Learn to love off shifts.

“I work three days a week, 7 p.m. to 7 a.m., and it can be hard,” says Kara Zogby Comp, BSN, RN, a traveling nurse currently on assignment in Panama City, Fla. “But once I got over the fact that I was working nights and weekends, I started to realize the benefits, like I get four days off when most people have only two.” Chicago-based Michele Martello, RN, has worked the night shift for 22 years—and wouldn’t have it any other way. Her favorite part? “I could take my son to school in the morning, sleep while he was there, help him with homework when he came home, then have dinner with him before going off to work.”

Get a good day’s sleep.

“I love sleeping in when everyone else is waking up and rushing off to work,” says Michelle Whitaker, RN, of Cambridge, Mass. To ensure you get the rest you need, make your bedroom a sanctuary. Keep the temperature on the cool side—60 to 65 degrees F, which is ideal for slumber, according to the Better Sleep Council. Dim the lights—completely. Consider a sleep mask, heavy drapes or window covers such as those made by Blackout EZ Window Cover (blackoutez.com). Adopt a pre-bedtime ritual that your body will come to associate with sleep, whether it’s ambient music, chamomile tea, relaxing aromatherapy or a soothing warm bath or shower. Don’t forget to turn off the ringer on the phone, set your cell to vibrate and make sure the answering machine is on low. And see to it that family members (pets, too) have what they need from you so your dreams won’t be interrupted.

Alert thy neighbors.

Let the folks next door, down the hall and upstairs know “your 3 p.m. is my 3 a.m.” Hopefully they’ll be respectful and keep noise to a minimum, and you’ll get the peace and quiet you deserve.

Don’t hit that mattress…yet.

Sometimes you want to be on a “normal” schedule—maybe to take on a volunteer stint that falls in the middle of your sleeping hours, or you just crave a typical dinner-and-a-movie date with your partner. Next time that urge strikes when you’re coming up on a few days off, don’t head for the bed as soon as you get home from work, advises New Jersey–based Kathy Madden, RN, FNP-BC, AOCNP. She worked off shift for 10 years, but says, “I’d flip back to an ‘everyone else’ schedule for my days off.” How did she do it? By staying up till dark—she’d do only light chores or catch up on reading. After a full night’s sleep, she’d be sufficiently rested to live like a “regular person” the next day.

Say goodbye to lines.

Ah, the beauty of the supermarket, post office, health club, bank or mall…at 10 a.m. on a weekday! “It’s really nice not to be forced to shop on the weekends when the crowds are heavy,” says Emily Smith, RN, of Austin, Tex. “I can browse to my heart’s content without being jostled or hurried.” Another perk? If you wash clothes at a laundromat or in your apartment building, you needn’t compete with the rest of the world’s dirties. Use 10 machines at a time to do three weeks’ worth of laundry in a couple of hours if you please.

Revel in your reverse commute.

When driving home from your night shift, it’s okay to smirk a little at the traffic-snarled commuters crawling in the opposite direction. “It takes me half the time it would if I drove to work during ‘regular’ hours,” says Philadelphia night-shifter and self-professed night owl Laura Hannu-Eckrote, RN. Plus, there’s a cash incentive: “Parking is often free at night. I would have to pay to park or to take the train if I worked during the day.”

Enjoy last-minute indulgences.

Reservations at the hottest place in town may be hard to come by on a typical weekend, but when your Friday is Tuesday, you’ll not only find a great table, but you’ll have an eager-to-please, un-frazzled staff at your disposal. The same holds true for other service-oriented businesses. Whereas you’d need to book a Saturday haircut weeks in advance, you’re likely to score midweek appointments at the drop of a hat.

CONTINUE TO NEXT PAGE–>

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Are you one of the 30 percent of nurses who work the night shift? If you are, are you frequently tired or do you often find yourself fighting off sleep? Do you have difficulty falling or staying asleep? Do these sleep problems disrupt your social, family or work life? Have these sleep difficulties been present for at least one month?

If you answered yes to any of these questions, then read on, because you may have shift work disorder, a type of circadian-rhythm sleep disorder that can adversely impact not only your job performance, but also the quality and even duration of your life. The good news is that by following a few simple recommendations, you can improve your health and well being and get your life back on track again.

