You’re On the Night Shift Now—Ways to Cope with an Upside Down Schedule

NursingNovember 14, 2016

Some jobs are 9 to 5, and some workers get every holiday off. Those jobs are not in the nursing profession, and those workers surely aren’t caring for sick folks. That’s the job of nurses. And the mission never ends. Patients get sick and need care ‘round the clock, 365 days a year 24/7. They don’t schedule accidents for work days, and they don’t postpone medical crises for after the long holiday weekend.

On the contrary, many holidays seem to generate their share of new patients. It’s a rare emergency department, for example, that sends staff home early on Independence Day. Alcohol-fueled celebrations and powerful fireworks are a volatile combination, to be sure, and accident victims are common during these celebrations. Likewise, mishaps in the kitchen are not uncommon at Thanksgiving.

Good Night

Which brings us to the issue of the night shift. Sooner or later, at some point in your career, you will probably be asked to take some night shifts. As a nursing professional, you will be aware that the concept of staying alert and active all night goes against millions of years of evolution. Humans are diurnal, meaning we’re adapted to being awake during daylight hours—and sound asleep after dark. Our circadian rhythms are finely tuned to ensure our alertness during the day, and to prepare us for restorative sleep at night. 

Working night shift requires your body and brain to upend that natural cycle, and doing so can be harder than it sounds. There’s a reason people who often fly great distances suffer from jet lag. Jet lag is a constellation of symptoms that arise when one crosses three or more time zones rapidly. The more time zones crossed, the more difficult the adjustment may be at the new destination. To say that it’s a simple matter of sleeping enough during the day to get the rest you will miss during the night is a gross oversimplification of the challenge of adapting to this drastic change. 

Many of the body’s processes, including cycles taking place within the digestive tract (and influenced by the communities of friendly microbes that constitute the microbiome), are “thrown out of whack” for lack of a better description, by the shift from diurnal to nocturnal activity. In short, abruptly switching from day shift to night shift can be surprisingly hard on your body. 

However, it is possible to adapt to this schedule. Many people have done it before you. But switching back and forth unpredictably from days to nights is arguably hard on your body. The human body simply doesn’t handle repeated interruptions to the circadian rhythm all that well. Some people will experience problems with appetite; having none, or being unexpectedly ravenous. Don’t be surprised if it takes you two weeks or more to adapt to your new work schedule

Coping Strategies

Some nurses split their daytime sleep hours into two sessions. It’s an approach that makes it easier to care for young children. In any event, it’s crucial that you sleep during the day, or you won’t be able to function at night. Lack of proper sleep and rest can put you at risk of making critical judgment calls. 

Prioritize your sleep time.

Set a schedule that works, with an eye towards making your sleep a priority. Make sure family members or roommates understand that you cannot be disturbed while sleeping.  

Prepare your sleep space. 

Research indicates that sleeping in a cool room fosters more restorative sleep. It’s also important to sleep in total darkness. Again, this is because natural melatonin production is inhibited by even the smallest amounts of light—particularly in the more energetic blue portion of the visible light spectrum. That means avoiding exposure to digital devices and television screens before sleep time. Consider wearing a dark, soft face mask.

Use caffeine and avoid simple carbs during your shift.

Caffeine can help keep you awake and alert at night, just as it does during the day. Choose healthful snacks featuring protein and complex carbs to help keep your blood sugar levels steady and avoid wild oscillations in insulin levels. Simple carbs (sugar) causes sharp spikes—and deep troughs—in blood sugar levels. Those troughs are experienced as periods of sleepiness and lethargy. Avoid this see-saw approach to blood sugar regulation by avoiding simple carbs.