Help a new nurse transition to the night shift?
June 25, 2012 2:05 PM   Subscribe

I'm a new nurse and was offered a night position (11-7) at an awesome facility. Please give me tips for working the third shift!

I'm a brand-new LPN (!!) and I've applied to a few long term care facilities.

I've been offered the day shift at one nursing home, but I would have 20 patients and it is a really, really unpleasant place. I got a terrible vibe when I went in there. The pay is also not great. However, the hours (645am-315pm are great).

I also got an offer for the night shift at the Ritz Carlton of nursing homes in my area. It's a coveted full-time position and pays $10/hr more than the other position. I will be trained on the day shift as well as the night shift, and I will not be the only LPN on at night.

The problem is that I've never worked nights. Right now I wake up around 8am and fall asleep around 11pm, and this is pretty typical for me. I live with my fiance and he is very much a morning person. He struggles to stay awake past 9pm and is up at 430am. The position is five nights a week and I'm worried that I will turn into an insomniac and never see my fiance. I also am training for a marathon and everyone I talked to says that I will gain 20 lbs on the night shift. This is obviously all in my control, but I imagine squeezing in the gym would be difficult.

I feel like as a new nurse I need to "pay my dues" and work the night shift. I'm also kind of intrigued by it and want to see if I can do it. My teachers say that it is generally more relaxed but when there is an emergency it's all on you. It also seems like, if I fall asleep by 9am, my fiance can wake me up at 5 when he gets home and we can spend the evening together.

Another plus is that the longest I see myself working here is 1.5 years, as in the fall I will be part-time when I'm in school to get my RN. Once I have my RN I will apply for med/surg jobs at local hospitals.

For those of you who work the night shift:
Do you ever transition back to a regular sleep schedule for your nights off?
How do you manage to spending time with your loved ones?
How long did it take you to get in the habit of falling asleep during the day?
Is it tough to squeeze in exercise?
Nurses: how does the night shift differ from the day shift, at a nursing home?

Thanks so much for your help. I am kind of agonizing over this decision.
posted by anonymous to Work & Money (15 answers total) 8 users marked this as a favorite
My thought is that you sleep all day while your fiance is out working. From about 9 to 5. When he comes home wake up, have a meal with him and hang out a bit then head to work around 10-ish. When you get home, you have breakfast with him, then go into your sound-proof, light-blocked bedroom and sleep. Wake up at around 5 and do it all over again.

For a short period of time, you can do this. Also, weekend can be challenging.

The pay is cool, and if you like the facility that is 90% of awesomeness, especially in a nursing home.

Also, nights are quiet and calm. You don't have to deal with meals, most of the other staff is out so there's no hub-bub. You catch up on charting, while folks mostly sleep.
posted by Ruthless Bunny at 2:13 PM on June 25, 2012 [2 favorites]

There were some good answers in this question with regards to night schedules, although not specific to being a nurse.
posted by jillithd at 2:14 PM on June 25, 2012

I'm not a nurse, but one of my best friends is a nurse working night shifts at a hospital. My take-aways from talking with him about the issue:

Do you ever transition back to a regular sleep schedule for your nights off?
Yes, when those days off are in blocks of 2 or more. Otherwise, the disruption to the sleep schedule is not really worth it.

How do you manage to spending time with your loved ones?
As Ruthless suggested, they still get to hang out on the edges of the day. Sometimes not in the morning, but since your SO is a morning person, you could hang out from 7am-8am or so. Have an after-work cocktail if you'd like -- it's the end of your day.

How long did it take you to get in the habit of falling asleep during the day?
A couple of weeks or so.

Is it tough to squeeze in exercise?
No tougher than it is for the daylight shift. So yes, but not particularly.

Nurses: how does the night shift differ from the day shift, at a nursing home?
Can't speak to at a nursing home, but at least at the hospital it is quieter and less stressful.

I'll see if my buddy has more to add and will report back.
posted by craven_morhead at 2:32 PM on June 25, 2012

I also am training for a marathon and everyone I talked to says that I will gain 20 lbs on the night shift.

Just one data point, but I (perpetually very overweight) hit my lowest adult weight so far while working an overnight shift, so it's not preordained.