What is shift work disorder? The human body naturally follows a “circadian” or approximately 24-hour period of wakefulness and sleepiness, with the desire to sleep strongest between midnight and 6 a.m., and between 2 p.m. and 4 p.m. Your circadian sleep-wake rhythm, which is linked to nature’s cycle of light and darkness, is regulated by an internal biologic clock located in the suprachiasmatic nuclei of the hypothalamus. Shift work disorder and its consequences occur when you try to stay awake when your internal biologic clock is telling you to sleep, or when you try to sleep when your internal clock wants you to be awake.

What are the major symptoms of shift work disorder?
It should come as no surprise that during the night shift, when your internal clock is saying you should be asleep, you would feel excessively tired, fatigued and less alert. It should be just as easy to understand why you would also have difficulty falling and staying asleep when your body’s sleep-wake rhythm demands you be awake. Thus, the major symptoms of shift work disorder are hypersomnia, or excessive sleepiness, and insomnia.

What are the consequences of shift work disorder?

• Shift work disorder typically results in a decrease in total sleep time of one to four hours and an “unsatisfactory” or non-restorative sleep quality.
• Excessive sleepiness, a consequence of both cumulative sleep loss and decreased circadian alertness, can result in difficulty staying alert, concentrating, remembering things and making decisions, as well as problems with eye-hand coordination, headaches, decreased attention span and increased reaction times.
• In 2005, Kenshu Suzuki, MD, and colleagues reported in their sleep study of nurses that those who were excessively sleepy during the night shift were more likely to make drug administration errors, have needle stick injuries and operate medical equipment incorrectly—mistakes that can impact both patient and nurse. Surveys of medical workers have demonstrated that 41 percent admit to making fatigue-related errors; 19 percent reported that their error worsened a patient’s condition. These findings are consistent with studies demonstrating that experiencing only two hours of sleep loss has the same effect on performance as drinking three alcoholic beverages.
• Individuals with shift work disorder also have increased absenteeism; gastrointestinal and digestive problems such as heartburn and indigestion; heart problems, including an increased risk of heart attacks and hypertension; carcinoma of the breast, uterus and colon; menstrual irregularities; colds and flu; and weight gain.
• Shift workers have more automobile accidents, especially driving to and from work, probably because they’re more likely to drive while fatigued and almost twice as likely to fall asleep at the wheel. In fact, two-thirds of shift workers report driving drowsy after a shift. In addition, associated irritability, impatience and mood disorders such as anxiety and depression can ruin job and family relationships and spoil social activities.

Do you have Shift Work Disorder? Take our quiz. To learn more about shift work disorder and get some tips on how to trick your body into sleeping (when the rest of the world is awake), read all of our Shift Work Disorder Articles series!

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I’m an emergency room nurse—straight nights, 7:00 p.m. to 7:00 a.m., often three nights in a row. I’m also in school to finish up my BSN. Sleep is something that I fit in around the rest of my schedule. It isn’t at the top of the priority list. It doesn’t even fall in the top three.

You’re a nurse. You know what it’s like. You live there, or you’ve been there, or you’re on your way.

And yet we can’t be sleepy. Nursing involves performing procedures or giving medications that can kill people if done incorrectly. Your patients’ lives—and your career—depend on your ability to stay awake and alert.

There are many paths to wakefulness. I’ve tried a bunch. Some work for me. Some might work for you. Some don’t work for anybody. Here are eight of them, listed with their advantages and disadvantages.

1. Coffee
Java. Joe. Mud. Basic, brute caffeine without much style or frills.

• Advantages: Plentiful and cheap (if not free) in most hospitals. Basically zero calories. Low fat. Low carbs. Nothing special, but it will get you through the night.

• Disadvantages: Most hospitals are not known for their good coffee, at least not the free stuff.

• Style Points: A paramedic I once worked with had a 2200 ritual where he brought out a personal-size press pot, a bag of fine-grind espresso roast and a silver measuring spoon. It showed a roomful of awed firefighters that in addition to everything he knew about patient care, he’d also be able to beat them on any Jeopardy categories involving coffee.

