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Would you consider yourself a healthy shift worker? I’m sure that fatigue, lack of sleep, suboptimal food choices and limited exercise is probably relatable to some degree, but does that make you unhealthy? As nurses, we have a pretty good understanding of what’s good for us and what things could be changed to better our sleep, energy levels and mood. But due to our rigorous, non-traditional schedules, the motivation to make these changes can be lacking. If you’re trying to improve your health as a busy shift worker and are feeling a little overwhelmed on where to begin, this post explores a great place to start, plus discusses other areas in your busy nursing life worth considering.
Before we jump in, I wanted to introduce myself. I am Emma Smith, a registered nurse of 10 years and co-founder of The Other Shift, a website community my husband Daniel and I created to support shift workers and those working night shifts to live a happier, healthier life. We identified a gap in “assumed health knowledge” when starting a shift work job and we wanted to help close it.
Our recommendations are based not only on our personal experiences as shift workers but also on experts’ opinion from evidence based research, reviews and interviews. If you’re struggling to find a routine which works for you and your family where you can sleep soundly (most of the time), exercise regularly, enjoy some you time and eat a healthy diet, we would be genuinely honoured to help. Jump onto theothershift.com or email us at info@theothershift.com. Now onto the article.
First Step: Take Sleep Seriously
How many hours of sleep are you getting on average each night? I know night shift and the dreaded late / early shift schedule can make this number look dismal. According to sleep experts like Matthew Walker, if it’s less than 7 hours, it’s not enough. Before you scoff and move on because that is simply impossible, stop. Good sleep health impacts on everything and it’s worth at least striving towards 7-9 hours majority of the time.
Think about what’s keeping you awake. Is it the light and neighbourhood noise when working night shift? Are you getting too hot? Or is your mind racing and you can’t switch it off? Identifying your own barriers to good sleep allows you to focus on particular areas, saving time and money on areas that aren’t actually a major problem.
Potential solutions
● Too hot? Invest in a portable air conditioner or fan, consider wearing thinner pajamas, change your bedding to something lighter and more breathable or invest in a cooling mattress topper. Turn off your electric blanket and ditch the weighted blanket despite how wonderfully cosy your bed may feel when you initially jump in.
● Too bright? Get yourself a quality eye mask (consider one or two straps) which gives you 100% black out or as close to it as possible. Install black out blinds or use foil as a temporary, cheaper alternative. Also, block out the light by wearing blue light blocking glasses 1-2 hours before bed. These specifically designed specs allow your sleep hormone melatonin to function effectively whilst still exposed to light. They are also incredible at minimising eye strain which often occurs when reading or watching when we are tired.
● Too loud? Get some ear plugs which don’t fall out, a white noise machine or consider relocating where you sleep, if logistically possible. Soundproofing your bedroom may seem excessive but could be very effective long term.
● Brain won’t stop? Spend some time away from your screens such as your mobile, the TV, laptops, ipads, games and computers. Set social media alarms to stop endless scrolling and be strict with yourself to not pick it up again. Try journaling, doing a puzzle, going for a walk, listening to an audiobook / music or simply talking to those you live with. Using aromatherapy, such as lavender, can also encourage your brain to switch off.
● Waking up too early? Think about your caffeine and alcohol consumption in the 6 hours before bed. Can you switch to a caffeine free alternative? If you’re exercising within 2 hours of going to sleep, this can also cause sleep disturbance for some. If this is you, consider a better “sleep friendly” option.”
Once you’ve identified your sleep challenges and have some potential solutions in place, it’s time to organise a routine. What can you do in the 1-2 hours before bed that look consistently the same regardless of what shift you’re on? Think taking a warm shower, relaxation / meditation, reading a book, stretching, drinking a herbal tea, having some time away from a screen etc.
It’s cool to sleep, despite the almost funny attachment to insomnia and lack of sleep in the nursing workplace. Outside of my number one recommendation in getting more sleep; here are 11 other areas you could focus on.
Be cautious regarding overtime and picking up extra shifts
The wonderful thing about nursing is that work is always available. Any day, any time there is a shift that needs to be filled. Hospitals, nursing homes, community clinics and nursing agencies are constantly on the lookout for appropriate staff to fill shifts; however it doesn’t mean you have to say yes.
This year’s theme of International Nurses Day, “A Vision For Future Healthcare” forces us to think about our own future in healthcare and how we can make it sustainable. Excessive time on the floor and working well beyond our scheduled roster, does help our colleagues and department in the short term but can be detrimental to our health if constantly repeated without adequate rest.
Next time you’re asked to do overtime or to pick up an extra shift, really consider if the scales are beginning to tip.
Take Your Breaks
Throughout my nursing career I have skipped my break many many times. I thought I was doing the department a favour because they would not be short staffed for the 30 minutes I would be gone and jobs would continue to get done without delaying patient care. Skipping my break seemed like a no-brainer. However, though I was partially right, a fatigued, needing to pee, hungry version of myself is likely to make mistakes potentially worsening patient outcomes (an ugly Riskman we desperately want to avoid).
I’ve worked the crazy, hectic shifts where the thought of having a break seems ludicrous but do yourself, your patients and your colleagues a favour by stepping away for 10 minutes. Use the bathroom, drink some water, have a few mouthfuls of food and even breath in some fresh air outside if possible. You’ll be a safer, calmer and a more empathetic nurse because of it.
