Switching to 12-hour night shifts: what am I missing?
November 21, 2013 11:09 PM   Subscribe

I'm a new nurse, just getting used to working second shift, now I'm switching to overnight 12-hour shifts. I haven't fully adjusted to the second shift way of life after two months of it, so I'm rather concerned with how this is going to go. I know intellectually the importance of sleep, proper meals, socialization, finances.... What am I missing?

Two months ago, I started working five consecutive shifts a week, 3 to 11:30 PM. Now I'll be doing two or four random nights a week (six in a two-week period) from 7 PM to 7 AM. I won't be working Monday or Friday nights, but it's any other combination.

For the evening shift, I've tried to get lunch with my friends/family beforehand if at all possible, or hit the gym, so I'll be well energized/fed/socialized. I've overstuffed my days off to make sure I'm seeing people, doing things, getting my life in order.

I'm a woman in my late twenties who can't even keep a basil plant alive, so there's no risk of keeping anyone else awake in my household: my time is my own once I come in through my door. This time is spent on the internet while watching cartoons until I fall asleep. It's not a perfect system, but it's been working somewhat. (I tend towards insomnia already, part of why this shift appealed to me in the first place.)

I'm worried about the overnights: there's a huge difference between an 8-hour and a 12-hour is a huge difference. So, I've been having nightmares, that sort of thing.

Things I have thought of when switching this schedule:
  • comfy clothes/shoes I can run around in for 12+ hours at a time
  • sleep mask, curtains, white noise, proper sleep hygiene, not trying to switch back fully during my days off
  • making up meals ahead of time, bringing protein bars, finding quick simple meals for when I get home
  • continuing to make plans/contact with friends/family so I don't feel isolated...
  • ...while still finding time for myself so I don't feel too stretched
  • not relying on coffee to give me energy
  • going to the gym, working out, staying active outside of work physically
  • studying for school! paying my bills! being an adult!
So, what are the holes in my plan here? How can I transition smoothly? Am I going to be driven mad by the end of next week?
posted by RainyJay to Work & Money (18 answers total) 3 users marked this as a favorite
Cover up every window in your bedroom so you can sleep during the day. I literally just pinned a thick dark bed sheet to the wall to cover mine. Start collecting audiobooks or podcasts or something that you can listen to that will help soothe distract your mind while you're trying to fall asleep. Try not to use sleeping pills.

Don't rely on caffeine to stay awake if you can avoid it. I've been struggling with this.

Eat well while you're working.

See if you can take naps during your shift.
posted by empath at 11:24 PM on November 21, 2013

Best answer: Could you clarify what you are most worried about with switching to overnights? Because clearly, if you're having nightmares, this goes beyond just average concern about a schedule change and shift work.

It's hard to imagine just the tedium/length of a 12 hour shift being that frightening a prospect, but I know I wouldn't be excited about it - I hate working 12s. But usually the tradeoff is that you're working fewer days of the week. It's a bit unclear from your question but it looks like you're saying that you're working the 2 to 4 nights per week instead of working any evening shifts, meaning that instead of working 10 shifts in 2 weeks, you're only working 6 - so, again, I'm just unclear about where the fear is coming from since you should have even more time than you had before to socialize, take care of yourself, etc.

I agree with empath about getting the window shades. I don't actually find a problem with using caffeine when I'm going in to my shift, it seems to make the night more enjoyable in my opinion. It is a problem to use caffeine to stay awake on your way home. I find that I can start falling asleep through any amount of caffeine after being up all night. I think the biggest thing for you to ensure here is safe driving home. I have found that for me, because I have always lived >30 mins away from work, I *MUST* nap either before I leave work in a spare call room, or in my car in the parking lot. It just isn't safe for me to try to make it home otherwise. I try to never schedule anything on the morning after an overnight so I will never feel pressured to drive straight home without napping. If you want any further tips on how to deal with sleeping in your car after a night shift, or anything else about working nights, feel free to drop me a line. But take deep breaths and try to be calm about this. Nights can be fun!
posted by treehorn+bunny at 11:32 PM on November 21, 2013 [1 favorite]

Response by poster: Not threadsitting.