2. Lattes, Mochas, Cappuccinos
Back in the 1990s, when I was managing an espresso shop and reading the coffee trade magazines, putting a cappuccino cart in a hospital was a new, trendy thing. Now it seems like a coffee stand is almost a JCAHO requirement for a decent hospital.

• Advantages: Goes down with better taste and more style than regular joe. My shift-starting fave at our espresso cart is the large vanilla latte with an extra shot of espresso.

• Disadvantages: Expensive! And often fattening! But a lot of hospitals allow you to buy coffee on a payroll deduction. Just don’t let your spouse see that deduction line on your paycheck.

• Style Points: Support your local coffee shop! Points off for bringing in a McLatte.

3. Caffeinated Soft Drinks
Mountain Dew, with 54 milligrams of caffeine in a 12-ounce can, is comparable to coffee in its power to keep you up all night. Coke has 35 mg of the big C in a 12-ouncer, and Pepsi, 38. We mourn the loss of Jolt Cola, a 1980s innovation that had 72 mg of caffeine per can.

• Advantages: Low-cost, easy to find, socially acceptable.

• Disadvantages: The caffeine in a 12-ounce Mountain Dew comes with 165 calories. You’re going to need to do aerobics all night to work off the calories in those 12 ounces.

• Style Points: The X Games vibe lends Mountain Dew almost as much cachet as cappuccino drinks at a fraction of the price.

4. Energy Drinks
Caffeine! Vitamins! Amino acids! Sugar! WAKE UP AND SHRED!

• Advantages: Red Bull has 80 mg of caffeine in each little 8-ounce can, along with 110 calories from sugar, plus vitamins and other proprietary ingredients.

• Disadvantages: Most of these drinks have to be overflavored to offset the revolting taste of all the nasty stuff that will keep you awake. My workmates can smell the sickly sweet citrus-on-steroids scent of my Red Bull across the ER when I crack open my 0200 can.

• Style Points: Red Bull leads the pack with even more Xtreme street cred than Mountain Dew.

5. Exercise
During a two-week fitness and weight-loss challenge, some of my coworkers got into the habit of running from the ER up a stairway to the sixth floor and back down in two minutes.

• Advantages: That’ll wake you up! And burn off some calories!

• Disadvantages: Sweat.

• Style Points: Fitness.

6. Essential Oils
A dab of lemon oil or peppermint oil on your wrists or neck can give you a renewed sense of alertness.

• Advantages: Natural, drug-free, non-jittery.

• Disadvantages: Your choice of cologne may get you some funny looks from your patients and coworkers.

• Style Points: Organic, natural, crunchy granola vibe.

7. Armodafinil or Modafinil
These narcolepsy medications, studied by the military to keep soldiers and pilots awake and alert, can be prescribed for shift workers.

• Advantages: Non-jittery, FDA-approved alertness, all night long.

• Disadvantages: It might take a few tries to find the right dose for you. The full dose gave me a headache refractory to Tylenol and Motrin. It also kept me awake for a full 24 hours. (I just wanted to be awake all night long, not all the next day, too! Half a pill is just perfect to keep me awake all night long.) Also, it’s expensive. And most insurance plans don’t cover it.

• Style Points: B-2 supersonic stealth bombers fly out of an air force base in Missouri. When they fly a load of bunker busters from Kansas City to Baghdad and back, you can be sure that the pilots have a couple of these in the pockets of their flight suits.

8. Sleep
Can you sneak in a little nap sometime during your shift?

• Advantages: My wife swears by the 10-minute “power nap.”

• Disadvantages: Anything less than three hours just makes me swear.

• Style Points: Orwell said it best (see below). Sleep is the greatest luxury of all for the overworked. At the end of your shift, you can just collapse into bed without ceremony, or you can add special rituals: chamomile tea, eye shades (for sleeping during the day), flannel sheets, white-noise generators….

