March 13, 2012

Preparing to work nights - an experiment

In nursing school, the last half of the last semester is spent in "practicum" or, in the new curriculum, "transition." During this time, students don't attend classes. Instead, they are paired with a precepting nurse and essentially work the nurse's schedule, which culminates in 180 clinical hours.  This year, we were given the opportunity to preference our top patient population, acuity and type of unit.

Right before spring break, I found out that I got my first choice for my transition - a cardiac ICU! I was stoked! Ever since working at Baptist over the summer, I've grown to love the cardiac specialty. But I didn't know who my preceptor was, which means I didn't know my schedule or if I was going to be working days or nights. Well, I found out Tuesday that I will be working nights and I start Wednesday!

There are a lot of pros & cons to working nights, which I'll recap in a later post as I become more familiar with the schedule. But right now, I just need a strategy to make me nocturnal ASAP!

My friend, Affitin, is also working nights and began today. I asked her for some advice so I'll be following some of her tips and documenting it here. In real time. The game plan is to stay awake until PDubbs wakes up. Let the great experiment begin...

6:30 PM - 8:30 PM: Take a nap
The idea behind this was to allow me to stay up into the wee hours of the morning. I worked out earlier in the day to help me get to sleep for this nap, which worked beautifully. I didn't wake up feeling groggy at all, but it was pretty weird waking up when it was dark outside.

9:00 PM: Eat dinner
I've been told to try to maintain a regular meal schedule like I would on my days off. 9 o'clock is a little late for us to eat dinner but hopefully it will prevent hunger pangs at 2 AM. Dinner was leftovers from last night's dinner: whole wheat pasta with onions & broccoli in a garlicky tomato sauce. It was delicious, familiar food that I know won't upset my stomach and I felt full afterwards. Let's see how long it holds out!

9:30 PM: Brew some coffee
Nothing wakes me up like a cup of hot coffee. I'm planning on saving it when I feel myself slipping. Otherwise, I'll be sipping on ice cold water all night to keep me awake. 

11:15 PM: Shower
I felt a little lull around my usual bedtime as I saw PDubbs preparing to go to bed. The shower woke me up a little bit. :)

11:30 PM: Blog
Woohoo! Another half-hour down.

12:00 - 1:15 AM: Beautify
The past hour has absolutely crawled by. I braided my hair, said adios to my nail polish, and poured myself another cup of joe. I've been listening to music & reading Extremely Loud & Incredibly Close, which I started over spring break. I'm going to try to make the whole reading thing last because I definitely don't want to be staring at a computer screen to keep me awake for the next several hours. But I got a text from Affitin updating me on her first night shift. She's loving it! She says it's been a great experience already and I will love it, too.

1:15 - 3:00 AM: Finished a book
For the almost the past 2 hours, I've finished reading Extremely Loud & Incredibly Close. It was very well-written with great characters & plot lines but it left me feeling - uneasy? I can't really describe the feeling. It dealt with a lot of heavy issues like death, regret, and grief with a bit of mental health issues thrown in too. Probably not the best choice on a night when I have so much time to think. Next time, I'll go with a lighter read. I got a little hungry right around 2:30 so I popped a couple of these bad boys that I made a couple of days ago. They're good for you and justtt filling enough. The ice water seems to be working; I've only had 2 cups of coffee all night!

3:00 - 4:00 AM: Just keep pinning

4:00 - 6:15 AM: Just. Stay. Awake.
The end is in sight! I've spent the past few hours mindlessly trolling the internet (I think that's a thing. Right, Dr. B?). More reassuring texts from Affitin about how awesome her night is going. Hopefully I'll have a similarly awesome & busy experience on my unit to stop me from wanting to fall asleeeeeep. During this time, I also started reading The Descendants even though I have zero interest in seeing the movie. After watching two seasons too many of Secret Life of the American Teenager, I don't know if I could enjoy any movie with Shailene Woodley. But so far, the book is OK. No more coffee, just water, but I'm starting to get a little hungry. Don't know if I should eat breakfast now or not...

6:16 AM: Ate breakfast
Yes, it had to happen. I already had oats-in-a-jar prepared in the fridge so all I had to do was grab a spoon & open the lid. If it wasn't already prepared I don't know if I would have bothered getting off the couch.

7:00 AM - 12:30 PM: Zzzzzz
I rolled into bed right as PDubb's alarm was going off so we got to chat a little bit before my head hit the pillow. Then it was easy sleeping. I actually woke up 30 minutes before my alarm went off but I felt refreshed and ready to go. It was really weird waking up to full daylight! We don't sleep in much on the weekends so it hasn't happened in several months. I ate some cereal as soon as I woke up & PDubbs had the coffee maker ready to brew, just like a normal breakfast. Thanks, PDubbs :)

2:00 PM: Just keep running
Since I woke up too early, I want to take a nap before heading in. I ran 4 miles on a treadmill and felt pretty good, despite some residual soreness during the first mile from doing pilates yesterday. Hopefully this workout will tire me out enough so I can sleep for 45-60 minutes. I also showered so I can sleep in my comfy bed instead of on the couch like yesterday :)

4:00 - 5:00 PM: Nap
Well, I didn't truly nap because I never actually fell asleep. My body was tired but my phone was acting weird so I was anxious my alarm wouldn't go off.  But I felt less tired afterwards, so that counts for something. I ate the last of the leftovers before catching the bus at 5:45.

7:00 PM - 7:00 AM: Save lives
Just kidding, none of our patients lives were in danger last night. But it was soooo much fun! I met my preceptor before getting report and just went from there. It was more of an observation day to become familiar with the unit, staff & nursing care provided. Even though our patients were relatively healthy compared to others on the unit, I learned so much from the experience. Everyone, including my preceptor, was extremely friendly and excited to show me all the cool stuff on the unit. Since it's an ICU, they don't have students very often so they relish it. As for being nocturnal, there was a natural lull in our night between 2-4, which was rough. I also got hungry around midnight and a smushed banana from the bottom of my backpack (how does it always get there?!) wasn't cutting it. Bless the poor souls working at Subway during the night who quenched my hunger pangs but I will definitely be bringing more snacks in the future.

8:45 AM - 1:00 PM: Zzzzz
I felt like a zombie once I left the excitement of the hospital and walked into the mellow morning. The people who ride the bus away from campus at that time are rough, and I definitely belonged in that category. I ate some breakfast before hitting the hay and I was asleep as soon as my head touched my pillow. I slept like a baby until I woke up 30 minutes before my alarm again. I felt fine then but by 3, I was starting to get sleepy again, despite downing 2 cups of coffee.

Overall, the past couple of days have been weird. That's the best word for it. I think if I was just working full-time it would be a lot easier to adjust to the schedule & maintain it. However, I have other priorities in my life that have to managed during the day. This makes time & sleep management a difficult balancing act and I realize now that next couple of months may be a more difficult than I initially expected. But it's definitely doable and having graduation looming so closely is a great light-at-the-end-of-the-tunnel motivator.

Have you ever worked nights or pulled all-nighters? What sort of advice would you give to struggling nocturnalists?


Patrick said...

7:00 PM - 7:00 AM: KICK ASS!!!

Patrick said...

Love the added picture! :)

Monica said...

I can tell you from experience that working a schedule that's so different from everyone's around you is tough... But it's manageable as long as you enjoy what you're doing and you're taking care of yourself... It sounds like you're doing a good job of remembering that you need your sleep and good eats :)