I was often tired, even when getting "enough" sleep. My friends who I met while I was working the overnight shift and who know me now say that I'm a lot funnier now than when they first met me... this I attribute to the overnight schedule.
posted by ThisIsNotMe at 2:37 PM on June 25, 2012 [1 favorite]

I tend not to transition too far from my typical night-shift schedule on weekends. My biggest issue on weekends is that I physically cannot fall asleep before 5AM, regardless of when I woke up.

Agreed that you should try to enjoy your evenings with your fiance after he gets home from work. You can also probably catch an hour or so in the mornings, before you go to bed and after he's woken up.

Some other suggestions that I've picked up after almost 5 years on the night shift:
- Vitamins are a must, especially Vitamin D supplements. You won't be seeing much of the sun come winter time.
- Bring healthy snacks and meals to the office. At 2AM the only takeout choices will be pizza or diner food. This is why us night-shift folks tend to pack on the pounds.
- Bring an e-reader, or lots of books, or something similarly stimulating. My biggest issue by far is the boredom and lack of human interaction.

Good luck, and feel free to PM me if you ever need support. It's not an easy thing that you've signed up for.
posted by Guernsey Halleck at 2:49 PM on June 25, 2012 [1 favorite]

I work 2-11 and I am not a nurse, but maybe I can offer some data points. I've worked this shift for about two years. I think probably everyone is slightly different and has different priorities/needs and ways of adapting, so just gathering as much info as possible about different strategies and coping methods could be helpful.

Do you ever transition back to a regular sleep schedule for your nights off?
Nope. I work a banker's schedule (5 on-2 off) and I actually tend to sleep more on my days off, but my doctor says I should knock that off. For a while I had a split weekend (3 on-1 off-2 on-1 off) and I felt very, very crazy and more or less took an extended break from playing the sport I was in (I split weekends to make more practices) and just sort of accepted it as being not the right time to juggle everything.

How do you manage to spending time with your loved ones?
See them on the weekends, mostly. Sometimes I meet my mom or dad for dinner during my "lunch" break, but obviously that's not an option for you. I bet you and your fiance could have breakfast together in a pretty relaxed way each day if that works for his schedule (ie, he doesn't leave for work at 6 a.m. or something). One thing that is important is to really, really commit to whatever you are doing as much as you commit to the job. Like, Saturday afternoons you do something together no matter what, the same way you would go to a doctor's appointment. That way, your relationship doesn't slip down the priority list.

How long did it take you to get in the habit of falling asleep during the day?
Ermm, I've always been a night owl, so it wasn't as much of an adjustment for me. It's kind of like...I have to go to work, so I just kind of do it. Sometimes I sleep away a whole weekend because I've slept weird during the week, but it's not, like, super terrible.

Is it tough to squeeze in exercise?
Oh my fuck, yes. That's one of the hardest things about this shift. You would think I would just get up and work out before work (sometimes I do), but I've never been much of a pre-work exerciser and I'm not in as great shape as I would like. I mean, you can do it, and I've had good stretches of a few months here and there, but overall for me it hasn't been really conducive to having a normal work-out schedule like I would like.

Basically, my feeling on this is that, yeah, there are some things that suck about the shift that I didn't anticipate or that were harder than I thought, but the job/situation met enough of my other goals and values that it was worth it to me for a certain period of time. It's not a "forever" job, and now I know more about whether I will commit to working this shift forever or whether I'm willing to suck it up and get up at 7 a.m. five days a week (something I thought I would never, ever do if I could avoid it).

400 EXTRA dollars a week at a wonderful work place is nothing to sneeze at, and you KNOW there's a end date for it. If you could walk out of this job in 18 months with 20k in extra wages that you've either saved or put towards debt or whatever other goals, with 18 month's worth of experience in your chosen field, with great references, and with your RN, I think that sounds like it would be worth it. I'm assuming you're youngish, and your 20s are the best time to basically just be a little more sleepy all the time and not run as much as you want, especially if you are getting a lot of value out of it. In your position, I would take the night job and commit to socking away the pay difference like WHOA and saunter off after 18 months like a boss. Like, to me, the sacrifices of the shift were small enough to be worth it. It's just a matter of whether the sacrifices are worth it to you, basically.
posted by Snarl Furillo at 3:01 PM on June 25, 2012 [4 favorites]

Yeah, speaking towards the exercise thing, I had a lot more time to exercise when I was working 2nd shift. I could go for a 2 hour bike ride pretty much daily, head in to work, then crash after work without worrying about sunsets or traffic or anything else that gets in the way of riding after my first shift job.

