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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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Everyone knows the jet-lag feeling of dragging through the day without having had enough sleep. Nurses are especially vulnerable to lack of sleep when assigned to shift work.

In fact, so many nurses suffer from sleep deprivation that it has turned into one of the most widespread issues affecting patient care and a nurse’s own health. Without enough sleep, nurses are at increased risk for obesity, heart disease and diabetes.

And really, aside from the jolt provided from multiple cups of java or taking medication prescribed for “shift work sleep disorder,” there is really only one cure for sleepiness: Sleep.

So the next time you’re feeling low on energy before or during your shift, try taking a restorative nap to refresh your senses. The 30-minute investment in your health will pay big dividends in your quality of life.

Here are 5 tips for getting the most out of your nap:

1. If you work day shifts, nap early—before 5 p.m., if possible.
2. Try not to sleep for longer than 30 minutes, or you may have a difficult time falling asleep when you go to bed for your full seven to nine hours.
3. A combination of a nap and a caffeinated drink can help counteract drowsiness. Do avoid unwanted calories, skip the beverage containing sugar and opt for coffee or tea instead.
4. If you work at night, try taking a 30-minute nap before heading out to work, especially if your main sleep was earlier in the day. At work, find a quiet, darkened room where you can lie down for 10 minutes during your break. It will help you feel more alert and awake for the remainder of your shift.
5. If you feel drowsy when driving home, pull over to a rest area and take a short nap. It could save your life.

If you have trouble sleeping, visit the National Sleep Foundation’s website at sleepfoundation.org for advice. You may need to consult your healthcare provider to treat underlying health issues that could be causing your insomnia.

Do you have time to nap? If so, where do you nap? Does your workplace offer adequate facilities for catching some shut-eye or are you forced to camp out on an empty gurney?

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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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There’s a lot of talk about how nursing is hard on your body. It’s true: Nursing can be very hard on your back (especially), your hips (secondarily), your arms (oh Lord, let’s not even talk about it) and even your neck. Feet are an entirely different subject, and one that deserves its own book. I’m not going to bore you with statistics about how lift teams can make all the difference in keeping nurses healthy, or how nice it is to have a Hoyer on every floor—oh no. I’m here to tell you stories, my Chickadees, of the most amazingly random things I’ve ever seen anybody, including myself, do.

1. I won’t even mention the time I walked into a room that had fresh (and very slippery) stripper on the floor, and how I skated on one foot and, with arms flailing, right into the lap of my patient. Nice way to put down warning cones there, floor guys.

2. One of my coworkers once broke two toes by dropping an IV pump on her foot. This doesn’t sound so crazy until you learn that the IV tubing was still in the pump and the pump was still in use on a patient. At least the pump was cushioned enough by her feet that none of the alarms went off.

3. Another person I know (cough, cough) had several chunks of ponytail pulled out when she walked into the MRI room, having removed all metallic articles from her person except for the barrette holding back her ponytail. There’s a reason I rock a pixie cut now: Barrettes can lift and rotate in a truly astounding manner.

4. Another coworker dropped her beeper into the toilet by mistake, flushed without realizing it, then sprained her ankle trying to get out of the bathroom as the toilet overflowed. It was a long time before we let her forget that.

5. Once, a brand-new nurse I worked with had, for some reason, taken the top and foil cover off of a bottle of tube feeding…and then dropped the bottle. It was like something out of a horror movie, seeing the ProCal fountain up out of the bottle and cascade over her. We had to find a pair of shoes for her in the lost-and-found after she changed from the skin out. It wasn’t an injury, except maybe to her dignity.

6. There was the time that another nurse and I were hauling a patient back from testing on a stretcher. We lost the stretcher at the top of a very long, very gently sloping ramp with a 90-degree turn at the end, and had to chase it frantically in order to catch it before it, and the patient, hit the wall. Again, no harm done to anything but our pride (the patient was sedated).