In his memoir Down and Out in Paris and London, George Orwell describes his life working dawn ‘til midnight, seven days a week, in a Paris restaurant in the 1920s. His thoughts about sleep may sound familiar to shift workers like us: “Work in the hotel taught me the true value of sleep, just as being hungry had taught me the true value of food. Sleep had ceased to be a mere physical necessity; it was something voluptuous, a debauch more than a relief.”

Now, don’t forget to turn off your phone. Sleep tight!

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I’ve always envied those who can flip flop back and forth between day shift and night shift. How do they do it?

I think I’ve nailed down some of their secrets, and in so doing have been able to work both day shifts and night shifts in succession. Happily! Nights are often a more peaceful time in the hospital and it’s definitely a nice change in my routine.

So, need some tips on how to survive the “dark side”?

Surviving the night shift.

Here are steps to jumpstart your circadian rhythm and allow for easier transitions from the normalcy of day shift to the non-so-routine night shift.

(1) If you are strictly a night shift nurse and you are having problems adjusting to the schedule, try a couple weeks of grouping all of the shifts together, three in a row. That way you can completely convert to night owl status for half of the week and then have four days to recover back to normalcy (that being if you indeed do work three 12-hr shifts).

For those who rotate and really cannot stand working three nights a week, ask your scheduling manager if you can split up your weeks into day and nights (be sure to work your days towards the beginning of the week and allow ample time for recovery after night shifts). For example, you would work Monday day shift and Wednesday and Thursday night shifts.

Wake up early on the day of your first night shift and take a nap in the afternoon. This strategy allows you to have a bulk of the morning to get stuff done and having some decent sleep prior to going into the long shift. I have heard people that just sleep in late (until like noon or 1 in the afternoon) crash around 3 or 4am because they have been up for so long.

My technique for the last day is to return home post last night shift, sleep for about four hours, then force yourself to wake up! You’ll be so tired by that night that you will be able to sleep during the night and be back on a somewhat normal day routine by the next morning.

(2) Right before a night shift, eat a substantial dinner prior to going into work (even if it is “breakfast-like”). That will hold you over for hours and give you a boost of energy to get the shift started. Try your best to avoid the comfort foods of night shift and bring a light meal full of protein and complex carbs that will fulfill your midnight munchies.

(3) Exercise! This not only applies to those working normal business hours. It becomes extremely important for those on night shifts because working out allows you to have more energy and creates for more sound sleep. I have friends that exercise after they get off their shift in the morning (I’ve always been too tired for that). If that is your preference, be sure to take time to wind down and drink a warm, non-caffeinated drink prior to going to sleep. I tend to exercise after I wake up – the beauty of that being that as opposed to working out early in the morning like a “normal” shift worker may do, you will be inundated with daylight hours for a nice run, pleasant early evening temperatures, and you will most likely beat the post 6pm rush at the gym. Hitting a wall at 4am? Run the stairs, it will most certainly wake you up

(4) Isolate yourself! Be sure to tell your loved ones, your neighbors, and your kids that just like they don’t like being woken up at 2am, you don’t like to be disturbed during your “night”. Turn your phone off, buy dark curtains that will keep the daylight out of your room, wear an eye mask, lock the dog out of your room, tie up the children (kidding), and for goodness sake don’t drink coffee within four hours of going to sleep. If you “need” coffee to get through the shift, drink it early in the shift and combine water with a stair run later in the shift as an energy boost.

You mind is a powerful tool. Keep in mind all of the positives of night shift. It can be extremely conducive to family life if you are a working parent. The shift differential is an added bonus in the bank account. You typically have more autonomy as a nurse on the night shift and have ample time to develop skills and master your assessments. With the pace of the shift usually being slower, you have more time to develop close relationships with your coworkers because you are relying on each other for second opinions, assistance with tasks, and camaraderie in staying awake when everyone else is snug in their beds.

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When you don’t get enough of it, you suffer. Big time.

No, we’re not talking about money, we’re talking about sleep. And if you’re among the third of working nurses who work the night shift, you probably don’t have the luxury of setting a typical sleep schedule. Sleep expert (and fellow nurse) Terry Cralle helps you identify whether you have what is called “shift work disorder,” suggests ways for night shift nurses (and their managers) to ensure a safe working environment, and offers up the following tips to help you get some shuteye.