I think the important thing is to avoid turning into a complete vampire. The hardest part for me was avoiding keeping a "typical" wake up-work-personal time-sleep schedule. Instead, it was wake up - personal time - work - sleep. 3rd shift might be a bit different, since society will be awake both before and after your shift, so there's a bit of leeway there.

Of course, I'd go back to 2nd shift in a heartbeat if I gave up the chance of ever sharing a shift with my spouse, so I'm not exactly unbiased.
posted by Kyol at 3:03 PM on June 25, 2012

- Bring healthy snacks and meals to the office. At 2AM the only takeout choices will be pizza or diner food. This is why us night-shift folks tend to pack on the pounds.

Yeah, to me also, it's sort of like- I'm, let's say, 15% more tired/irritable on this shift than I would be otherwise, and for me, that 15% seems to be the difference between, "I should have a frosted croissant for breakfast" and "I should make myself an omelet and throw in some bell peppers." Also the difference between "I should get some more sleep tonight and tomorrow night" and "Fuck it, I'm buying a giant diet coke and a bag of M&Ms and LIVING ON THE EDGE."
posted by Snarl Furillo at 3:07 PM on June 25, 2012

That Ritz Carlton job sounds like a plus for your cv if you can manage it for the limited time you mentioned. The only question I can see is if you are a 'night person' and won't miss the midday sun. Your bf should be able to adapt since he surely wants what is best for you.
posted by Cranberry at 3:32 PM on June 25, 2012

I worked overnights as an RN in a psych hospital for a while. Staying up was no problem but getting quality sleep during the day was a huge issue for me. Black out curtains, noise machines, phone off and I'd still get woken up midday at least once a week. I did 3 12's though and had split days off, yuck. Nights were way quieter but god forbid you needed orders, the docs would either be super pissy or just not return pages. I usually had at least one pt in mania so i'd have someone to chat with which was nice. I saw my husband never but again I was pulling 12 hour shifts. I ended up leaving after a few months because i just could not adjust but i'm glad I tried.
posted by yodelingisfun at 5:00 PM on June 25, 2012

I worked an overnight shift for close to 3 years, but not as a nurse.

Do you ever transition back to a regular sleep schedule for your nights off?

Some people can flip it like it's a switch. For me, I had to be a sleep Nazi and stick to my schedule even on my days off or I was going to be miserable for a day or two while I readjusted. Downside for some is it meant lots of late nights by myself when normal people went to bed, but I prefer that anyway.

How do you manage to spending time with your loved ones?

You have to get yourself out of the evening "We both come home from work and have dinner together and then we watch TV and have a leisurely evening together" kind of mindset and figure out alternate arrangements for this sort of thing. Maybe you have a leisurely breakfast together as your partner wakes up and you get ready for bed. Or maybe you go for a jog in the morning when you get home and he wakes up, thus bonding AND exercising.

How long did it take you to get in the habit of falling asleep during the day?

For me, it took little time, but if left to my druthers, I'd stay up til 2-4am and sleep til noon to 2pm every day. Like even now, years removed, if I take a week off, I'll naturally drift to that schedule.

Is it tough to squeeze in exercise?

Exercise is the thing I miss most next to the lifestyle. I'd get out of bed and roll down to the gym and have it pretty much to myself. There are a lot of gym chains that have some kind of 24 hour arrangement, too. Your "lunch out" options will probably be things like Denny's and 24 hour diners, so you'll pretty much have to either bring your own healthy options or gain 20 pounds. I brought lunch and did fine.
posted by Ghostride The Whip at 5:33 PM on June 25, 2012

Congratulations on the job offer, that's really exciting! I worked night shift for years, in a managerial capacity which meant that I was often coaching newcomers to the shift.

