Tips For Working Nightshift (and for life!)

We all come from a number of different domestic, social, and family situations, so it might be hard for some to apply these tips to their day-to-day schedule, but after much research, and through my own experience, I have come up with a list of Do's and Don't's for trying to maintain a healthy lifestyle as a nightshift nurse:

1. You are what you eat. Nutrition and diet are number one on this list. I know, I know, in the break room there's always a plate of cookies, or a tub of brownies, or in my case a massive bowl of candy, that are always too delectable to pass up. OR, you're exhausted and sleepy and you just need that sugar rush to get you through until 0700. DON'T DO IT. Eating large amounts of sugar will make your blood sugar spike, and then crash, and you will end up feeling more exhausted than if you had just left the sweets alone. I find it works best to eat a BALANCED diet of low glycemic foods, and make sure not to eat too much before falling asleep, BUT do not go to bed hungry! I typically eat breakfast at 1730 when I'm leaving for work, then lunch around midnight or 0100, and then a small snack around 0300 or 0400, and if I'm hungry, another small snack around 0600 or 0700.

2. Exercise is key. Even if you wake up only 15 minutes earlier and go for a walk, you will notice it makes a dramatic difference in your energy levels at night. Some nurses I know work out in the morning after work, but I prefer to get my energy levels up before I have even started my shift. Also, working out right before bed, often makes it much harder to fall asleep. I typically get up an hour earlier and either go to the gym, or do a workout video, or sometimes just go for a short walk. It's tough, but the rewards are worth it.

3. SLEEP. Try to get 8 hours of sleep before a nightshift. I know it's difficult because our bodies are meant to be awake during the day, but there are a few things you can do to help you sleep. Make sure the room is dark to mimic nighttime; black-out shades are a God-send! Have some white noise, either a fan, or noise machine, or whatever you can rig up, to help drown out the sounds of your neighbors lawnmower, or the roofing men, or kids playing outside. I find that having white noise helps me fall asleep, and STAY asleep. Sometimes I listen to relaxing music when I'm trying to fall asleep in the morning. If you have especial difficulty falling asleep, you can take natural supplements such as melatonin or 5-HTP that can help. Some nurses I know take benedryl, but I find that it makes me more groggy when I do have to wake up.

4. Turn your cellphone on silent! And turn off the vibrate option too. There have been many a time where I have been woken up in the middle of the day by 1 short vibration from my phone, and then been unable to fall back asleep. Go off the grid if you want optimum resting time after or before a nightshift.

5. If you have trouble staying awake on the drive home (I know I sometimes do with my 45min+ commute), chewing ice can help, when rolling down the windows and/or loud music fails.

6. Get rid of toxins that cause your body harm. Quit smoking, quit excessive amounts of ETOH, and quit all the ridiculous things that you know causes your body to work overtime. IT IS NOT WORTH IT. The health benefits that come from quiting these bad habits are numerous! We are nurses, we know better, and we should be leading by example.

7. Take time for quiet and silence. Pray or meditate, or just close your eyes and breathe. Whatever it is, take time to be silent. Turn off your brain. Allow your muscles to relax. Breathe deeply and slowly, and prepare yourself for sleep or for your night that lies ahead of you. It's simple, and yet so helpful in this hectic and crazy world. Try to do this at least twice a day.

8. Finally, but still very importantly, make sure you take time to have a social life. Go out with friends, or family, have a hobby, enjoy the sunshine on your days off, read books, visit museums, go to concerts, and just enjoy life! So many nurses become jaded and frustrated with their jobs, because they lose sight of what's important. We don't live to work, we work to live.

This list may seem totally ridiculous and impossible, and I'm not sayng that I am 100% consistent with it, but I do notice a difference when I incorporate all or even just some of these little nuggets of knowledge. Try it! What's it going to hurt? Even if you change 1 or 2 of your unhealthy habits, and implement 1 or 2 of these healthy ones, you will already be on the path to living a more balanced and happy life!

Tonight, I am tired

I haven't written in awhile. I have been traveling again, because that is what happens when I only work 3 days a week. I have decided that something has to change. I feel that I could travel the rest of my life, and never be satisfied with how many wonders of the world I have seen. I need to put my roots down, and let them grow. I am lacking stability, and everyday-ness. I keep looking for the zebras, to spot the next big thing, to experience the next big thrill. It leaves me empty. I want to garden, I want to cook, I want to hike and climb, even if I have to do it alone. I also want to give. I have lived too much of my life taking from other people, and I now need to share what I have been given. It's not mine, I didn't earn it, and it's far too much for me to keep for just myself. I will now step foot into reality. Into the world around me. Into the friendships in front of me. Courage, do not fail me now.

I am tired tonight. Nightshift takes such a toll on my body. How much longer can I keep it up?