Here are 19 things you can do at home to ensure you’re getting the sleep you need:

1. Make sleep a health priority, like diet and exercise.
2. Wear sunglasses if you’re commuting home in bright sunlight. Light is the most powerful zeitgeber, or influencer of the body’s circadian clock, and will negatively impact your ability to fall asleep. In contrast, once you wake up, go outside into the sun to cue your biological clock that it’s time to be awake and alert.
3. Only go to bed when you’re sleepy. Don’t go to bed just because it’s “time.”
4. Your body likes routines. Like light, your bedtime routine is a powerful zeitgeber. Establish a standard, relaxing, soothing bedtime ritual. Put on your pajamas, wash your face and brush your teeth to signal your brain you’re preparing for sleep. Play soothing music; take a warm bath for 30 minutes, one hour before bedtime; read a relaxing book or magazine. Allow enough time to unwind and relax, but try to go to bed as soon as possible after your shift, ideally within two hours. Don’t fall asleep in your recliner or sofa with a television blasting in the background.
5. Try to maintain a consistent and regular sleep schedule on work days AND days off/weekends. Keeping a routine helps your body know when to be alert and when to sleep.
6. Stop working at any task and attempt to resolve anything potentially stimulating, worrisome or upsetting one hour before bedtime. Writing down your emotional worries and thoughts in a journal may help release these concerns from your mind. Learn a relaxation technique, such as progressive muscle relaxation, and practice it in bed.
7. Use your bedroom only for sleeping and sex. Keep it stress and clutter-free. No paperwork, bills, unfolded laundry, TV, electronics or pets.
8. A darkened room signals your brain that it’s time to sleep. So keep your bedroom as dark as possible. Blackout shades, heavy curtains and eye masks can help. Standard window shades let too much light in. Cover an illuminated alarm clock, especially if you’re a “clock watcher,” or remove it, if necessary. If you need to get up, use a small nightlight instead of turning on bright lights.
9. Eliminate noise with earplugs, a fan or a white noise machine. Turn off or unplug the phone. Install carpeting or sound-absorbing curtains, drapes or shades.
   Keep your room well ventilated and the temperature on the cool side, ideally between 60 and 65 degrees (range: below 75 and above 54 degrees).
10. Invest in a good mattress. A poor or an old mattress can disrupt your sleep. The average mattress lifespan is about seven years.

More tips:

1. Make your sleep time sacred. Enlist the help of your family and friends and request that they respect your sleep. Put a “Do Not Disturb” sign on the front door, so friends and delivery people won’t knock or ring the doorbell. Have family and friends wear headphones when watching TV or listening to music. Ban vacuuming, dish washing, lawn mowing, loud games and any other noisy activity.
2. Tell your kids not to go into your room unless it’s an emergency, and be sure to specify exactly what is and is not an emergency. Schedule appointments outside of your sleep period.
3. Get at least 7.5 to 8.5 hours of sleep per day. Try to make up for lost sleep on days off.
4. Nicotine and caffeine are stimulants. Alcohol, while initially a sedative, causes arousals and awakenings, sweats and nightmares after it’s metabolized. Ideally, avoid caffeine-containing beverages and food such as coffee, tea, sodas and chocolate at least six to eight hours before bedtime. If you’re having problems falling asleep in the morning, avoid caffeine after midnight. Avoid cigarettes before bedtime and during awakenings, and alcohol at least five hours before bedtime.
5. Don’t go to bed too hungry or too full. Avoid eating two hours prior to bedtime. If needed, have a glass of milk or light snack before bed. Milk contains the amino acid L-tryptophan, which research has shown helps people fall asleep. Avoid consuming protein at bedtime, which may be harder to digest. Don’t drink excessive fluids prior to bedtime to avoid having to get up to urinate.
6. Don’t lie awake in bed for more than 20 minutes to avoid developing a negative association between your bedroom and sound sleep. After 20 minutes, leave the room and do something relaxing, such as reading, listening to music or watching television. Don’t return to bed until you feel sleepy.
7. Schedule 20 minutes of regular aerobic exercise and work it into your normal routine, but not within three hours of going to bed. Exercising raises the body temperature and can be alerting too close to bedtime. Walk or bike to work instead of driving; climb the stairs instead of taking the elevator. Consider exercising before work or during breaks to help you stay alert on the job. Keep a resistance band or hand weights at work for strength training. Find an exercise buddy to make exercising more fun and keep you motivated. Exercise will improve your sleep, energy level, mood, stress and cardiovascular fitness.
8. Address your partner’s sleep issues, if present. One partner’s sleep problem causes the other to lose, on average, nearly one hour of sleep a night.
9. Begin altering your sleep schedule three days in advance of a shift change. On the third day prior to the shift change and each subsequent day, postpone your bedtime and wake time by one to two hours compared to the previous day. By the time you begin the new shift, your circadian sleep-wake rhythm will be reoriented. For example, if you’re on a 5 p.m. to 1 a.m. shift and moving to an 11 p.m. to 7 a.m. schedule, do the following:

• Three days prior to your shift change, rather than sleeping from 3 a.m. to 11 a.m., postpone your bedtime to 5 a.m. and sleep to 1 p.m.
• Two days prior to the shift change, sleep from 7 a.m. to 3 p.m.
• One day prior to shift change, sleep from 8 a.m. to 4 p.m.
• On the day of the shift change, sleep from 9 a.m. to 6 p.m.

To learn more about shift work disorder and what you can do to make your work environment safer and more productive, read all three parts of our Shift Work Disorder series!

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Random, right? But she had this amazing-looking water with oranges, ginger, cucumbers, and berries in it. Just looking at it made me thirsty! It got me thinking: I wake up, drink coffee, take coffee with me to work, drink that, get more, and don’t drink anything else for the rest of the shift. How bad is that!?! And what’s worse is that I never even thought about it.

So I went home and dug through the cupboards looking for just the right water cup–one of those plastic, reusable ones with the straws (straws help me drink more of just about anything…not so good when it comes to cocktails, but GREAT when it comes to water!). I even filled it with lemons and ice to keep it flavored and cool.

What a difference! I don’t feel as tired anymore, and I don’t snack as much (when your water tastes good–try flavoring it with Mio drops too!–you don’t feel the need to snack on whatever’s lying around). It’s a lot easier to make it through my shift when I’m well hydrated. Sure, it means more bathroom breaks, but that’s a small price to pay. Even my skin feels better now.

So lesson learned: wanna feel great, hydrate! It’s amazing what you learn when you least expect it. Now excuse me while I go fill up my water bottle!

Maridav | Veer

So I’ve been on the NOC shift for two weeks, though it seems much longer than that.

I’d really like to know how long this “adjustment period” is going to take. My body’s had enough already!

Here’s a little bit of how I’m feeling now, two weeks in:

• My days seem a lot longer – on the bright side, time doesn’t fly by so quickly.
• I generally have NO IDEA what so ever what the date is, and most often, what day of the week it is.
• On that note, I also have a lot of trouble figuring out if I’m trying to say “tomorrow,” “tonight,” “yesterday,”  or “last night” because the day changes 4 hours into my shift but my mind is still back in yesterday… or, I mean, last night?
• My body hasn’t figured out when it’s supposed to sleep versus when it’s supposed to wake up.  This is more of an issue on my days off when I try to switch back to “normal” time. My brain says sleep but my body says stay up, and then I can’t ever wake up before 10:00 am to get anything done – even if I DID get to bed on time!
• I see a lot less of the sun – especially since daylight savings time. I enjoy my drive home for the bright crispy autumn days that we’ve been having (we’re actually getting seasonally appropriate weather here!), but I am a bit bittersweet about not getting to enjoy them more because I am asleep through most of it.
• I AM adjusting to more independence. At this phase in the training, my night shift preceptors are letting me do a majority of the work on my own, but are always there for me when I have questions. I’m finally starting to feel like a REAL nurse.  With emphasis on “starting to.”

Image Source Photography | Veer

The other night my husband told me that he has a new dream for our lives: that I would get a day job.

