Shift work — so many nurses do it or have done it at least once in their careers. While patients definitely need care around the clock in certain settings, the nurses who care for them also need sleep.
According to Amy Witkoski Stimpfel, PhD, RN, an Assistant Professor at the NYU Rory Meyers College of Nursing, “Shift work—particularly nights and evenings—misalign our body’s natural circadian rhythms. Simply put, as human beings we were not made to be awake late at night or very early in the morning,” she explains. “Thus, there is a cascading effect on this circadian misalignment on the rest of our body’s functioning.”
The biggest problem with this is that nurses must be able to provide safe care and going without sleep can be problematic. “Obviously sleep disruption is one of the biggest and most dangerous consequences of circadian misalignment caused by shift work. Being sleep deprived is also especially difficult because we are not good judges of how impaired our functioning is when we are sleep deprived. So, as nurses it can be very dangerous to practice when sleep deprived,” Witkoski Stimpfel says.
She cites the National Academy of Medicine, which recommends that nurses not work more than 12 hours every 24-hour period or 60 hours per week. There is also evidence that shows nurses should work a maximum of two to three shifts in a row.
Witkoski Stimpfel gives the following tips for nurse on how to best perform at their jobs when working overnight shift work:
Achieve enough adequate sleep during off shifts
Judicious use of caffeine
Use blue-blocking sunglasses on the way home after a night shift
Use blue-blocking apps/filters on smartphones and other electronic devices before getting sleep
Limit voluntary overtime hours
Have a bedtime routine that doesn’t include alcohol, nicotine, or other drugs
The bedtime routine can include taking a bath, listening to music, medication, talking with a spouse, friend, or family member—these will all help the body to shut down for rest.
Know that you can make mistakes when working nightshifts. “One of the biggest mistakes nurses can make when working night shift is to not sleep before a shift. Most studies on this topic indicate a small portion of nurses simply do not sleep before going into night shift, which is very dangerous,” says Witkoski Stimpfel. “Using melatonin or other sleeping aids should only be used under a provider’s guidance.”
If you have to switch from dayshift to nightshift in one week, Witkowski Stimpfel suggests the following, “It will be challenging to get “good” sleep when working one off night shifts, which is why that kind of scheduling should be avoided. If it happens occasionally, the nurse should try to get a nap before the night shift and definitely sleep as much as possible following the night shift. Using caffeine at the beginning of the shift and taking a walk or going up a few flights of stairs around 4 a.m. can help with alertness during the shift. If possible, using public transportation or having a friend or family member drive the nurse home after the shift could help to avoid drowsy driving,” she says.
Remember that these present, strange times we’re in have caused a lot of additional stress on everyone, especially health care workers. So it’s important to get the sleep you need. “The COVID-19 pandemic has placed additional and unprecedented stress on nurses, often resulting in disrupted sleep,” states Witkoski Stimpfel. “It is really important to reach out for help, whether it is therapy or counseling, meditation, a consultation with a sleep medicine physician, etc. Sleep is crucial for functioning across the board, both mentally and physically.”
Are you like most nurses, filling your days with taking care of everyone else but yourself? That may seem heroic, but putting yourself last ultimately leads to a dip in on-the-job productivity and career burnout. But when you take care of your own needs first, not only do you benefit, and so do your coworkers and patients.
Is there a secret formula to boosting your health and happiness? Fortunately, there is no secret. It’s simple, though not easy, to make yourself a priority in your own life.
By attending to your own self-care, you’re more likely to head off the symptoms of overload which can cut your nursing career short. But where do you start, when there are so many components of a happy, healthy life?
Self-care is easier to establish if you know what’s most important to you at this particular point in time. You may want to focus on a major life activity—eating, exercise, sleep, or relationships—because they seem like obvious drivers of well-being. Improvements in any of those important areas can certainly yield major benefits, but they’re usually tough to crack.
Even if you highly prioritize self-care, it’s difficult to say “No” to that big slice of cheesecake, fit in workouts, or turn in for bed on-time. Especially when your schedule is already jam-packed, your shifts are long, or you work nights.
Why not try another tactic? Consider setting a self-care habit in motion by starting with baby steps toward your ultimate goals. Improvements don’t have to start in your “hot zones” either. Like dominoes, a shift in one habit or routine will cascade down to every other area of your life.
Here are two powerful ideas to spark your thinking:
1. You Need a Budget.
Who even uses a budget anymore? It sounds so old-school, like playing music on 8-track tapes and paying with paper checks at the supermarket. But sitting down to crunch the numbers, and getting a grip on your income and outgo, can be an effective stress-reliever. Your financial situation may remain the same, but seeing the actual facts can stop the free-floating anxiety that’s fueled by imagination.
Your budgeting system doesn’t have to be fancy, either—just use a notebook and pencil to note and track your household expenses and income. Some people like to allocate cash to specific purchases, using an envelope system popularized by Dave Ramsey. One envelope for cafeteria lunch money, another for…
And don’t forget to plan for seasonal outlays (holiday gifts or taxes) and emergencies. That way if you need to replace a dental crown, you’ll have a buffer fund to cover it, and won’t panic as much.
