Written by Ingrid Vennonen, Bachelor of Nursing (Graduate Entry) graduate (2017)
Does the thought of night shifts make you feel uneasy and stressed? They did for me – until I worked out how to conquer them.
As a nurse, the typical night shift starts at 9:30 pm till 7:30 am the following day. Night shifts are generally longer than the normal day shift, presenting unique challenges for both your work and social life. Generally, your patient-to-nurse ratio is higher than during a day shift and doctors are sparse or on call, meaning less support if a patient’s condition deteriorates.
Working night shifts also means you have less contact with the outside world, perhaps disconnecting you from your loved ones and disrupting your life and sleep patterns. When night shifts aren’t tackled successfully they can be detrimental on your health, therefore it’s great to have a plan to make it through them.
Research shows insomnia, daytime sleepiness and sleep deprivation are commonly found in individuals who undertake shift work, as nurses do (Harrington 2018). Additionally, alternating shift work patterns and night shifts influence these side effects further (Harrington 2018).
Why is it that shift workers face these problems?
Naturally, our body’s intention is to follow a 24 hour cycle, our circadian clock. This ‘clock’ plays a role in influencing our body temperature, hormone production, heart rate, respiratory rate, urinary excretion, cell division and other bodily functions (Harrington 2018). Regularly following this natural cycle helps our body regenerate cells and eliminate toxins promoting longevity. When working night shifts our cycle is disrupted which can result in less sleep and a decrease in our physical and mental health.
However, when nurses understand their circadian clock and learn to combat the sudden changes on their body and mind from night shifts, the transition can be easier.
Tips to prepare for the night shift:
1. Schedule sleep
Try to stay awake for longer the night before and sleep in as long as possible in the morning. Schedule in a long nap during the afternoon before you start the shift to help with clarity and focus at work. To choose to go without sleep for up to 24 hours in order to adjust was found by a 2011 study to be the least effective strategy to adapt one’s circadian clock to a night shift schedule (Borsetti 2011).
2. Minimise stress in the hours before
This will allow you to conserve energy and also start the shift in a better frame of mind ensuring clarity and minimising the risk for stress.
3. Exercise after you wake up from the afternoon nap
Physical activity helps to flush your body which will refresh you for the shift. Additionally, exercise helps to manage stress and maintain a healthy lifestyle during shift work.
Getting through the shift:
1. Hydrate
This is key to a successful night, keep regularly sipping water to maintain alertness and to combat signs of dehydration.
2. Make healthy meal choices
Choose items which release energy slowly such as low GI foods (wholemeal foods, vegetables, nuts and grains) and ensure your meals are well balanced with carbohydrates, protein and fats. Some nurses choose to have spread out meals during the shift whereas others may adopt a ‘grazing’ approach by eating small meals more regularly. Bring a few healthy snacks as a pick me up if you do get tired such as a naturally sweetened granola bar. Avoid snacks which are high in sugar or caffeine to avoid crashing and burning later in the shift.
3. Make a plan
At the beginning of your shift make a plan to decrease stress and manage tasks which come your way. One way is to schedule tasks for each hour of the night, bearing in mind to schedule tasks which are cognitively demanding or tedious to the beginning of the shift and not around 4am when you are getting tired!
4. Consume caffeine wisely
Between the hours of 0100 to 0800 is when the physiologically and the normal circadian rhythm is telling us to sleep (Diekins 1990). Studies have demonstrated that 300 mg of caffeine significantly improved task performance in individuals working night shifts (Diekins 1990). However, as caffeine also markedly disturbs sleep, it would be wise to not consume coffee 2 hours before finishing the shift.
After the shift:
1. Minimise light
To ensure your body and circadian rhythm isn’t put into ‘wake mode’. Wearing sunglasses when travelling home, making the bedroom dark, wearing a sleep mask and not spending time out and about after work are some ways to decrease exposure to sunlight.
2. Travel home safely
Keep in mind you will be tired and avoid driving long distances to travel home. Find alternatives to travel home such as public transport or carpooling with co workers.
3. Practise healthy sleep hygiene
Prioritise sleep and try to get to sleep as soon as possible after your shift when your body is still cool. Our natural circadian rhythm causes our body to be coolest in the morning which is an important factor when trying to fall asleep, the hotter your body is, the harder to fall asleep. Turn off all devices and any blue lights. Try wearing ear plugs and an eye mask to ensure you aren’t woken.
4. Reward yourself and prioritise self care!
Take it easy the following day to recover from the night shifts and keep in mind your body will take time to adjust and for you to find your routine. My tip: Treat yourself with a massage, sweet treat or just a movie! Also keep in mind to not be too hard on yourself and not to put too much pressure on yourself to complete all the tasks you usually do on a normal day; you will be tired!
Sources:
- Harrington, J M, 2018. Health effects of shift work and extended hours of work. Occupational and Environmental Medicine, [Online]. 58, 68-72. Available at: https://oem.bmj.com/content/58/1/68.info
- Borsetti, H M, Ciarleglio, C M, Carver K, Gamble, K L, Hamilton, N, Hicks J, Hida A, Johnson C H, McMahon D G, Motsinger-Reif A A, Robbins S, Servick S V, Summar M L, Wells N. 2011. Shift Work in Nurses: Contribution of Phenotypes and Genotypes to Adaptation. PLOS Biology, [Online]. 6. Available at: http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0018395&type=printable
- Diekins Q S, Humm T M, Muehlbach M J, Schweitzer, P K, Sugerman J L, Walsh J K. 1990. Effect of caffeine on physiological sleep tendency and ability to sustain wakefulness at night. Psychopharmacology, [Online]. 101:271-273. Available at: https://link.springer.com/article/10.1007/BF02244139
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