Some people take to it, others absolutely cannot deal with it at all. Most people fall somewhere in the middle of the spectrum. The only way to find out which one you are is to take the leap and hope for the best. (Statistically, you probably will be able to deal with it reasonably well.)

I loved night shift. It's so wonderful to be up and about when the rest of the world is quiet and sleeping. Daytime started to seem jarring by comparison. (The grocery stores are so crowded! Everything is so bright and noisy!) It also means that you get to see a side of your town that most people don't. It's pretty great.

My #1 best tip is this: cover your bedroom windows with white foam core board. This is stuff you can buy at art stores and in the "presentations" section of office supply stores. The foam core keeps light from coming through. The white means that from the outside it isn't noticeable. (As opposed to, say, tinfoil - which looks ever so trashy. It works well, though.)

The more light you can block, the better you can sleep. Set up a fan near the head of your bed, to lay down a layer of white noise. Get earplugs, for those inevitable afternoons when that guy next door just will not quit with the weed whacker.

Personally, I had a firm rule that once I was on night shift, I never rolled off. This meant sticking to night shift hours during my weekends as best I was able. This is by far the best thing for you, if you can do it.

However, many people have friends and family commitments (and sometimes just the overwhelming urge to sleep when it is dark out). It happens.

Whenever possible, always roll your shifts forward. In other words, stay up "late" rather than getting up "early." This is more natural for most people.

Understand that there will be an adjustment period. It's basically jet lag. It can make you feel stupid, groggy, irritable, etc. Just as with jet lag, the first few days are the worst.

If your fiancee is a morning person, then he will probably be elated to have company on weekend mornings. Let's say you usually get home at 8AM and fall asleep by 10AM, that means that on weekends you'll be up when he wakes up at 4:30AM, and you two can go do stuff until you get super tired around noonish.

Exercise is the same as it always was. We just tell ourselves that it's normal to gain weight on night shift because it covers up the fact that really, it's just an excuse to be a bunch of lazy, snacking sods.

The only thing I would strongly urge you NOT to do is "split shift" sleeping. This is where you get home and sleep for a few hours, then your fiancee comes home from work and you're up for a while, and then you get the second half of your sleep later in the night.

Everyone I know who has tried this (including myself) ends up a complete wreck. Sometimes literally: as I'm sure you know, sleep deprivation is a major factor in fatal automobile accidents.

Um... gosh, I think that's all. Good luck, and enjoy the new experience!
posted by ErikaB at 8:25 PM on June 25, 2012 [2 favorites]

I used to work both 8 hour evening and night shifts in the same week as a nurse and occasional Baylors thrown in for good measure. I found the night shifts to be much much quieter, but anecdotally I would say you do have more deaths on them.
I did use pharmaceutiaacl sleeping aids when I first started to get used to the change of sleep pattern. And plenty of B vitamins for waking hours.
The only problem with weight gain I could see was that other staff tended to bring in more treats on the night shift. If you are worried about exercise, sometimes another nurse and I would "fast walk" the halls together.
By all means take the position at the better institution. Nothing will turn you off from nursing quicker than working at a subpar facility.
Good luck in your nursing career!
posted by Isadorady at 12:46 AM on June 26, 2012

My friend gave a long reply:

I'm a nurse (RN) and when I first graduated was only able to find a job working Nights. I wasn't sure if I would be able to handle it, but it turned out to be a wonderful decision! I too live with my fiance, and see him just as much as when I worked days (more than when I was in school). I would absolutely, without hesitation, advise you to take the job at the better workplace. Don't be affraid of Nights. Some people do have trouble with Night shifts, but many people love them. I even have a few co-workers who used to work day, but changed to nights. Working at a place you enjoy is incredibly important. And you might be surprised at the tight knit community on Nights. Not to mention you don't deal with rush hour going in to work. Running errands at 8am is much easier because there are no crowds. There are lots of perks.