Clarification: never worked overnight before, have problems sleeping past 10 AM... even if I've been up to 5 or 6. Going to 12-hour shifts also means I'll be more on my own at work... there will be less of the safety night, less overlap with the day shift of people. It's also... if I have an off night now, that's one of five that week. If I have an off night

No naps will be possible: we will have less staff on this shift, so breaks will be hard to come by. There is no napping location unless I commandeer a vacant patient room, which is frowned upon.
posted by RainyJay at 11:41 PM on November 21, 2013

Best answer: Try and focus on the positives. I work a lot of night shifts, and my girlfriend does permanent nights when she can (we're both nurses).

Night shifts are: quieter, there's less politics, your patients generally sleep, the whole thing is more relaxed, the pay is better and management isn't around.

Honestly, everyone's different but I never sleep on night shit - every time I've tried it I just feel groggy the rest of the shift and have trouble sleeping the next day. I just push through, have breakfast and crash until the next night. Just remember to drink lots.

Good luck! I've just come off a run of 4 nights in the emergency department and I'm currently facing my worst thing about night shifts: getting back into day shift mode!
posted by Silentgoldfish at 11:45 PM on November 21, 2013

Best answer: I'm on a night shift right now (in the lab) and one thing I found was for me, taking a sleep break during the day worked better than trying to do a full 8 from 1000-1800 or so. I generally get home, shower, stay up a bit reading, eat breakfast, then sleep until mid day, then do some quiet at home stuff when possible (versus going out to do errands) , and then nap again until the evening. I also found eating very lightly while I was on shift stopped me from feeling post prandial.

And oh yes, eyemasks are great once you get used to them, and do whatever you can to block out bedroom light and keep very strict sleep hygiene wrt banning working or screens in the room. Best of luck!
posted by cobaltnine at 12:02 AM on November 22, 2013

For napping at work, I found that the best thing was to drink a cup of coffee and then nap for no more than 20 minutes. That'd keep me going for a few hours usually.
posted by empath at 12:05 AM on November 22, 2013 [1 favorite]

Best answer: Michelle of Nom Nom Paleo has a helpful post about working the night shift at a hospital.
posted by neushoorn at 12:07 AM on November 22, 2013 [1 favorite]

The biggest thing you're going to have to do is become kind of an asshole about your schedule. People will assume since it's during the day and you're around, you're available. People I knew were like kids. HEY WANNA PLAY no I have to sleep NO YOU DON'T IT'S DAYTIME. Don't try to flip flop back and forth if you can avoid it. Try and stick to your routine as much as possible, even during the weekends/days off.

Be prepared for all your big, busy plans to go out the window. I used to work 4 10s as well as 3 12s and one of my "extra" days off was always just resting and trying to recover.

Bring snacks or energy bars or something you can nibble during your breaks, assuming you get the 10-15 minute kind of break, because you'll want a little pick me up. I'd also stay away from really heavy things that make you feel tired, because grinding through those last hours when you're already tired and lunch is dragging you down is rough.
posted by Ghostride The Whip at 12:30 AM on November 22, 2013 [3 favorites]

Best answer: Medicine resident here. We work long shifts, sometimes just one 28-hour shift every 4-6 days, other times we work 5-6 days in a row for two weeks.

-Don't sleep during your shifts. It makes me groggy and I always feel like I end up missing something, even if it's minor. Plus, it's horrible to be frightened-awake by whatever your contact mechanism is - phone, pager, whatever. If you have to take put your head down, commit to 10 minutes.

-If you have a short break (one or two days between shifts), don't break your day-night cycle if you can help it.

-If you have a few days and you want to be awake during the day, try to only sleep for a few hours after you get home (ex. when I get off at 9am, I only let myself sleep until 1am), so that you can use the rest of the day to do stuff that doesn't require a lot of thought. My post-call days are my laundry-and-cleaning days, and I try not to drive anywhere if I can help it.

-If you break your day-night cycle and need to get ready to go back for a night shift, wake up early-ish, and take a nap 5-6 hours before your shift. The first night back is probably going to stink no matter what, but the nap will be what pulls you through. Wake up early enough before your shift that you won't have any residual grogginess.

-Drink lots of water at work. Staying hydrated helps you keep awake, and doesn't have quite as much diuretic effect as I find coffee does. I do occasionally use No-Doz if I need a little pick-me-up, but I don't like feeling jittery. Stay away from heavy snacks and greasy cafeteria food - bring your own fruit and veggies. Consider a subscription to Graze to help with this - it's been a godsend for me this year. (It's invite-only at this point, but memail me if you're interested and I'll give you a code.)