7. Less amusingly, back in the olden days when we still had chart racks, a friend of mine had a chart rack fall over on her. She, thank Heaven, was unharmed—but the resident who flew to her side and dug her out from under the charts was Our Hero for several days thereafter.

8. In the Unfortunate Accidents to Clothing department, how about these?

> A nurse of my acquaintance once got her scrub pants caught in a continuous-passive-motion machine she was storing away in a utility room. The pants tore, spectacularly and irreparably, when she tried to walk away.

> Or the nurse who discovered that Domeboro solution will indeed bleach clothing if you leave it on too long.

> Or the nurse who discovered (again, cough, cough) exactly why more experienced nurses never stand at the foot of the bed of a patient with a fresh tracheotomy.

9. None of these nurse-accidents match what happened to a doctor friend of mine, now a seasoned and well-respected surgeon, back when I was a new nurse and he was a fresh-faced resident:

A patient coded. He, being the tallest guy in the room and thus having the best reach, started compressions on that patient. He had underslept that morning and so perhaps didn’t tie the drawstrings of his scrubs tightly enough—his pants came down about 30 seconds into his compressions.

And, of course, you can’t stop doing compressions to yank up your pants, even if you are wearing Batman boxer shorts.

The patient lived. The doctor almost didn’t. Be careful out there, people!

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Winter is in full swing right now. Depending on where you live, you could be looking at two to three more months of cold weather. What can you do to keep the wintertime blues at bay and take great care of yourself?

1. Moisturizers
Keeping your hands moist is even more important in winter when humidity is often lower. Constant hand washing can leave your skin chapped and raw. Invest in at least one heavy-duty hand lotion or cream to carry with you on the job and use it every time you wash your hands. Remember to buy a water-based moisturizer for work if you wear latex gloves. Try inexpensive brands like Glove’n Care, Amino+Derm or 3M Cavilon that are designed for healthcare settings. Then use a petroleum-based or oil-based moisturizer at home for maximum skin restoration.

Next: Shoe Covers →

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I hesitate to say I never get sick because whenever you say never, it is the equivalent to shouting out, “Here I am infectious world! Come and get me!”

It is the horror movie equivalent to saying, “I’m going to go check this out alone. I’ll be right back.”

It is the … well, you get the idea. Never say never.

I would say, however, that I rarely get sick. I think part of this is because I spent most of my first year of nursing sick all the time. After a year of coughs, colds, vomiting, and the like, my immune system just got better at the whole immunity thing. But I also think that the following tips may have helped:

1) I am crazy about washing my hands. I carry antimicrobial hand sanitizer everywhere. In every purse, in every gym bag, in every nook and cranny of my house. I even carry it in my car and I sanitize when I get in the car from anything…the grocery store, the gas station, ALL THE TIME!

2) I don’t wear my work shoes in the car or in the house. They stay in the garage, on the front porch, or in the trunk of my car.

3) I try to be SUPER aware of touching my face. Before I do touch my face, eat, put on lipstick or anything I…yes, you guessed it, sanitize.

4) I take a multi-vitamin every day and try to drink at least one liter of water. I know what you don’t use you pee out, but it just makes me feel better.

5) I exercise at least three times per week. It is good for the mind and body. And, I think, for the immune system!!

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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!

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It’s the time of the year when we nurses can go overboard for the sake of holiday spirit.

We sleep less, eat more, work more and drive our anxiety levels through the roof.

Here are 5 tips (straight from Kris Kringle himself!) on how we nurses can start enjoying the holidays again.

1. Commercialize, Schmercialize

Remember what the holiday season is really about. It’s clear that Santa does...he’ll listen to your litany of desires, but in the end, he’s all about giving gifts to those on his “nice” list. So remind yourself and your loved ones: It’s not about the next big thing or an expensive gift, indulgences or bragging rights. It’s about sharing, caring and the human condition. It’s about trying to be the people we always hoped to be (and the nurse our patients and coworkers will admire).