Here are your questions:

Do you ever transition back to a regular sleep schedule for your nights off?
Yes. When I have days off, on my first day off I typically only sleep 4-5 hours. That way I am tired by 8-9pm and can go to bed at the same time as my fiance and transition to a day schedule. Then on my first day back to work I just take a 1-2hr nap before I go in. It's really about learning how much sleep you need, and when you will get tired depending on how much you have slept.

How do you manage to spending time with your loved ones?
My fiance works 6am-2:30pm and goes to bed by 9pm. I sleep 9:30am - 5:30pm. So we have every evening together. He goes to the gym after work and starts dinner, so when I wake up we have dinner together and see each other from 5:30 - 9pm. Then when he goes to bed, I will sometimes even go to bed with him and take a nap before work. If I want to hang out with friends, I have all evening. I get dinner with people, go to movies, etc all on nights I work.

How long did it take you to get in the habit of falling asleep during the day?
As soon as I bought thick curtains that blocked out the light in my bedroom, I had no trouble sleeping during the day at all. I was fine after a couple weeks. I still struggle some when people mow the lawn directly outside my window in the summer, or when people call me during the day. But I am usually able to fall back asleep or nap again before work.

Is it tough to squeeze in exercise?
It can be. I try to go to the gym after work (at 8am). It's a little hard to motivate myself to go after a full nights work. And it can wake me up more so that I don't get to sleep until 10am sometimes. And working out when you first wake up is better for your metabolism. But, it's not bad. Still very workable.

Nurses: how does the night shift differ from the day shift, at a nursing home?
I work in a hospital, so it might be a little different, but I can tell you the differences here, and let you decide what applies for you. Night shift is much more flexible. Since most of my patients have less night medications, I can see them each at different times, which gives me flexibility. I don't have to see everyone within the first hour of my shift. That flexibility gives me time to spend with patients too. If a patient can't sleep, I have the ability to sit down and talk with them for a while, rather than being so crunched for time. On Days, every patient has 8am medications, so you have to see everyone right away. You also have therapists and doctors rounding all the time. On Nights we rarely have to deal with doctors. When you do call them, they can be pissy, but you learn which ones those are and how to deal with them pretty fast. For the most part, if you tell them why you're calling and exactly what you need, they'll say yes and hang up the phone. Day shift is also when managers and most of the "senior" nurses work. With that, you have more oversight, and often times bigger egos to deal with. On Nights, we don't deal with that much at all. One of the problems can be that all meetings and education happen on Days. So either Night shift people are expected to stay late, or else you miss important meetings and training. Lastly, there is a difference in perception. Many people think that Days do all the work and Nights sit around reading. For me at least, that is not the case at all! It's why staffing is different from Days to Nights (because they staff so that all shifts are busy all the time). There is maybe one shift every month or two that it is slow enough that I can sit down and read a book. I am just as busy on Nights as when I pick up a day shift and work then. If anything, Days has more resources in case you get too busy and need help. On Nights, I am expected to be much more self-sufficient. That means it is a little harder to find other staff to help me with personal cares. But if there is an emergency, I still do have resources available to call upon.

Hope that helps! Don't be affraid of Nights. It might be the best career change you ever make.
posted by craven_morhead at 7:03 AM on June 26, 2012 [1 favorite]

My wife is a night-shift LPN, although she works at a hospital instead of a nursing home (she *has* worked in nursing homes, though). I work days. We have five kids and have never used daycare.

I'll say this: the "time with loved ones" issue is the toughest for us. Since we have kids to take care of, our only 'together' time is three nights a week for about three hours. It's not easy. So if you plan on having kids in the near future - or if you have them already - don't plan on having much free time.

Having said that, we did manage to make two of those kids while on this crazy schedule, so apparently we were alone together a time or two... :-)

My wife has the best sleeping ability of anyone I've met. She gets up Friday morning and stays up all day with the kids, then stays up all night at work (on a 12-hour shift). She comes home Saturday morning and sleeps eight hours in the day, then works another 12 hours. She sleeps all day Sunday, does another night shift, stays up all day Monday with the kids, and then sleeps during the night on Monday-Thursday.

I would never be able to do that. I need stable, steady sleep. I thrive on ritual. But she seems to do okay.

Good luck!
posted by tacodave at 3:30 PM on June 26, 2012

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