Top 10 Tips on Surviving Nightshift

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

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Comments

  1. says

    I have worked permanent full time nights for three years now, in a busy maternity ward. I have young kids myself so have found the perfect balance for us. No social life .. but that’s fine, I Quilt! Love night shift!

  2. Dree Daugherty says

    I am 60 y.o., have 3 teens still at home to be a mother to, and have been working 9 pm-7 am for 20 years. My secret?: PROVIGIIL! I only use it when I work, even though tempted throughout the other parts of my busy life. It has enough serotonin happy factor with the awakeness factor to get me to look forward to each shift. And most important, after I stagger into my home after a shift, I can fall right to sleep (unlike amphetamine or sudafed derivatives). It is a dream drug.

    I also like not being part of the drama and politics of day shifts. And everyone is at home when I whisper sweet nothings in their ears. As I teach the residents: No one is awake, so just tell them what you need them to know, and promise to do what is right for their patient. Saves time and energy.

    • says

      Totally agree that nights are somehow more pure and simple. I’m a relative newbie compared to you! Only started them 13 years ago but I love them and used to swap out of days to nights on the rota. Missing out now doing a daytime job for the year, but plenty more where that came from next year!
      As for chemical adjuncts, it’s a fascinating science. Melatonin is quite popular over here. I’ve heard (and seen) lots of horror stories about benzodiazepines and sedatives as well as uppers. I’d best leave it to the experts and advise people see their local doctor to work out a plan. It’s such a personal thing -- glad you found what your body likes!

    • says

      Agreed Rob! I can’t do eye masks, it freaks me out. I bought heavy curtains (go all the way around the window frame so no edge leak) for my place. For those of us in rentals, hospital accommodation and those weird 1960s motels that country locum jobs seem to lead to, try:
      Tinfoil cut to size of window pane, a small amount of water rubbed onto the glass then stick it on.
      Magnets onto metallic blind fittings to hold a dark piece of fabric in place
      Pegs or hardware-store bought clamps to hold a dark piece of fabric in place
      “Sun is bad, hisssss”

  3. Dave Prosser says

    To avoid post-nights ‘Jet-lag’ (feeling like you should be in bed in the middle of the day, days later), after the (essential) post-final-night team breakfast, DON’T sleep until an early-normal time: 1800-1930, then have a megasleep. As with jetlag, the bodyclock will recover much quicker with a really long ‘day’ (30+ hours) than short ones

    • says

      This is a great method, and I’m envious that you can make it work. Sadly I’m too soft to go the distance so I often need a nanna nap to get there.

  4. Vicky C says

    I have a coffee cutoff at 0400 & then go for a gym workout before heading home. After a warm shower I am asleep very quickly.

  5. Daniel Haustead says

    I would agree with Dee r.e Modafinil….. Taking one after your final night shift to keep you awake until your normal bed time works wonders…. Or take them before a shift if your problem is staying awake

  6. Beverly Cracknell says

    I find white noise from a loud fan blocks out all the noise in my house from my kids, knocking at the door, even the doorbell sometimes. Blackout curtains and earplugs are essential too. I take an antihistamine to help me sleep faster. I find it keeps me asleep longer than not taking it. I never feel groggy when I get up. My favorite part of a set of shifts is my pre night shift nap. 2-4 pm is set aside. I feel best coming off my last shift if I nap for two hours in the morning then head to bed on the early side that night.

  7. Merilyn says

    Thanks Deanne, Always looking for more tips to help with being permanently on nights. I have seen you around on nights before and look forward to you coming our way some time again soon. Thanks also to everyone for all the helpful comments especially liked comment 3 ‘zombie drug dealing’ great post -- can be tricky with kids having to live both a day and night routine.

  8. Xander says

    FYI ceremonial airing of the grievances would be Frank Costanza no Homer J.

    I HAVE A LOT OF PROBLEMS WITH YOU PEOPLE, NOW YOU’RE GONNA HEAR ABOUT’EM

  9. David Barbic says

    How has everyone missed one of the most important things so far??
    Bring lots of food for your nursing/emergency department team. My personal favourites are bagels with cream cheese, ice cream bars or pizzas.
    When they’re happy, they’ll help make your night shift run smoother.

  10. adam says

    Hello iv just started 4 on 4 off night shift have you got any tips of how to get to sleep on the days I’m off thanks.

Comments