I have been thinking a lot about the challenges that we nurses face, especially when confronted with death and suffering. I have noticed that I seem to have become more desensitized over the past 2 years as a nurse. Seeing people in pain no longer hurts me. Often times I find myself saying in my head, "Oh, I wish they would just suck it up." Stories no longer shock me, even when involving gruesome details, and I cannot recall the last time I shed a tear over a patient of mine, or a story involving someone else. As nurses, we are bombarded with so many shocking things, over and over, that these things tend to lose their shock-value. Our emotional triggers become rusty. Our cells no longer respond to the insulin that our body produces. Some have said that this is a good thing, because otherwise we nurses would be unable to even step foot in a hospital, after all of the suffering, pain, hopelessness, and evil that we have seen.

My challenge has now become one of a balancing act. How to grow skin thick enough to cope with the suffering I see, while maintaining an empathy for my patients that allows us to share our lives with each other. Believe me, if I knew the answer, or the chemical equation, I would most likely not be writing about this. For me, this is one of life's unanswered questions. One that I will most likely always ponder, and never quite understand the answer.

Asthma, Kawasaki's and IVIg, S/P intubation with current aspiration of feeds...In love with all 3.

I've worked the last 6 out of 8 nights. I am exhausted. Sometimes when I get caught up in the daily drudge of my work and my life, I forget that every day I have a huge responsibility, and an amazing opportunity. To make a change. To love in a world that is often too busy to even smile. Nights like tonight remind me of this.

Yesterday around 5am, I admitted a patient with asthma. Pretty routine for my unit. I spent a total of approximately 30 minutes interacting with her and her mother. Vitals, admission database, assessment, some snacks, and settled her into bed. I also chatted with her a little about my own experience with asthma. When I came back to work that night, my little patient had a huge grin on her face, and from behind her back, she presented me with this card. "I love you, you are cool." Children have a way of taking such simple words, and giving them immense meaning. I myself have always had trouble articulating what I mean (probably one of the reasons I became a nurse, no thesis!). This little girl is not only an inspiration of love for me, but an inspiration to use my words. To write. To speak up. Not to be afraid that I won't sound smart enough in this blog. She hardly knows me, and yet she loves me. Who has the courage to love like this? To take time, to make a little gift, to prove her affection.

Another patient I had was admitted for possible Kawasaki's. She was a wreck when I first took over her care. She had only been admitted a couple of hours before I started my shift, but was already heading downhill. Terrible rash all over her body, her hands and feet were swollen and turning purple due to poor perfusion, 40.0C fever, irritable and crying, and she did not want me to get within 5 feet of her, and God forbid if I had to take a blood pressure. IVIg was ordered, aspirin, tylenol, the whole routine. I spent the majority of the night in her room. In the morning, I gave report to the dayshift nurse, and headed home. When I came back that night, I swear she was transformed into a new woman! She was playing the the playroom, had eaten approximately 10 boxes of cheerios, drank caprisun after caprisun. She told me a story of talking to her brother on the phone, half of which I did not understand because of her toddler lisp, but it was entertaining nonetheless. Her parents thanked me profusely for caring for her. Even though the doctors call the shots and write the orders,  I was the one in the room, loving her, caring for her, and bringing her more cheerios. And I know that those things make all the difference.

Last but not least! In fact, I almost took this little boy home with me this morning. Ladies and gentlemen, I have just witnessed the most beautiful child that God has ever created. Gorgeous, long eyelashes draping his grey eyes, and a smile that would melt even the Devil's heart. No joke, it took me less than 3 days, and I am totally and utterly in love. Anyway, this little babe has had an extensive medical history in his short months of life. Currently, he is doing well, except is having difficulty swallowing after being intubated, and has been aspirating some of his feeds. No one has been able to get him to take his formula + rice cereal mixture from a bottle. But also, no one has been picking him up, and holding him, and loving him, and taking him around the unit to keep him stimulated, and of course to meet the other staff! Baby took 3 out of his 5 bottles for me. He did so well tonight. He loved seeing the sights outside of his room, flirting with the other nurses, and learning how to keep his head held up (I call it his abs workout). I saw him laugh for the first time tonight.

Folks, I'm not saying that I am a miracle worker, that I can fix kids all on my own, or even that I am good at loving other people. But I have noticed a trend in my nursing care when it comes to interacting with other people. The more effort I put into caring about them and the more I show them my love, the deeper our connection becomes. It is something that is almost unexplainable. It is something that reaches my core. Maybe my soul? Something that I just know, and something that is deeper than just a feeling or emotion. I love these children. They have done nothing the earn it, nothing to coerce me, no one is bribing or threatening me. I guess this is what is meant by unconditional. I unconditionally love each one of them.

Military, Firefighter, Police, government employee...Nurse?

Finally, public recognition for working as a nurse. Sad that it wasn't for being a nurse, but for working in a Hospital that is primarily funded by the government, but I will take the recognition nonetheless!