I had to laugh a little, because as we nurses know, switching from days to NOC or vice versa is a difficult task. Having all the pros on the night shift in mind (it works well with my kid’s schedule, the money is better, I love my night team and the night environ), I also had to sit back and count the cost of nights at my husband’s urging.

A coworker told me recently, “So what if NOC takes 7 years off my life–working with the day crew would probably take off ten!” I laughed and laughed, but the fact remains: NOC is really hard on the body. Scientific research aside, I can personally attest to the fact that nights has completely jacked up my sleep cycles (I take Unisom with a vengence).

Another issue I can attribute to working the night shift are my weird midnight eating habits, which I am convinced has messed up my metabolism. And dieting is almost impossible for me: if the schedule doesn’t throw me off, the stress does! I wonder if statistically speaking, night nurses are fatter than day nurses? Hm?

And then there are my emotions: only nurses that work 3 and 4 night stretches know how crazy they can feel after such a run. I usually have a crying jag when I try to turn myself around, and am somewhat irrational, plus I laze around in my PJ’s and have trouble feeling really awake on my days off! And just when I get turned around and feel human again, I have to go right back to a night regime.

The solution is to switch to a day job. Yeah, not so easy! Day jobs are the last to open up–and working days brings with it it’s own nightmares (think waking at 5AM, morning traffic, management on the floor, and visiting hours with consequent family members everywhere).

So yeah, my body is feeling it and is telling me to do something. In the next year I see myself making the change and going to days. That should be fun to blog about!

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This is year 4 of the night shift for me, and I think I have finally gotten comfortable with balancing the autonomy of the night shift and working with doctors. For a while, I’ll admit, I had the whole “doctors chose this job so I don’t care if I have to wake them up” attitude–which didn’t really endear me to my doc-co-workers (not that I want to be buddy-buddy with them, but it does make sense to try and have a good working relationship). We all know that good working relationships between doctors and nurses increase patient satisfaction and safety.

So, here are my doctor-rules for NOC nurses in hopes they help someone who maybe is new to this whole night-shift-world:

1. Most nurses never wake a doc for a tylenol, a Tums, or a fever under 100.4 (to name a few). To do so equals an almost guaranteed chewing-out. Expect it!

2. Think hard before calling a doc at 3AM–can you use your autonomy or critical thinking to work out a problem, or do you REALLY need them?Can you bounce stuff off your charge nurse or do you REALLY need a docs input?

3. If a patient wants to see or speak with their doc at say, 2AM, it IS totally appropriate to call the doc/wake them, IMHO. Yes, try to problem solve w/ the patient, but the reality is that you shouldn’t come between the doc and pt relationship. That type of behavior not only goes beyond the nursing scope of practice, but it will bite you in the butt big-time in terms of doc-nurse working conditions.

Plus…

iStockphoto

Starting in November I’m switching over to the NOC shift, something I’ve never done before but need to get used to, since I’ll be a night owl once I start working on my own.

I just read these tips on trying to survive, but I must admit, I am freaking out a bit…ok, maybe more than that.

Like I said, it’s something I’ve never done before. Believe it or not, I’ve never even pulled an all-nighter to study – I’ve never been able to. The only time I can ever remember staying up all night was when I was about 13 when we had a movie night slumber party with lots of laughing, candy, and Mountain Dew to keep me sugared up. And I remember crashing out after watching the sunrise. Not very effective.

I’m actually not so worried about surviving the shift,  because I think that if I can prep myself for it and sleep ahead of time, I’ll be okay. But I am worried about prepping myself for it.  What do I do? Do I sleep the day before? Do I sleep all day in between shifts? Is it better to get work done before I go to sleep or after I wake up and before I go to work? What about on my days off? Can I go about sleeping at night like a regular person?

It seems so very different from what I’ve always been used to that I don’t really know what to think.  I’ve heard lots of great things about NOC, but then everything I read talks about your body hating you, gaining weight, and getting sick all the time.  NO FUN!  And with a wedding in my future sometime in the next year, I’ve got nerves about starting married life and not being home at night

What’s a new-grad to do? What works for you and how long did it take you to adjust to the night schedule?