-Blackout curtains are amazing if you can afford the good ones. I also use a sleep mask.

-I use an app called Pzizz to help talk me to sleep when my brain is less enthusiastic about sleeping than my body is. There is a trial version, and it's available for iOS and Android. Costs $5, has been worth every penny.

As far as general sleep hygiene beyond a dark environment, phone should be on DND if at all possible, no phone games or television before you tuck in (the blue light from the screens confuses your brain), and set a consistent wake time and bed time. Don't do anything but sleep and have sex in your bed.

It's really hard to commit to exercise when you're on a night system. Probably best to wait and see how much you're sleeping, and decide whether you can handle adding it in before you go to sleep, once you've adjusted. In the mean time, I'd advise you to stick to your days off. I find that trying to work out before bed, even after I've been up for 30 hours, makes it far more difficult for me to fall asleep.

Good luck!
posted by honeybee413 at 12:35 AM on November 22, 2013 [2 favorites]

Best answer: I've worked overnight before, and I think the biggest thing is to make sure that you really, really get some decent sleep during the day. I used to try to get away with sleeping as little as possible when I was working on movies that shot overnight (5PM until 7AM the next day), and only when I finally gave in and stopped trying to take advantage of the day did I stop feeling like shit.
posted by ablazingsaddle at 12:59 AM on November 22, 2013

Best answer: I am a nurse, on 12 hr night shift, right now as I type. I was a new nurse last year. It's nice to start off on nights when you have less people bugging you. I try to clump my days off every now and then so I can have, say, three *normal people* days in a row. I used to try to stay up late every night but now I suck it up so I can be out in the morning sun sometimes, and, although not ideal, it's fine for now.

I did invest in blackout curtains and currently have a window too wide for curtains so I use blackout EZ window covers. I also bought a white noise machine because I'm an apartment dweller and upstairs neighbors never seem to work a standard 8-5 anymore. My boyfriend sometimes still likes to barge into the room with exciting news at noon, but I'm training him to stop.

I sleep fine in the day because I'm so exhausted by the end of the shift. I'm going to switch to days when it's available, but I will miss night shift folks, quiet(er) halls, and quiet(er) patients. Good luck.
posted by evalunatik at 2:09 AM on November 22, 2013

Best answer: Here's what I do: Sleep from 8am to 3-4pm. If I'm working 2 days in a row, I don't do much between shifts aside from sleep, clean, make food, relax. You can't be too hard on yourself. Mixing days and nights is torture. I don't do it. Even on nights when I don't work, I still go to sleep around 3 or 4a.

I used to ingest a steady stream of coffee or tea throughout the day. Now, I just have a cup when I wake up, which I've been doing for most of my adult life.

One great thing about working nights is that I don't have any temptation to buy food as I would during the day. There's less food around. I've sworn to myself not to eat from all the nasty little bowls of snacks people have around. When I'm by myself, I put food people have left otu of my eyesight and I find I don't crave it.

Sometimes, I've gotten into a funk from not getting enough daylight. If I wake up early and sacrifice a few hours of sleep every once in a while, I can get some stuff done before work.

Yesterday, I had a massage before work, which was great. It's easy to book certain things during the day than it is during prime hours.

There are real pro's and con's to the night. I won't get into the cons, but here are a few pro's: it's not as much of a competitive atmosphere as the day, Seeing the sunrise is beautiful, and I love not having any traffic on the road. I love listening to college radio at night. I feel a close connection to the radio at night. I've found that having something going on in the background helps time pass. Find something to research.

Ah! If you're a nurse avoid gossip! There's this weird, false sense of privacy that can come about during the night shift. Don't say anything at night that you wouldn't say during the day.

If you are someone who can work nights, you are really valued. There's a lot of job security.
posted by Hennimore at 3:15 AM on November 22, 2013

Best answer: When I started night shift I was really unprepared for the crazy food cravings I get when I wake up in the afternoon. Stock up on healthy snacks and freeze some meals in case you don't feel like cooking.

I transition into night shift fairly well but coming back onto day shifts is a killer. I have been using the anti-jetlag 16 hour fasting method with some success.

