Nurse on the Run

So, happy new year, blah blah blah.  New Year’s Eve at work was actually pretty fun, or at least maybe as much fun as I would have had out at a bar somewhere, as I think NYE is a bit overrated.  We had crowns to wear over our bouffants, and we all crowded into an empty room to watch the ball drop, blow some noise makers, and yell happy new year.  There’s an awesome picture that I missed being in because I was drawing an ABG on my patient, and I’d post it but not so sure how everyone feels about it at work, soooo just let me tell you it’s a fabulous group.

But, as you can tell by the fact that I was at work at midnight, I’ve gone back to night shift.  I can’t say I’m overly thrilled with it.  I don’t mind night shift, it’s just the fact that it messes with the rest of your life so much.  We can rotate to day shift, which is nice, but they changed our rotation from four months of night shift followed by two months of day shift to SIX months of night shift followed by two months of day shift.  I understand why this happened, but those extra two months are going to be killer.

To my NYC friends, sorry if I don’t see you until June.  #dramatic

But really.  I absolutely love the night shift people who I work with, and the pluses involved in working nights include the fact that you are a little more autonomous as not as many doctors, managers, PT, social work, etc are floating around.  You can do things a bit more on your own time versus adhering to working around other people’s schedule.  At night, the only people who are really there are nurses, whatever medical staff are covering (a PA and a senior fellow on my unit), sometimes a night manager, and the administrator.

This actually is a good deal because, as I said, you can kind of do what you want.  The problem is that so many things are categorized as, “Well, we’ll figure that out in morning rounds.”  Or it’s 3am and some things just aren’t open and must be deferred until the morning.  Sometimes I feel like night shift is just a holding pattern until the morning when things can start happening again…kind of a “keep them alive until morning” idea.  That’s a very black and white way of saying it, but sometimes that is what it feels like.

But enough random babbling.  At the moment, I’m here to dispel some myths that I’ve come across in regards to night shift.  My schedule is very different from what most people work (I’m talking the 9-5-ish, emphasis on the ish), so it’s hard for some people to understand.  But, here we go:

1.  All hospitals are different, but at my hospital we do strictly twelve hour shifts.  So, that means 7:30pm-8am (30 minutes of overlap between shifts so we can give report).  So when I say I’m working at night, I literally mean all night.  As in, when you’re heading to work, I’m probably wrapping up my shift or heading home.

2.  Patients don’t sleep all night.  Sometimes they do.  I’ll tuck them them after midnight vitals (not literally…well, sometimes literally) and tell them I’ll see them at 5am for vitals/lab draws.  This is not usually the case.  ICU patients will be sick whenever they want to be sick, so there’s that.  Non-ICU patients have problems of their own, whether it’s pain, bowel issues (I love a good bowel emergency at 2am…), or the fact that they realized that their wallet was locked up by the ER and they want it now.  Or, physical therapy/social work/whatever discipline is only there during the day told them they would do something with them during the day, and they didn’t.  Fun fact:  I can’t help you with that right now other than pass along the message in the morning.  It’s always fascinating what becomes really, really important at 3am.

3.  Based on what I said above, no, we don’t get to sleep at night.  Some shifts are slower than others and I will plan an entire vacation at night, but other times I may not have time to go to the bathroom.  Usually it’s pretty nice flow, and I learned to be efficient very early in my nursing career, so I have that going in my favor.

3.  I don’t “get to enjoy my time during the day.”  When I work night shift, I sleep during the day.  There’s 11.5 hours between shifts, so I might squeeze in a run, but for the most part, I try to sleep.  It’s not like I’m checking out the Guggenheim every day, although if I didn’t need to sleep maybe I would consider it.  I will say that having the option to run when the sun is up is definitely a plus.

4.  When I’m not working, I attempt to flip my schedule back to a “normal” schedule.  Flipping your schedule a full twelve hours every few days is really, really hard.  I generally apologize to anyone who has to deal with me and limit the people who I’m allowed to see on my first day of flipping.  That being said, this time around I’m trying not to be so hard on myself about getting up after a short nap and then being exhausted all day.  It’s a balance that I honestly haven’t figured out yet.