There are also many apps out there for budgeting, including the grand-daddy, You Need a Budget (YNAB).
2. Do a Digital Detox.
Are you always texting, Skyping, Tweeting, Facebooking, or otherwise deep in your digital stream? That’s the case for many “social media natives” and even for their oldest colleagues.
Even if you’re following social media guidelines for nurses in your workplace, you may find that digital is a distraction, always in the back of your mind, ringing, buzzing, or vibrating to get your attention. You could get relief from all sorts of social media ills, from text neck to FOMO, by choosing a set time to disable it, for hours or days.
Some people like to set aside long weekends to go away on formal retreats, like the ones offered by Digital Detox while others simply reduce everyday use. Digital refers to all smartphones and computers (sometimes TV’s too), so resolving to stay away from electronics and screens after 8:00pm could be enough to calm your down, and make it easier to get to sleep at a decent hour.
Oh, but wait, what if you ditched your alarm clock? There are all kinds of new devices for improving your sleep hygiene that you may want to check out. One example is the Philips Wake-Up Light Alarm Clock with Sunrise Simulation, which costs less than $50. The light on this clock slowly gets brighter over a 30-minute span, to gently awaken and welcome you to the new day.
It’s important for you (and your patients) that you engage in self-care every single day. So resolve to take a baby step toward making yourself a priority in your own life.
The term “self-care” is a big umbrella that covers a ton of wellness topics, such as life-balance, stress relief, weight management, fitness, relationships, spirituality, and much more. It’s tough to pinpoint just one life arena you’ll want to make changes to in order to become happier and healthier. But it’s possible and may make your self-care journey easier.
Here’s a tip: Start with sleep.
Why Sleep Is So Important
This is probably the number one area where you can improve your health and well-being. Nurses are notorious for not getting enough sound sleep on a regular basis—odd shifts and rotating schedules don’t help the body to regulate rhythms. Fatigue is one thing but it’s worst when a sleep-deprived nurse actually nods off while at the bedside or on the road after a late shift. Obviously, that’s extremely dangerous—for you, your patients, and everyone near you.
Most American adults don’t meet the guidelines for sufficient sleep (seven to eight hours) and many of us consider it a luxury we can’t afford, or try to “bank” shut-eye by sleeping for 5 hours on work nights and 10 on days off. We like to think that getting along on little sleep is a sign of superhero strength and those who prioritize rest are weaklings. None of those beliefs are accurate. Here’s how you can take care of yourself, in spite of our hyperactive society’s mistaken take on rest and sleep.
The Basics of Sleep Hygiene
Chronic sleep deprivation and sleep disturbances, such as sleep apnea, can be improved by following good sleep hygiene protocols. Try these tips:
Cut out caffeine later on in the day. (That includes certain soft drinks and chocolate, as well as coffee and tea.)
Drink alcohol in moderation, or not at all, because it’s more likely you’ll wake at night after a drink or two.
Another reason to stop smoking cigarettes: nicotine interferes with sound sleep.
Finish your last meal of the day a few hours before bedtime so you’re done digesting.
Don’t do heavy exercise late at night, though gentle stretching or yoga can be a restful entrée to sleep.
Setting the Right Environment for Rest
Digital sights and sounds make it harder to slow down and get ready for bed. Younger nurses, being social media natives, are especially prone to texting, tweeting, Pinteresting, and streaming movies in their bedrooms. Make it a rule to keep your smartphone, iPad, or other devices out of your bed. That way, you won’t be tempted by social media, news, or entertainment right up to the time you turn off the lights. Some nurses even set a digital curfew and power down devices two to three hours before bedtime.
When Your Mind is Too Busy to Turn Off
Some nurses find that the simple act of journaling before bed helps them quiet the worry, anxiety, and fears that may be keeping them awake. Nursing is an emotional occupation and there isn’t always an opportunity to process what happens during the day while on the job. That’s when a notebook and pen by the bed can be a curative. One of the principal researchers in the area of journaling and health is James Pennebaker, a psychology professor at The University of Texas at Austin and author of “Writing to Heal.” His studies have shown that expressive writing (journaling) is a simple and effective way to relieve stress while boosting both mental and physical health.
Very soon it will be Halloween, the start of a holiday season that researchers warn adds an average of eight pounds — if you’re not careful about sweets and snacks.
Ouch!
Nurses have a lot of practice saying “no” to treats at work – boxes of candy from grateful families to trays of pastries from coworkers. Temptations abound, but they become especially intense during the next two months of the year.
Of course, we love getting together with teammates to mark Halloween, Thanksgiving, Hanukkah, Kwanzaa, Christmas, Solstice, or the New Year. Plus, we’ll continue to toast other happy occasions: birthdays, anniversaries, weddings, graduations, and job promotions.
So what’s the problem? Some surveys show that nurses are more likely to be overweight than the general population. Could the reason be extreme workplace stress and long shift hours? Or maybe it’s because the nurse population is aging, which correlates to a higher BMI.