Also, from a "civilian's" perspective - lower your voice when you are around patient areas. It may be a "working day" for you but it is sleepytime for many patients. I was surprised how many night staff didn't take that into account!
posted by Naanwhal at 5:01 AM on November 22, 2013 [1 favorite]

Not a nurse, but I am currently working night shift. I just wanted to add that taking melatonin has saved my sleep despite the heavy construction going on in my complex 6-7 days a week.
posted by rideunicorns at 6:20 AM on November 22, 2013

Best answer: I worked overnights for 6 years. My favorite tips:

You will walk out and it will be day and your body will get a second wind. Combat this by keeping your house dark when you get home. Keep blinds down, lights low, etc. Record a few primetime shows the night before and watch them vs turning on the morning news and getting stressed out about the day's events.

Stay up for about 1.5 hours after you get home. Eat a small dinner-like meal or a bedtime snack.

When you wake up (probably around 4-5ish) open those curtains immediately. While this is harder in the winter, during the summer you're letting in that daylight and it will help recharge you.

Eat breakfast when you wake up. I don't care if it is 6pm. Cereal, fruit, bacon, eggs, whatever.

Invest in a good white noise machine. Keep your phone off. Ditto everyone who tells you to be completely unavailable during your sleep hours.
posted by haplesschild at 7:39 AM on November 22, 2013

If you are on different shifts, it is absolute hell on your SO. Also, the familiar places where you stop for gas or whatnot can be very different at those hours.

I learned things on night shift. I found things. Horrible things. Do not pick up bags you find on the ground.

Be safe and plan your commute so you don't interact with other denizens of the night.
posted by Mr. Yuck at 7:41 AM on November 22, 2013

Best answer: When I was a new ICU nurse, I learned the most on night shift. Patient going bad? Everyone pulled together and helped me start drips and page anesthesia. You will really, really learn important nursing stuff by having to figure it out with fewer support staff around. You will have the time to pay attention to subtle stuff without all the daytime distractions. BP continuously falling, but over a couple of hours? Hello, sepsis. Get fluids ready and page the resident. Watch respect for your assessment skills develop. On dayshift I might have missed this because there were visitors asking me stuff, or the pharmacy was on the phone. On nights the senior nursing staff and residents were more friendly and supportive. It seemed like we were all in it together without all the attendings and families looking on, and I got to know and like people I thought were snarky from my observations of them on the day shift.

I found that there was less physical work at night because we tried not to disturb patients who were able to sleep, so less changing out of IV tubing, fewer bedbaths given, and generally less of routine nursing stuff, less interraction with families after visiting hours ended, no meal delivery, very little getting patients into and out of bed after visiting hours. So the down times can be boring, and I always had a book with me while I sat and watched monitors. But if I got an admission from a code on the floor, or if a patient went bad, or I had a new admission from a late surgery, it was fun, if that doesn't sound too disrespectful. I was "on", and it was up to me to get the patient's history, get them settled, do an assessment and write my note, follow their possibly unstable vitals, and interevene with whatever med or procedure needed doing, all while getting tons of help from my colleagues who had also been a bit bored just a few minutes earlier.

One bit of advice I can offer is to let everyone you know that you are NOT REACHABLE while you are sleeping. Turn off the phone, get a white noise machine, use earplugs if you need to and make sure your bedroom is dark. People will persist in trying to reach you because most of the world operates on the opposite schedule. Try to figure out how to silence your doorbell, if you can hear it in your bedroom. Sleep deprivation is an awful condition, and can really wear you down!
posted by citygirl at 7:56 AM on November 22, 2013

Best answer: You can cheaply cover windows with foil. You could buy a white-noise machine. Leaf-blowers and children with balls are the worst, I hope you don't have to deal with either. Try to space small rewards over your shift, like hour 4 is when you eat a fruit. Walk around at least every hour if your job involves a lot of sitting. Don't let coworkers or the previous/next shift who sneakily sleep in the closet or under tables influence you, they are often fired fairly quickly. Eating at safe popular all-night diners after your shift can make you feel a bit more human if your job isolates you a lot. Cats don't care when you are awake, if your circumstances allow you could get one to sleep and hang out with.
posted by meepmeow at 10:47 PM on November 22, 2013

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