Today, my lovely sister and I took a trip to a local, popular museum. Our research told us that we would have enough time to tour the entire museum before closing, if we arrived in the early afternoon. What our research failed to turn-up, was that only a certain number of tickets are distributed each day. We arrived at 2 o'clock, and much to our disappointment, the sign read "Tickets Sold Out For Today."

Because both my sister and I enjoy meeting new people, and striking up conversation with random men, we found ourselves talking with the "Special Police" guard in front of the museum. While deep in conversation about his passion for abstract art and painting, our new friend off-handedly joked that we might get tickets if we bat our eyelashes, or show our disappointment with a few tears, to the man at the ticket counter.

After parting with our friend, and thanking him for the advice, I walked up to the counter to try my luck. Making myself sound as desperate as possible, as if I was dying of a rare illness and my final wish was to see this exhibit, the ticket-man replied with an, "I'm sorry ma'am, unless you are military, a firefighter, police officer, or work for the government, you won't be allowed to enter." I pleaded with him, that I was a nurse, and had just worked the nightshift, and that this time was the earliest I could possibly get here, and that my sister was visiting, and this was the only day we could visit, and blah, blah, blah, and then a little lightbulb lit up in my brain. I do work for the government! My Hospital receives it's funding primarily from the government, based on the population we care for and our location in the city. Eureka! I ran to the car to retrieve my nurses badge for work, and no further dialogue between myself and the ticket-man was needed. He handed me two tickets, with an "enjoy your visit," I skipped off to meet up with my sister, as if I was holding the winning numbers to the State Lottery.

This might seem like a simple and maybe trivial moment in my life. Tickets to a museum exhibit. Tickets that I could just get next week. Yes, it was simple. A simple joy that added a much greater richness to my life, and to my sister's. The time we spent reading about the lives of so may Jews who were tortured and killed in concentration camps across Europe, seeing the horrors that they endured, and hearing first-hand testimonies, was a priceless moment for us today. We met one of the few living survivors while she signed her books for us, and as I looked her in the eye and told her my name, my connection with history became a bit more real, a bit more human.

Thank you to the guard at the museum, thank you to the ticket-man, and thank you to Elly, who have all taught me today, to be a bit more human.

"I'm gona kill ya, and make it look like an accident."

Not the most proper response coming from a college professor. Especially not from one teaching the art of nursing care (can you imagine a nurse saying that to one of their patients? Lawsuuuit!) We were all convinced we deserved it after our entire class failed an exam. Our professor explained afterwards that she liked to use this phrase with us during our senior year, because our graduating class was "all freaking out about nothing!" Well, when a 79.9% was a failing grade, what else were we to do but freak out?

Looking back on nursing school, I remember wishing someone had written a guide to surviving. Surviving our classes, clinicals, careplans, and most importantly, the ever-looming day that we would take the nursing board exam - the NCLEX. I used the word "surviving," because in my mind, who breezed through nursing school? Maybe there were some. Some who were 4.0 GPA, Magna Cum Laude, graduate-with-honors-type-of-nursing-students. Not me. And not my closest friends.

Despite often academic freak-out moments, I do not regret the nights I stayed up late, not studying, but spending time with friends, meeting new people, and enjoying life experiences that I knew I would never have the opportunity to experience again. I will never regret the extra loan money used for studying abroad in Europe, for traveling places on our school breaks with close friends, or the trips into the city to try new and exciting food, to rockclimb, shop, attend sporting events, and all of the other things we did in our leisure time. I will never regret not having a 4.0 in college. Afterall, if I had not chosen to experience life, how would I be able to relate to people I meet later in life? How would I be able to relate to my patients, or have anything at all to share with them? I cannot share good grades, I cannot share honors, I cannot even share my piece of paper with the title, "Bachelors of Science in Nursing." I can only share my experiences, good and bad. What I've learned, and what I hope to learn.

Maybe this is all just a rationalization of laziness on my part. Maybe I could have worked harder and gotten perfect grades and honors, while still experiencing life. Or maybe I'm not smart enough to do both. Maybe this blog is boring, and no one will want to read it. Our lives are full of maybe's. But what I do know, is that regardless of these maybe's, I have learned to be a better nurse and a better person through my experience. Through the chaos, and insanity of working in hospitals. Through meeting some amazing people, with great minds, and loving hearts. Through meeting patients that have touched my life, and given me reason to continue getting out of bed at 5 o'clock in the evening, and working through yet another sleepless night, when I often daydream about being back in bed, because what normal person works nightshift? (I can tell you from experience, 8 hours of sleep during the day is not the equivalent of 8 hours during the night!)

So, when I say I wish someone had written a guide to surviving nursing school, what I am really saying is that I wish I could tell my 19-year-old-self to stop freaking out. Life is not about freaking out, life does not consist of our anxieties, and worries, and maybe's. Life is about our experiences, the people we meet, and the people we love, and the people we can't stand to be around for more than 5 seconds. Life is about choosing to continue the path we have set out on, to find purpose in our work, to find a reason to get out of bed.