Sometimes my friends ask me why I sleep so much on my days off. Usually I can prevent myself from laughing in their faces because I understand that they wouldn't be asking if they had any idea.
The only person who truly understand the life of a nurse who works shift work is another nurse who works shift work, but I think there are some things that people should know about my job and why I am so exhausted after just a few days of work:
1) 12 hours is a long time in and of itself. However, I also get up at least 1.5 hours before my shift and rarely get home until an hour after I stop getting paid*. When I get home, I need to wash, change, eat, pack food for the next day, and unwind before crawling into bed. I find it really hard to function on less than a minimum of 6 hours of sleep, so during a run of shifts I basically work and try to prepare for my next shift. And that's it. In addition, I usually find that my first day off is a throwaway because I am sleepy and lethargic, still recovering from work, and I rarely get much done.
2) Sure, I only work about 4 days a week but, as I am clearly completely unproductive anywhere else on my work days, I only have my days off to keep up with everything else: family, friends, cleaning, shopping, cooking, appointments, laundry, world news, and relaxing. I also have to try to catch up on the sleep I missed during my shifts, and that can burn some serious daylight.
3) I work both days and nights. Because of union rules and the way lines work at my job, there are almost no straight days or straight nights positions. This means that we switch between day and night shifts, and those transitions can be brutal. I am not blessed with the ability to just sleep wherever and whenever there is an opportunity for as long as that opportunity lasts. I have to carefully adjust my sleep-schedule to stay on point. If you're on days, you need to be getting up and going to bed early. On nights, you want to stay up excessively late (so late that it's early) so you can sleep well into the afternoon. When I'm not at work, I am trying to either maintain or adjust my sleep-wake cycles for whatever shifts are upcoming.
4) Living in a Northern city means I miss a lot of daylight during a run of shifts. On days, I get up before dawn and might just be lucky enough to catch a few rays as I walk into the hospital and again as I stumble up the steps to my house. On nights, I get up as the sun is setting, go to work and come home in darkness, and then curse the sun forcing its way through my curtains while I'm trying to sleep.
5) My backpack is always heavy. Besides the ID tag, pencils, eraser, black pens, highlighters, calculator, and calipers, I need to make sure I also have hand lotion, lip balm, advil/tylenol (for my own headaches), a book (for breaks or on the off-chance we have a quiet shift), my reference guide (because wikipedia is good but a manual is both reliable and nursing-specific), my phone charger, a sweater, a water bottle, coffee mug, and a lunch bag with breakfast, lunch, and a pre-dinner snack for before I go home (on nights it has supper, a snack, and breakfast). If I didn't work somewhere that they provide our scrubs, I would also need a change of clothes because when you need to change your scrubs, you need to change your scrubs right now!!
6) Although I have to take what my patients say about how they're feeling (nausea/pain/breathing/sensation/etc.) very seriously, I have had to learn to completely ignore how they're feeling. I have been swung at, sworn at, spit on, ignored, threatened, told I'm incompetent/stupid/ugly/loose/etc., yelled at, pinched, and brushed aside. And that's the just the families! (Mostly joking). If I took it all personally they would have to put me in a padded room with an IV drip of Vitamin-P and Zuclopenthixol, but it is still exhausting to cope with.
7) There is this awful thing called The Vacation Planner. Every new nurse hates it. Vacation is doled out to nurses based solely on seniority - we literally have a spreadsheet that lists every single employee on the unit and their start-date, all in descending order. Only 4 nurses can be granted vacation on any given day, and if you haven't been on the unit for more than 8 years you're left with a smattering of days in October, November, or March. Also, you have to put in for 100% of your vacation allotment a full year in advance. Do you know what you'll be doing one year from today? Well, I'm supposed to!
8) The only predictable thing about my job is that it is unpredictable. I never know what kind of patient I'll have, how sick they'll be, if they're going to stay stable or crump, if they'll be cooperative or combative, if they'll even understand English. The plan throughout the shift may change: You'll have a quiet day, nope - you're going to MRI, MRI takes 3 hours instead of 1 and so you're late giving your medications, now you're on call for the O.R., new orders from the doctor, all your orders have changed, all your orders have changed again, it's 2pm and you still haven't had a break, O.R. has been cancelled, your patient is being moved to another hospital, your patient is now staying here, your patient's family is freaking out, etc., etc., and on and on. Predictably, your day is going to be unpredictable.
Working with humans, and so many different kinds of humans from a million backgrounds and areas of knowledge, means there are an infinite number of factors changing every minute of every day. And nurses just have to go with the flow of it - deal with things as they happen, plan as best they can, re-plan when things go wrong or just plain change. It's mentally, physically, and emotionally exhausting. Yet so many of us love it. You get one patient or one family member who says something along the lines of, "Thank you so much for everything you do. You really brightened his/her/my day ... You're a great nurse!" and just like that, all the hair-pulling, pinching, yelling, poop, adjustments, sweat, confusion, tears, and frustration are totally worth it.
It's a high stakes job that keeps your constantly on your toes. Every day is a gamble, and you win some, you lose some. The losing is awful and depleting, but the thrill of the win, or even just the chance of winning, makes it totally worth it. I hate my job and I love my job.
I adore being a nurse and I love my current position, but that's why I sleep so much on my days off.
*Nurses get paid from 0700-1900 or 1900-0700. The next shift starts right at 7 (am or pm) but I have to give them shift report (reason for admission, history, what happened during my shift, plans, concerns, updated orders, etc.) before I can go home. This usually takes approximately 15 minutes (although I have stayed as long as 30 minutes JUST for report), and it is time that I essentially "donate" to the health care system. It may not sound like much, but add up 15 minutes multiplied by every single shift, and it's not just chump change. Essentially, a full time nurse donates about a full 40-hour work week every year, just in report. I know it has to do with our contract and the union and blah, blah, blah but this is a point of frustration for me, if you can't tell. Sigh.
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