10 Tips For Nurses Working Rotating Shifts
By: Mariam Yazdi, BSN, RN
Is it sleep time? Is it work time? With a variable/rotating shift schedule, life fluctuates from week to week and from shift to shift, and things can get out of hand quickly. Of the different schedules nurses work in a hospital setting, variable shifts are arguably the most challenging. Any given week for a nurse with this schedule could like this:
- 7 pm to 7 am on Monday night
- 11 am to 11 pm on Wednesday
- 3 pm to 3 am on Thursday.
Needless to say, variable shifts give you the opportunity to become familiar with what the job looks like at all hours of the day and night. Yet with this prerogative comes the need for creative time management with your meals, sleep, and off-time lifestyle in order to counterbalance an irregular sleep schedule.
So let’s start with the basics: what you eat!
Veggies, Veggies, Veggies
Make up for the lack of sleep regularity with mother nature’s greens. From spinach to zucchini, all-things-veggie are packed with vitamins and minerals that become depleted from alternate sleep. Plus, the fiber makes for healthy bowel habits and there’s no carb crash.
Ditch The French Fries!
Speaking of carb crashes, if you haven’t experienced a carbohydrate overload while sleep deprived, you’re in for a rude counter-awakening. Do not put yourself through this torture and save the bread, rice, pasta, and potatoes for your first meal after rest.
Love Yourself, Water Yourself!
Hydration will help prevent you from feeling hung over when you wake up after sleep. If you find yourself peeing less than q4 hours, you could probably afford to increase your water intake. As a reminder to help you get your water in at work, attach a water and bathroom break along with a patient’s routine medication or treatment. Time to check a blood sugar? That reminds me, I should pee first. Hydrate your cells, keep your organs happy.
Coffee: Friend or Foe?
Strategically plan your caffeine as it can make or break your rhythm. I recommend giving yourself a week to see how your body reacts to the fluctuating sleep schedule, then insert a nice hot cup at a time where you need it the most and notice if it alters your sleep quality come rest time.
Schedule The Z’s
This one is plain and simple: you must sleep when you can and as long as you can to be ready for your next shift. Many nurses craft their sleep to fit their schedule, but this gets tricky with variable shifts. Consider the following approach: if your body is asking for sleep, give sleep to your body. Forcing yourself to stay awake in order to sleep later and closer to your next shift may result in poor quality slumber.
During times when you find yourself negotiating with your body to sleep, do not underestimate the power of resting – laying with eyes closed in a quiet environment. You may not drift off to sleep, but at least you gave your body some time with minimal stimulation. As a sleep aid, I suggest exercise as a first-line treatment. Use cardio to your advantage; fit it into your schedule as a way to help you wind down for bed or perk up for the next go.
The First Night Back
I’ve made the mistake of staying up all night before a night shift in attempts to sleep during the day and get on a schedule. All I did was make myself sleep deprived and exhausted when I got to work. I’m wiser now and know to prepare for the first night shift on, I need to oversleep. I try to go to bed early and get up late and have a calm, low-expectation day until I head out to work. Oversleeping before your first night on may help set up your entire week.
The Dreaded Hour
Whether your dreaded hour is 5 pm or 4 am, you know that sometimes deep breaths and face slaps won’t cut it. For these times, I have a small trick up my sleeve: Fireballs. Not the whiskey, but the candy. When the crash starts to hit, I pop one in and the burning cinnamon stimulates my senses enough to pound out the last few notes and the small sugar hit floats me through to shift change. Hearing the crackle of the Fireball wrapper in my pocket gives me reassurance that I can make it through a bout of drowse.
This sort of schedule creates a balanced dichotomy of work-days and off-days, and many management teams are happy to accommodate this request. By clumping your working days/nights together, you are allowed the flexibility of getting work out of the way and using the 8 days of rest to rejuvenate and tend to your normal life.
Just know that during those six days on, you will probably disappear from the world, putting non-imminent tasks on hold while you enter your workflow.
Advocate, Advocate, Advocate!
Take those advocating skills and bring them to the scheduling manager. Nurses working variable shifts must advocate hard for a sane schedule that will make work-life balance possible. Having at least 24 hours between flipping from night shift to day shift should be non-negotiable in order to provide safe care. Clumping similar shifts together may make transitions easier and allow for more efficient recovery times. This type of scheduling is very intrusive to one’s lifestyle and should be highly accommodated.
Working this type of schedule for an extended amount of time can take its toll on the body - it takes a lot of adjusting to. Make sure to check in with yourself and pay attention to what your body is telling you.
With this sort of schedule, self-care shouldn’t be left on the back-burner, it’s necessary to put yourself first sometimes. If you want to go to Yoga class but, have a sink full of dishes - just go to class, your body will thank you (and the dishes will be there when you get back.)
If the schedule is too difficult, again, talk to your scheduler about your concerns.
If it’s your turn to put in the time on variable shifts, remember that rest and relaxation must be a priority, sometimes even over productivity. Besides all the extra water and vegetables, treat yourself to some pampering on days off; massages can work wonders after an exhausting week, and a hot candlelit bath can help soak the week away.