Manch Medic’s post reminds me to ask: Any tips from EMers on transitioning to a week of night shifts? I’m incredibly excited to dive back into clinics with another ER month next week, beginning with a week of 10pm-6am shifts. Sleeping suggestions, napping suggestions, caffeine suggestions? Thanks in advance.
This is a medical weblog--a collection of thoughts about medicine, medical training, and health policy--written by a fifth-year medical student.
I recently stopped blogging, as I graduated from medical school and I'm now a physician in my residency training in New York City. But feel free to read and enjoy!
(To get rid of this thing, just wave your mouse over it. Ta da!
Learn you sleep cycles: Go to bed one night just when you get tired, and note when you get up. Divide hours slept by four. Try to nap in increments of that, or thirds of it. I’m a little rusty on WHY this works, but I know it does.
As for caffeine - go to an international market and pick up some good instant coffee (I like Ricore or Bru, which both have chicory in them - tasty, and an additional stimulant!).
In terms of waking up: buy a good halogen or other full-spectrum lamp and put it by your bed. When your alarm first goes off (especially if you hit ’snooze’), turn it on and point it at your face. It’s almost like daylight.
Hope this helps!
Michael,
I would suggest that when you sleep during the day after your night shift, find blinds that darken your room completely. Women who work night shifts have an elevated risk of breast cancer, whereas completely blind women have a very low risk (up to 80 percent lower). It is felt that melatonin, manufactured by the brain in complete darkness may lower estrogen levels. Since some of the risk factors/and “dietary protectors” seem to be similar between breast cancer and prostate cancer, it can’t hurt!
Lynne Eldridge M.D.
Author, “Avoiding Cancer One Day At A Time”
http://www.avoidcancernow.com
I can’t vouch for it myself, and I am still trying to figure out how it works, but my friend is really enjoying this SleepTracker watch that supposedly figures out when you’re most awake (within the interval you give it) and wakes you up then. I assume it’s just a motion sensing thing that reads “no motion at all” as REM sleep periods, and guesstimates beyond that, but the website is pretty cryptic. (It’s not attached to your head with electrodes, so it can’t be much more sophisticated than that).
I worked nights while I was in college. Here’s what I remember that worked:
1) While you’re on nights, sleep twice. Once when you get off-shift - this is your regular sleep - and a good nap a couple of hours before you go in. I never could sleep more than four or five hours in the morning, anyway, so the nap was essential. Without that nap it’s like working swing shift with a day life. I’d go in tired.
2) Remember to turn down/on your A/C before you go to bed in the morning (or your fans or whatever). It’s going to get warmer as you sleep, not cooler like at night. I slept better if I wasn’t overheating.
3) Whatever your caffeine source - double it the first time you partake. I’d always bolt down one can of Coke or whatever, and drink the second one (and the rest for that night) normally. You can also drink one before your nap, if you have trouble waking up.
4) Don’t sit down if you’re tired. EVER.
5) Buy a pack of Vivarin. Carry one with you at all times. Take it only if you feel the need - the earlier you know you’re going to lose the battle with sleep, the better. I hated them, and I felt like crap while I was awake, and my kidneys would twitch if I had to do this two nights running (I know that’s not physically possible, but that’s where the spasms were), but I was awake. Had to be.
Hope some of that helps. I always enjoyed the third shift. You meet the most interesting people…
CS
I worked nights during grad school. Good luck with transitioning. Overnight shifts can really be mood altering.
1) Definitely invest in honey comb shades (I think my landlord got mine through Hunter Douglas). Buy a sleep mask if you can’t get the blinds. Or use foil to cover your windows–yes it’s creepy looking, but it works.
2) Invest in good ear plugs.
3) Excercise as often as much as possible before a shift.
4) I completely agree about turning the A/C on. It’ll help with temperature, but also, help to create whitenoise, if you don’t like ear plugs.
If you can’t sleep–you gotta eat.
Eat. Eat. Eat.
And eat some more.
I’m not kidding. Carry lots of snacks and chow down when you can. You’ll be fine after a day or two.
2 essential elements for sleeping during the day: Get some really good ear plugs. The kind made of foam (sort of like memory foam) are the best. I think they make a remarkable difference in the quality of sleep you get during the day. And of course, room darkening shades.
I didn’t find my week of nights to be that bad & I was on from 6pm to 9am (never slept on call)… Just stay up as late as you can the night before you go in & sleep in as late as you can to start getting into shift mode. If you start on a Sun night then stay out late Fri & Sat nights. After 2 nights of work you will be so tired when you get home that falling asleep shouldn’t be a problem.
Hey, along with all of these great tips, sheer willpower can never be beaten. :)