will have to find useful ways to overcome the "invisibility"
  of not being frequently seen by administrators and committees. ---Tasks often tried include coordinating night scheduling, orientation and
  inservices presented, liaison with EMS, projects, etc.

• People will say "Good Night" to you in the morning as you leave. Insist upon saying "Good Morning" as you can deal with
  astrophysical facts and maintain a good sense of personal balance.

• "Twelve-Hour" shifts are now widely prevalent. Some hospitals only hire for 12s. Seemingly, this is a benefit --more "free" time,
  or time for another job. However, remember that unions fought for years to achieve the "eight-hour day". Twelve-hour
  shifts are often thirteen or fourteen if there is overtime or other delays. Factor in your commute time, and household chores, and
  there is little time to recover your "sleep debt" or to be a "human being" to your family. Extended spells working more than one
  job will sap your strength, your personality during working hours, and your joie de vivre!

• If you are the Charge Nurse on your night shifts, be aware of how your colleagues pace themselves, or when they "hit the wall"
  physically and emotionally. Try to ensure their breaks at appropriate points before this happens. You may be under pressure
  to downsize staff during "slack periods"; avoid this on those nights when "there is no let-up." You may also find that you
  are overburdened with admitted patients who have nowhere to go due to staffing by actual census upstairs.

• Grocery-shopping at off-peak hours. Isn't this self-explanatory and an obvious benefit?

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  CBS News: 60 Minutes: The Science of Sleep
  Lesley Stahl Explores The Latest Findings In Sleep Research
   

  
  National Sleep Foundation website

  Go to ENW!'s "Sleep Medicine" links.

  Attention is called to the excellent article: "Defying Circadian Rhythm: The emergency nurse and the night shift"
  by Valerie G. A. Grossman, RN CEN CCRN in Journal of Emergency Nursing JEN:Vol 23, No 6, December 1997 pp 602-607
  "While the clock on the wall runs 24 hours a day, the human body is internally programmed to function only about two-thirds of that time.
  Health care workers who work the night shift (11PM to 7AM) defy the body's natural internal programming
  and the long-term effect of this defiance can be disastrous."

  Go to: Circadian Technologies, Inc. website for useful information and links

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  "Night Shift Survival Tips"
  [http://ENW.org/NightShift.htm]
  is a webarticle presented by:
  Emergency Nursing World ! [http://ENW.org]
  ©1997-2008 Tom Trimble, RN CEN [Tom@ENW.org]

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