I’ve been asked by a lot of people how to manage night shift and its little friend, sleep disturbance, so I thought I’d write down a few of the tips that I have gathered over the years. Would love to hear your coping strategies and tips in the comments section…
Going onto nightshift
1. Try to do something physical “the day before the day before”. Physical activity is good for your general wellbeing anyway, and it will set you up for a decent “pre-nightshift” sleep. I would go swimming, running, boxing or have a mega-housework blitz. Then get a decent amount of sleep prior to starting nights:
- Method 1: Stay up really late (at least 3am – 6am) the night before (calling/Skyping mates in different timezones or a TV marathon can help) then sleep for the majority of the day before your first nightshift.
- Method 2: Go to bed as usual the night before , sleep in until late morning, have a big feed for lunch then go back to sleep for an afternoon/evening nap.
On nightshifts
2. Drink water and eat food (bring real food, not just junk, and a big water bottle that you can reach for when you are writing notes). Drinking enough water is my absolute number one piece of advice. It’s hard to be high functioning when you are symptomatically dehydrated. (Same goes for a BSL of 1.8!)
3. Just like with day shift, caffeinating during the second half of your shift reduces your chance of sleeping when you get home. Plan your caffeine. Eg. bring a big plunger and invest in decent Peruvian coffee to have on arrival during handover, and at the halfway mark of the shift. (Sharing means your whole night team runs smoother & happier too!)
Between nightshifts
4. If you suddenly realise you are too tired to drive home, DON’T. Get a taxi or phone a friend. We don’t need any more post-nightshift road trauma (ask your seniors and they will all know of past incidents, one more is one too many).
5. Your body reacts to sunlight. Wear dark glasses home, and invest in cut-out curtains; or an eye mask. Avoid artificial light – constantly checking your phone or iPad because you can’t sleep will make it worse.
6. Most of us use noise (alarms) to wake up. So, if you need to sleep, invest in ear plugs.
7. Don’t use alcohol to help you sleep. It is a sleep inducer but it will disrupt your REM sleep which impacts on how rested and functional you are on waking.
8. Don’t commit to things during the day because daytime people expect you to – you are living their life in reverse. Eg: Delivery service*: “So, you’re on nights, you’ll be home during the day, we can deliver at 3pm.” Me: “So, when you’re on dayshifts, do you plan to wake up at 3am to let random people into your house?” [*insert “Rellies inviting you to lunch, a course from 9am -5pm, friends wanting a shopping date” etc]
Turning around
9. There are many turnaround styles to consider. Just make sure you get the amount of sleep you need before you go on to do other higher functioning after your nights.
- Method 1: After post-nights breakfast, go home and have a four hour nap eg 10am-2pm. Potter about and get some daylight exposure, then go to bed at your usual time.
- Method 2: Sleep for 36 hours (all day and all night). Have a glass of water, some carbs like crackers by the bed and a clear path between the bed and the loo. Consider DVT prophylaxis.
10. DO make sure you make the time and headspace for Post-Nights Breakfast. Critical Care rosters lend themselves to this and I’d argue that in any teams that do a round of nights together, this is an incredibly useful space to wind down; congratulate one another and reflect on ways to improve. I make a point of having a debrief, called “The Ceremonial Airing of Grievances”. Homer (Simpson) has a lot to teach us. Venting prevents explosion. Use the formal positive critique/Pendleton’s model/the “hashtag rant” – just make sure everyone on the team can identify any painful experiences, reflect on how awesome they are; and work out how to be more awesomer next time.
In all seriousness, please look after yourself as you navigate the nightshift rhythm. These are just things I have found helpful, there’s lots of advice out there – head online to search for more nightshift and sleep tips. If these things are not working, go and see your GP (yes, I have one of those, so should you) to discuss individual techniques and adjuncts for healthy amounts of quality sleep.
Sleep long, and prosper
Deanne Chiu
Emergency Physician, FACEM. Visual & kinaesthetic learner. Multi-modal teacher. Occasional filmmaker. | @drdeannechiu |