Here’s how the flip works:  The night before my first night shift, I try to stay up late and sleep as late as I can, then I just pray for the best at work.  The first night isn’t necessarily too hard…it’s the following nights that can get tiresome.  After my last night, I come home and try to sleep for a few hours, then make myself get up around 1-2pm in hopes that I can fall back asleep at night.  Sometimes it works, sometimes I end up sleeping until 5pm.  As I said, I haven’t figured out the perfect formula yet.  Overall, the schedule really wouldn’t be that bad, except the rest of the world isn’t on this schedule and people don’t really understand it much.

5.  Yes, I eat a meal in the middle of the night.  Sometimes.  Usually eating goes one of two ways:  either I’m eating everything in sight or absolutely nothing sounds worthy of eating.  (But I will always drink more coffee.)  When I get home, sometimes I force myself to eat a bowl of cereal but that’s usually the extent of it.  I understand this doesn’t go well with marathon training, but it is what it is.

6.  Working overnight includes working Friday, Saturday, and Sunday night.  All night.  I’m usually surprised by how many people think that nurses may not have to work weekends.  I will say that this is one of the harder parts of working night shift, as that’s when the rest of the world is more likely to be doing things.  Luckily I’m friends with my nursing crew so we’ll do things on a Tuesday when everyone else is going to bed at 9pm (looking at you, Kelly and Jocelyn).  Going out on a limb to say that this makes dating very difficult.

7.  Day sleep is not like night sleep.  People eventually understand that when you work at night, you sleep during the day.  I don’t know if you’ve ever tried to sleep during the day on a consistent basis, but it’s not the same as sleeping at night.  If I’m asleep by 9am, I usually sleep until 1pm or so then wake up every hour until I finally give up and get out of bed.  Some nurses do take melatonin or Benadryl, but I try to stay away from it (I have no basis for that statement).  This is why I drink so much coffee, although so far it’s been two cups before work and none at 3am yet.

I’m not sure what I’m counting to.   But that’s a good start.  Night shift isn’t the easiest thing in the entire world, but there are perks.  As I said above, you mainly have the other nurses to count on, and I really do like the teamwork I find on night shift.  Plus, you more or less have to start on night shift, so it’s a younger crowd who I’ve become friends with over the past year which really has made a difference.  Not that I don’t love my friends outside of work (you’re all runners, so of course I like you…), but it is nice to have people around who understand the weird hours and the craziness that happens at work.

The other perk of night shift, or at least the perk of working twelve hour shifts, is that I get random days off…and on those random days I can run at 2pm without any care in the world.  I’m trying not to beat myself up about needing to sleep in, so after not being able to fall asleep until 4am on Wednesday night/Thursday morning, I ended up sleeping/staying in bed until noon.  I probably could have made myself get up and been somewhat productive, but I really have no one to answer to so who really cares if I sleep more?  So I did.  Then I went running at two in the afternoon and it was glorious.

I ran over to Riverside Park and actually managed to not get lost, which doesn’t usually happen.  It “felt like” 20-something, but it was sunny and not windy which is actually great running weather.  I admittedly had been fairly grumpy the night before (sorry to those who had to experience that…), but a nice run made me feel so, so much better. 

First run of 2013, I think I’ll take it.

I don’t know if this post was more to attempt to explain what night shift is like or to make myself feel better by talking about it.  But I hope it helped to shed some light into what night shift is like.  I would like to write about nursing a little bit more, as the more I talk to people about it, the more I realize that people have absolutely no idea what it’s like in the hospital.  (This is probably a good thing since it means you haven’t spent time there!)  It’s not like on TV, I promise, even the NY Med shows. 

Let me know if there’s any topics about nursing/the hospital world you would like me to talk about, otherwise I’ll come up with them myself.  In the meantime, I’ll probably just be drinking a lot of coffee.