Sleep…. it is high, very high, on the list of things I covet in my life.  Having worked in healthcare since I was 16, I have complete respect for the jobs people do that require 24 hours a day, 7 days a week scheduling.

I remember my first night-shift.  I was 18 years old and working as a nursing assistant in a nursing home.  The nursing supervisor called and told me I was being mandated to stay over until 7 am.  The first thoughts that crossed my mind were: “Is that even possible? Can you really make me stay awake all night?”  At that age, working until 1130pm was late enough.  I was so nervous to work the night shift the first time.  I didn’t really know anyone, I had no idea what work they did, and I had no idea how I was going to stay awake. (I wasn’t able to).  My coworkers had to keep waking me up when I fell asleep with my head on the desk.  The drive home that morning was awful.  Over time (years) I have gotten used it and I figured out what the key is for me to stay awake (coffee and standing)… no joke, sometimes I’m so tired if I sit down, I’m done.

I have worked straight night-shifts for the last 3 years.  There are some nights I go to work sleep deprived, not having slept well during the day.  There are mornings I come home, walk my dog, crawl into my soft comfy bed, in my dark room, so exhausted my body aches and I can’t fall asleep.  Even worse, I’ll fall right asleep, sleep hard, wake up, look at the clock and its only 1030 in the morning.  The napping will continue throughout the day; waking up at 1 pm, 230 pm, and 3 pm.  Then I will finally surrender to being awake and just get up and clean my apartment. I do have days in which I will come home, sleep, and wake up at 5 pm just in time to back to work. It always seems like a crap shoot. I’ve never had a consistent sleep schedule.

It is a surreal and odd schedule to work and an odd lifestyle to live.  I live by myself (my dog loves to sleep so I take her out of the equation) and that allows me to sleep as long as I want on my days off.  I will then frequently find myself wide awake at 3 am spending my nights off doing my grocery shopping, laundry, and going to the gym to run while no one else is there.  I can remember many instances of my mom calling at 3 pm and her being surprised that I was still asleep and that she had woken me up.  I had roommates in college that would wake me up and ask if I wanted to go get lunch (I always wondered how they did as nurses when they started working nights).  When you are waiting for a delivery from UPS its super nice to technically be home for the delivery, though frequently I never hear the doorbell.   I schedule appointments during the day, set my alarm to get up and run errands, and make phone calls.  So many things can only be done during the weekday.

In my sleep deprived state, I have done so many strange things.  They are funny now but at the time they were kind of scary.

-One morning after work, about 8 years ago, I went to the grocery store.  I came home and put my groceries away.  When I got up in the afternoon I saw that I had bought 13 boxes of popsicles and put them away (well actually, crammed them) into the freezer.  I looked at the receipt to verify that this was what I did and sure enough… that was all I bought.  I didn’t remember buying any of these at the store.  I also didn’t remember the obvious cramming I had to do to get them all in the freezer.

-Not too long ago I was putting my isolation gown and gloves on to go in my patients room.  A coworker asked me a question, I answered, and then just like second nature, put another gown and set of gloves on over what I was already wearing.  I didn’t realize it even until a coworker asked me what I was doing.

-I ride my bike to work and a few days ago when I got home in the morning after work, I grabbed my keys out of my bag and tried to unlock the door.  I stood outside my building pressing the unlock button to my car and getting angry as the door to my apartment wasn’t unlocking. (I hit that button like 10 times before I realized what I was doing)

-I spend countless hours looking for my keys, forgetting what I was doing, and retracing my steps… especially at home.

-I have come home in the morning and fed my dog three times in a row, somehow forgetting that I had just done it (she’s a lab so she just kept eating).

-I fell asleep in the dentist chair one morning while they were putting on a crown and I accidentally bit the dentist. He pretended to be sympathetic and understanding, though I could tell he was irritated.

Even before all of the recent news surrounding the air traffic controllers sleeping on the job, sleep deprivation and its effects on health, well-being, and job performance have been researched in health care.  Medscape has a fantastic article A Wake-up Call for Nurses: Sleep loss, Safety, and Health.  It’s a well written article; really highlighting the challenges of being a nightshift worker. It is unbelievable the negative health effects that working at night and fighting your natural circadian rhythm can have on your body.  Increased risks of certain cancers, insulin resistance, and cardiovascular disease as well as the mood swings, lack of concentration, and lack of energy that you experience on a daily basis.  It’s ironic to me how important we have made sleep for the healing and well-being of patients, but we don’t place the same priority on it for ourselves as nurses. I know I’m guilty of it.

Working nights, you have to make great efforts to adapt your life to your work hours and sleep needs.  You have to make sleep a priority.  It has taken me years to learn this and I’m still working on it.  It’s a difficult thing to prioritize the rejuvenation that your body needs over all of the things in life that need to get done.

Not everything about working the night shift is bad.  There are some fantastic benefits to working while the rest of the world sleeps.

Many of my friends work it as well.  So while we can’t go out for dinner and cocktails many evenings, breakfast with beers is frequently a possibility.

The night shift is very patient focused.  There are very few distractions, not as many visitors, doctors, consulting services, or ancillary therapies interrupting care with your patient.  Many nights it is just you and the patient.  It is a fantastic opportunity to spend time getting to know your patient, giving a thorough bath, changing dressings, shaving, shampooing, and focusing care around the patient.

The ability to have schedule flexibility for child care, school, and family is also a big reason many people choose to work the night shift. The pay differential isn’t bad either.

However, the greatest reward I have found over the years of working the night shift is the chance for the most breathtaking sunrises.  Sometimes staying awake all night to see one is worth it.

For now I’ll take it…

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