By Lucy Osborn MACN (ENL)
This column, The Scrubs that Fit, is all about the highs and lows of being a junior nurse, from the perspective of an ACN Emerging Nurse Leader. The aim of these blog posts is to help ease the transition from university to grad years and beyond. Find Lucy on ACN’s neo and or Instagram @aussie_nurses.
This is Part 2 of a three-part collection of helpful skills, tips, tricks and personal reflections, written at the end of the first rotation of Lucy’s graduate year. Part 3 is still to come, you can read Part 1 here.
My first rotation was in an extremely busy surgical ward, they specialise in upper GI, colorectal and gastroenterology. When I heard this I have to admit I was daunted, I never imagined myself in this sort of area of nursing, although incredibly grateful for the position. Every person I spoke to about the ward said, “Once you work on *insert ward name here* you will be able to work anywhere”. In other words, this is a very full-on ward and if you can survive here you’ll be fine on other wards. Two shifts in and I had already decided this ward was going to be hectic. So don’t be alarmed if your rotations are not what you had in mind, you may find that your preconceived ideas of what a ward, or department is are incorrect and in fact you will grow, learn and achieve aspects of your nursing that you had never considered. As a result, you may gain a greater scope of practice that can help you achieve future positions in areas closer to your goals. I certainly did and I am incredibly grateful.
In two months, I had called two code blues/met calls, which are medical emergencies, seen more blood, stools and emesis from the same person at the same time that I thought was even possible and been a part of the care of over 100 patients. Those reviews were not lying and I was stoked. I love a busy and intellectual environment, one where I am relied on to use my clinical judgement and training to care for unstable patients. Stools and emesis are not a big issue any more, although, yes, I do see/smell them pretty much constantly. This ward was extremely challenging, physically, emotionally and skills-wise. I am sure I would have struggled without the support and team work of the amazing multi-disciplinary team and I am truly grateful to them and was sad to leave.
Early shifts are generally a popular shift, you work super hard and fast for the first six or so hours and then you’ve got the double staff time to catch up if you need. You also get to finish whilst it’s still sunlight and can enjoy the afternoon and evening. Although I’m not really a morning person, it’s great because you don’t have time to be tired once you get to work. But doing lots of these in a row is extremely tiring, best to mix them up.
I loved the late shifts because they are mostly a little slower than an early but faster than a night, a great in-between. Unfortunately, I quite often find myself rolling out of bed at 11 and I’ve wasted the morning and now pretty much have to start getting ready for work. On this shift I try and have a good hearty dinner in my break, so I am not hungry when I get home and can just have a sleepy tea and go to bed.
In my third week I completed my first ever night shift, leading up to it I was terrified. I go out on the weekends dancing with my friends and would happily stay out until 4-5 in the morning. Generally, I utterly regret it the next day but I always had fun. So to approach a ten-hour shift from 2045 to 0730 I was reasonably concerned. I am one of those people that doesn’t function well, physically and emotionally, with a lack of sleep and here I was facing four consecutive night shifts.
My preparation was simple try my hardest to stay up late the two nights leading up to my first shift. Day one I managed to stay up till 1am but was awake at 9am. Not helpful. Day two I managed to stay up until 2am, this time I woke at 10am, I was already tired. I was about to do my first ever overnight and I was tired. Fantastic. I tried my best to have a nap at 6pm before I had to go to work. I probably got only 20 mins but lying in bed for two hours was the boost I needed.
I got to work half an hour early, anxiety gets the better of me when it comes to time, I made sure every staff member knew I was my first ever night shift. They were all very reassuring and promised to guide me through. As well as having plenty to keep me busy during the shift I also had a super cool buddy who chatted to me all night long. All in all, I had a good night. After my first night I went home and slept for five hours and had another afternoon nap just before I left for work. I had bought a block out curtain and use aluminum foil on my windows to get the room as dark as I could. I had given my house mates two weeks’ notice and daily reminders of my impending night shifts and put a sign on my door saying “NO NOISE, SLEEPING”. Overall the dark room worked like a charm and my housemates were reasonably quiet.
I had assumed the nerves would have worn off after the first night but I found myself keeping busy and having another good night. Between four-hourly observations and for some patients’ hourly pain relief, I completed some online study whilst I listened to stories of ghost bells and unusual occurrences; let’s just say I was not unhappy that I needed to stay awake for a few more hours.
I always wondered why there are so many people that choose to do night shifts exclusively, but I totally get it now. No phone calls, more patients asleep than usual, super chilled environment (most of the time), less commotion on the ward leads to a quieter more relaxed environment. Just you, your buddy and a cheat sheet. But don’t be fooled, not every night shift is like this, sometimes it will be just as busy and even more crazy than a day shift.
Here are some tips for surviving over-nighters.
- Stay up the night before, this worked for me, may not be ideal for you
- Sleep in, if you can
- Have a super dark room
- Eat healthily and keep hydrated
- Try and maintain your usual exercise routine (it helps you sleep)
- Sleep when you can and when you feel you need to, your body clock will be totally confused and have no idea when you are supposed to be asleep.
Read the rest of Lucy’s The Scrubs that Fit articles here.