You may not be able to do anything about events at work or your own slowing metabolism. But you can control your own actions, which will help you keep on the nutritional straight and narrow.
Here are a few ideas that have worked for other nurses:
First try to become aware of any emotional basis for your cravings for sweets and treats. It’ll then be easier to make behavioral changes, which will go a long way toward keeping you at your healthiest weight.
Decide beforehand on your “food rules” for this season, and then don’t deviate from them. For instance, you may decide to bring low-calorie snacks to events so that you’re not so tempted by sugary, fatty, or salty offerings. A cup of cubed cantaloupe is sweet (only 7 grams of natural sugar), while cut vegetables with Greek yogurt dip and air-popped popcorn with chili spices are savory.
Devise a healthy-eating phrase to repeat silently to yourself when you’re most tempted. Here are a few mantras to try this Halloween, and if some prove helpful, to keep handy all year long.
“My stress level is through the roof, but chocolate is not the solution.”
“Sugar is not the best antidote for fatigue from 12-hour shifts.”
“I can accept the good wishes, but resist the treats from families and staff.”
“I deserve better than sugary goodies when I work a night shift.”
“Sweets can not change my not-so-sweet feelings of anger at work.”
In addition, try to cut out sweets in other areas of your life, too. The American Heart Association says to limit added sugar to 6 teaspoons for women and 9 for men. That’s a tall order when you consider that the American average is 22 to 30 teaspoons a day.
You have to be a good detective because sugar hides where you least expect it, like in coffee drinks. Compare a Starbucks’ Grande Vanilla Latte vs. plain coffee with a packet of sugar. The difference is a whopping 32 grams of sugar!
Of course, plain black coffee would be best, but that would probably be too big a shock to the system for a coffee drinker with a sweet tooth.
It’s better to make small and sustainable changes, such as eating and not drinking your snacks and meals. Fruit smoothies, for instance, enjoy a “health halo” but can pack on the pounds because they’re high-calorie, high-sugar, and apparently innocuous.
Sometimes it doesn’t pay to fight the inevitable, like candy on Halloween, though you can sidestep some of the danger. So, don’t go hog wild but instead enjoy a fun-sized piece of candy (80 calories for most bars), and you won’t do too much damage.
It goes without saying, but don’t be the health saboteur who brings bags of candy to work. Your fellow nurses and other staff members won’t appreciate it.
At home, buy your least favorite candy for trick-or-treaters – and fewer bags than you think you’ll need to prevent leftovers. If you want to avoid temptation altogether, give out mini-toys or stickers instead of sugary treats. In a pinch, just reach into your wallet or piggy bank for some quarters and dimes. The youngest goblins appreciate even pennies!
It’s not easy to limit treats around Halloween, but remember, you’re taking good care of yourself, and setting a good example for your patients.
Stress in nursing is most likely attributed to the physical and emotional demands of patients and families, work hours, shift work, interpersonal relationships, and other pressures that are central to the work nurses do. Stress adversely affects the health, safety, and well-being of nurses, patients, and health care organizations alike; therefore, it is essential for nurses to reduce job stress and increase their happiness through their work.
Studies show that loving your job has less to do with your job and more to do with you. That’s right, there are simple ways you can ensure your own happiness at work every single day. Because happiness is the sum of love, optimism, purpose, courage, productivity, health, perspective, humor, and fulfillment, you must manage to achieve. Happiness won’t come to you if you do nothing.
Here are six simple actions you can employ to reduce stress and enhance your happiness.
1. Find out what makes you happy.
When you know the answer, you can add it to your life. If you are not sure, you should start taking detailed notes whenever you feel happy.
2. Create and write down a daily goal of joy each day.
Creating a goal allows you to focus on who you are in the moment, recognize and live your values, and achieve your emotional energy and happiness. Try to create one thing that you can look forward to each day at work, whether it’s seeing a specific coworker or your special lunch break. Whatever it is, the simple act of looking forward to it will increase the happiness you associate with work.
3. Make yourself familiar and comfortable with each of your coworkers and patients.
Studies show that working with unfamiliar coworkers and in different settings negatively impacts you at work. Make sure that you take time to introduce yourself to your coworkers and get to know your patients. Being familiar with your coworkers and patients increases your confidence and happiness at work.
4. Be optimistic.
Research shows that positive people are less likely to become ill. Optimism has been linked to an improved sense of well-being so try to look on the bright side whenever you can.
5. Love yourself and take care of your health.
Caring for yourself must be a priority. Eating well, staying hydrated, and getting enough sleep can make you feel good. And when you feel good, you have the physical and mental energy to work through daily challenges and focus on what’s good about the day. Make time to do the things that make you happy in the moment as well, such as listening to your favorite song during a lunch break.
6. Last but not least, put a smile on your face, act happy, and laugh every day.
Acting happy and keeping a pleasant expression on your face puts your mind in a positive state. Try to let go of negative feelings and learn to forgive because forgiveness will help give you inner peace.
