I’m a critical care nurse who works the night shift, so sleep and I have had a precarious relationship in the past. There’d be yelling; there’d be tossing and turning; there’d be wistful glances at the alarm clock to count down how many hours I wouldn’t get restful shut eye that night. There’d be even more tossing and turning, followed by a pleading apology to the sleep gods for whatever misdeed I’d done to deserve such a sleepless existence. Thankfully, during my five years on the job, I’ve learned a thing or two about trying to snag a good night’s sleep in a high-stress, chronically sleep-deprived profession.
I learned early on that nurses must first care for themselves before they can care for their patients. There is nothing to give if you start out on empty. Eventually, your professional life will begin to pay for your exhaustion. The stakes are high when your job involves dosing medications and spotting changes in patient health. There will be consequences for not getting proper sleep. Trust me on this. That’s why I’ve learned to follow my own tried-and-true method for getting quality shut eye every night (or day).
“I learned early on that nurses must first care for themselves before they can care for their patients. There is nothing to give if you start out on empty.”
I’ve worked both day shifts (7 a.m. to 7 p.m.) and night shifts (7 p.m. to 7 a.m.) during my many years in health care, but no matter which literal round-the-clock shift I worked, sleep remained difficult to come by. On the job, I’d daydream about the moment I’d finally be off my feet and could drift off to sleep, my eyelids made gradually heavier with the weight of the day’s exhaustion. I’d fantasize about how the stress of the day’s code blue alarms, patient call lights and noisy monitor alerts would melt away as sleep overtook me. But when I’d finally make it home after a grueling shift, I’d lie in bed, wide-eyed, staring at the ceiling, with the mechanical sound of ventilators and cardiac monitors still ringing in my ears.
I work in what’s known as an inpatient setting, meaning the people I care for stay overnight (or longer) at the facility. Most hospitals operate on the 12-hour-shift format. Being tired for 12 hours ― rather, 13 hours after you give report and clock out ― is a “Game of Thrones” kind of feat. You’re not only burned out due to a lack of quality sleep, but the emotional toll of patient care fuels it’s own kind of exhaustion.
On the clock, you administer medications, rush to code blue alarms, communicate with patients and their families, and collaborate with other care providers. Ask any nurse: There is no downtime in an inpatient setting. Nurses barely have the time to sprint to the restroom, let alone catch their breath. When you clock in, you hit the ground running. Exhaustion puts you at a disadvantage from the start.
When getting ready for bed, I have to wind down both physically and emotionally. Sure, nurses clock out, but we often keep our patients and their loved ones in our hearts and on our minds long after our shift has ended. There have been times I’ve driven home and worried myself sick over a particularly memorable patient. That’s why I have to allow for at least 30 minutes to an hour for “decompression” before hitting the sheets. Taking either a bath or a shower helps me purge those emotions that follow me home when I’m off the clock. I have even tried meditation to help me get into the right frame of mind and, yes, it works. You can’t expect quality sleep to happen overnight without a little practice. You need to calm your mind, slow your thoughts, and relax internally before sleep can come.
“Sure, nurses clock out, but we often keep our patients and their loved ones in our hearts and on our minds long after our shift has ended.”
Once I’ve decompressed internally, I prep my external environment for bedtime. I completely close the curtains and blinds, oftentimes using a blackout curtain (key for daytime sleepers). Next, I get my “nest” ready, which includes cozy bedding, a firm mattress, and a cooler-than-average room temperature for my ideal sleep environment. And I can’t forget my accessories. I’m a light sleeper, so my earplugs, sound machine and eye mask are essential to block out the sights and sounds of the world around me. For some people, falling asleep happens as soon as they hit the sheets. For me, it’s like doing a bedside procedure. I need the right tools to make it a successful process.
By default, nurses constantly put the needs of others above their own. We care for our patients and their loved ones over extended periods of time. We often don’t eat, take breaks or use the restroom for fear we won’t be there when we’re needed most. (In fact, I’ve passed out while performing CPR because I hadn’t eaten!)
We push our bodies harder than we should, giving our patients our undivided attention and unwavering support because we want what’s best for them. But for us to provide our patients with the care and attention they need, we must turn that passion inward. We must care for ourselves in the same manner we care for our patients. Only when we are cared for can we care for others.
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