2. Be fair to yourself

Be fair–to yourself, that is.  Make time for you. Santa has mastered this…he gives himself 364 days a year to relax and clearly he indulges in plenty of milk and cookies on his one workday. You may not have 364 days to spare, but you should dedicate time for yourself (preferably by a cozy fireplace) as best you can. You’ll be a better nurse when you’ve lost some of that stress.

3. Share

Not just the holiday spirit–share the responsibilities that come along with it. When Santa needs help he turns to his elves, his reindeer, and Mrs. Claus of course. You’re not alone either. Don’t try to do all the baking, cooking, shopping, or planning. Don’t try to take on too many shifts just to “be the nice guy.” Delegate and share.

4. Take it bit by bit

Rome was not built in a day, so don’t try the traditional “power shopping” feat. Santa’s elves keep the workshop open all year so that they’re not crazed the first week of December. There are two ideas here: Don’t worry about trinkets and gifts for your coworkers this year. Instead, donate to a relevant cause like Nurses House. And when it comes to shopping for your family, have the discipline to start earlier next year. I’ve heard some start planning as early as late summer! Wow.

5. Nibble

Do not bite off more than you can chew. Did Santa give YOU everything you asked for when you were a kid? Didn’t think so. He’s conscious of a budget, and you should be, too. Don’t spend so much money that you’re “spending” the entire following year trying to repair the holiday damage. Nurses may be in demand (and we may be the most trusted profession), but we still aren’t paid like Wall Street bankers (isn’t that ironic).

What other wise tips can nurses learn from Santa to keep ourselves sane during the holidays?

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It’s also the end of the calendar year, so you subliminally start to measure your eating performance. Did I eat too much junk? Did I gain/lose/maintain that weight I was hoping? Am I setting a good example for patients?

What if none of that mattered? What if–and humor me a minute here–the calories within every sweet treat in the break room didn’t matter?

What if you could eat to your heart’s (and gut’s) content at work without the guilt of packing on the pounds? A superpower sent as a little “thank you” from the karma police for all the hard work we do to take care of people all year round.

Yeah, like I said, humor me here. I’m daring to dream about the nurse’s ultimate holiday “treat”!

Here’s what I’d do…

I would eat every piece of cheesecake I could get my hands on, especially the ones with homemade crust (my great grandma’s is still the best). I would eat every Christmas cookie that crossed my path. I would surround myself with miles of pumpkin roll (without any nuts, please). Oh, and I’d be eating anything that had chocolate in it.

Now, in this fantasy world, those extra calories still have to go somewhere. I’m a nurse after all — biology is biology. My solution: Calories could be “worn” like removable tattoos. At the end of the day, I would simply peel and remove.

My belly is grumbling just thinking about all that darn food.

The truth of the matter is, I have a horrific sweet tooth (we’re jumping back to reality now). No, I don’t live in misery over what I can’t eat, but I do have to exercise a bit of control (okay, a lot). I guess this is my way of poking fun at the idea that even I have to pay attention to what I eat–especially around the holidays!

Eating right can be fun and easy, and heck yeah you still can eat sugary treats. But, unlike the fantasy world I spoke of, there are definitely more permanent consequences to our real-life eating actions.

What do you think? What superpower would you love to have over the holidays?

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As a nurse, it’s your nature to put others first: your patients, your family, your friends.

Well, before this year comes to an end and the new one is upon you, put yourself first for a while and spend some time making a plan—we’re talking about a health plan here—that will keep you from ignoring yourself any longer.

Here are some smart tips for nurses to develop a health plan.

1. Unless you already have the following scheduled, get cozy with your telephone for a few minutes and make these appointments for 2012:

• A complete physical with your family physician (Ensure that he or she does or orders the recommended tests for your age. Medline Plus, a service of the U.S. National Library of Medicine, offers excellent guidelines on what an annual physical exam should include, based on your age and gender.)
• An eye exam with your optometrist
• A check-up and cleaning with your dentist

Next: Get real with your weight →