Make time for those who love and respect you
After you’ve worked multiple nights / days in a row, you can feel somewhat isolated from your friends and family. Feelings of disconnect are not uncommon but can be addressed and even avoided with forward thinking and organisation.
Take a second to consider the people in your life who treat you with kindness, make you laugh and feel good. These are the people you should be making time for between shifts. Try and not feel pressured to catch up with everyone, particularly those who you feel you always make the effort to see and don’t reciprocate.
Get used to exercising when you’re tired
Exercising consistently is hard, particularly when working a rotating roster, which limits your ability to participate in a local social sports team or club who meet regularly to train and play.
Us nurses are forced to find a form of exercise that is appealing enough to be potentially done 7 days a week at all hours of the day and night. The main challenge of course being we are tired before we even consider changing into activewear.
The avoidance mindset of, “I walked enough during my shift” is fine, but it won’t help improve your flexibility, fitness level or cardiovascular health. We need to accept that feeling totally refreshed and energised before every workout is an unlikely reality for us and we need to push on. If you’re feeling good, make the most of it but if your energy is lacking consider something slower like pilates, yoga, swimming or a brisk walk.
Address Your Stress Triggers
Nursing can be a very stressful job but we know significant stressors also exist outside the workplace. Money, caring for eldery family members, marriage, friends, kids, chronic health problems and different social situations can disrupt our thoughts and behaviors.
Take out a pen and notepad or open the notes section in your phone and write down the moments when you feel stressed. What causes you to feel uneasy, nervous or anxious. This process may take you a week to do. However, undertaking this little exercise can help you set boundaries, make plans to potentially speak to somebody if necessary and regain control, allowing for better sleep and a less stressful life.
Enjoy the sun wherever you can
How much vitamin D is hitting your skin each day? This “sunshine hormone” as it’s often termed, controls calcium levels in the blood necessary for healthy muscle, bone and teeth development. It is also critical for our body clock’s circadian rhythm which is often disjointed for us.
However getting enough of this important vitamin is tough for nurses who mainly work indoors and at night. If you’re thinking you can “bank” your vitamin D levels by sunbaking on your days off, think again. According to Better Health, the body can only absorb a limited amount of vitamin D at a time so spending extra time in the sun won’t increase vitamin D levels – but can increase your risk of skin cancer.
Consider; having your dinner outside, exercising regularly outdoors between shifts, hanging your clothes on a washing line instead of using the dryer or indoor clothes rack and walking where possible. You only need about 10-30 minutes per day to get enough vitamin D.
Use caffeine wisely
Most shift workers cannot function without some form of caffeine and this is okay and even comes with it’s own health benefits. But it’s the timing that can be detrimental to our sleep. If you are drinking or consuming caffeine within six hours of going to sleep, you may experience unwanted sleep disturbance.
If you love a cup of joe and you’re having trouble sleeping or experiencing sleep disturbances, consider moving your brew to the start of your day or switching it with something like coconut water which may in fact give you the same energy kick.
Try a meal delivery service
You’ve probably heard about the advantages of regular meal prepping and how it can ultimately save you time and money if you’re organised enough. However, we both know that preparing your meals consistently is hard and takes work.
One potential solution you may be surprised to hear is to not meal prep at all and instead rely on a meal delivery service. Companies like HelloFresh, Marley Spoon, Dinnerly and Every Plate can take the stress out of going to the shop and deciding what to cook. Even if you just try it for a month, this time can help you find a healthy eating routine again whilst spending more time with your family and less at the supermarket.
Don’t miss the roster lock out period
One of the most powerful parts about being a nurse on a rotating roster is that you get to choose when you’d like to work. Being able to request your shifts around your social life and other commitments is what makes nursing such a special profession. The key here is to actually put in your requests! Though it can seem tedious, don’t leave your roster to chance.
Don’t forget about annual leave, conference and study leave either!
Charge your phone outside the bedroom
At risk of causing controversy, this recommendation needs to be included. Winding down for sleep with your phone firmly gripped in your hand, to the point your hand has gone numb, is a widely used technique. But our phones are causing a few problems.
- The blue light is preventing melatonin from being produced
- The stimulus from whatever you are looking at is not allowing your brain to relax
Do yourself a favour and go to Kmart. Buy a cheap alarm clock and start charging your phone outside the bedroom. If you don’t like the alarm clock idea, use your phone’s alarm but charge it out of reach from your bed.
Take a supplement
If you are significantly deficient in vitamin D despite your attempts for more exposure, consider taking a supplement.
If you work nights and you find you’re not eating enough healthy items and feeling restless, try a magnesium supplement or incorporating a green juice powder into your every day to “fill the gaps” from what your diet may have missed.
By eating a healthy, balanced diet we can meet a lot of the nutritional recommendations but sometimes we simply can’t get there due to our rosters and personal lifestyle. Talk to your GP and consider having a blood test to see if and where you are deficient.
In conclusion, the phrase, healthy shift worker is not one spoken too often but that doesn’t mean they don’t exist. Creating new habits with the aim of becoming a healthier shift worker is well worth your effort. No two nurses are the same though so avoid comparing yourself to others whilst developing your own strategy. Best of luck and happy nursing.
If you need any further advice or have any questions, don’t hesitate to reach out at theothershift.com
Cheers,
Emma Smith
Co-founder The Other Shift
Registered Nurse – Emergency
Want to write for The Nurse Break? Email us hello@thenursebreak.org
