NHS night shifts

[kittensmittens1]

I am a new student midwife and for my first placement I am on 6 weeks of night shifts. It's my 3rd shift tomorrow and I'm really, really struggling. I'm dreading my shifts, I feel so exhausted after 1/2am that I can barely think.

It wouldn't be so bad if my shifts were 3 consecutive nights but this weeks it's been Tuesday, Wednesday & Sunday and the rest of my placement is similar. What do I do with myself for the days inbetween, stay nocturnal and not see my family? I can't keep flipping back and forth.

The day before my shift I've been having a late night then waking up early morning and then having an afternoon nap but i still really struggle.

The team has a lot of student so no wriggle room to change and no one else would swap with me as they've all said they'd hate doing all nights. I'm following my mentors schedule and she works permanent nights which is the reason behind it.

Do you have any tips or advice for me? The thought of doing this for another 5 weeks fills me with dread. I feel like it's ruining my life. If I was on day shifts I know I wouldn't feel this way.

My nights routine is go to bed normal time the day before and wake up earlyish. Go back to bed for an afternoon nap from 2.30/3-5pm and then up have dinner and off to work. In between nights I have really good quality black out blinds so I come home, super quick shower and straight to bed. I usually sleep through until around 2pm, then have a snack and try to go back to sleep until 5pm again. I always feel better on night 2 than night 1!

Once my nights are finished I go to bed after shift and wake myself up at midday. That way I have a bit of the day left and am always tired enough to get a full nights sleep that night.

I’m lucky because I’m a good sleeper and I have no children to worry about during the day. Do you get a sleep break on shift? I remember hating nights when I was a student but honestly they get easier the more you do and once you’ve settled into your ‘nights’ routine!

Why are you having a late night then an early rise? No wonder you struggle so much on the first night, it’s hard enough even when you are rested.

You do get used to it. I’m not NHS but I do nightshifts.

Afternoon napping is impossible for me before a night shift too. You’re better off going to bed later the night before and sleeping in as late as you possibly can the day of your night shift

I hate nightshifts so you have my sympathies. I hate sleeping during the day so can never nap before the first one. I have an eye mask and ear plugs so I can try and sleep in as late as possible. Other than that I just struggle on. Currently looking for a new job!

@LiquidGlee thank you, I've been doing similar to you.
We have an hour break, if there's a room free we can go in and have a sleep. I tried but couldn't fall asleep in time despite being tired, hopefully I'll get better at this!

I have blinds and curtains which work fairly well but not blackout blinds. If it doesn't improve i will have to invest in some.

I just lost it a bit and had a really big cry, I'm exhausted and anxious about my next shift. Lockdown doesn't help either! I'll be ok, I just hope I get used to it soon.

I don't work nights yet, my DH does 7pm/7am

He goes to bed normal time the night before, he gets regular time has breakfast etc and goes to sleep about 1pm-5pm

Following nights he gets home, straight to sleep until about 3/4 then has something to eat and gets ready / goes to work

I worked permanent nights for over 20 yrs . On the first night I used to get up normal time and have a normal day , after a while I’d got it down to a fine art and would come home do the school run , walk the dog , shower , bed by 10am and then be up and raring to go by 2/2:30 . On the last night I always went to bed like normal in the morning and then just went to bed at normal time that night . My theory was always that you don’t need more sleep during the day than you would during the night and I’ve always been fine on 4/5 hours . The key to keeping going overnight is staying busy , drinking plenty and fruit gums .

I would ask for consecutive nights. You aren't required to work every shift with your mentor and you should have a practice supervisor as well as an assessor who you can work with. If not then I would speak to your university or ward manager to talk about how you are finding it. I know as a department manager I would absolutely accommodate consecutive nights.

Oh wow @Floralnomad you're an expert then!

I think it's the the non consecutive days which are causing me problems. I definitely felt better on shift 2 than I did on shift 1, but come Sunday night I'll be back to square 1 again!

Tuesday, Wednesday, Thursday would be manageable, but Tuesday, Wednesday, Sunday!?

I hope I get used to it soon.

I did nights for a year as a nurse and we did similar to you by taking a 1 hour break. I would always tune into a guided meditation on YouTube, it wasn't sleep but it is was total relaxation.

We did 4 on/4 off and I have kids at home. Night 1 I'd get up and put them to school as normal then go to bed from lunch to school finishing, the next day I'd sleep the 6 hours they were in school. After night 4 I'd still go to bed when they went to school but would try to be up around 1pm so that I could sleep again at night. The longer you do it, the easier it gets!

@addictedtotheflats that's helpful thank you.

I know I'm supposed to have a supervisor and an assessor but there's only ever been 1 midwife on with me. She's been lovely, but says she's not sure which one she is for me (if any) as she hasn't been told. I haven't met the manager as she only works days.

I will try to get an email address for her to clarify these points as it is important and I need to know who's signing off my online bits.

Many thanks

I’m quite envious, OP! When I was a junior doctor, many years ago, we worked an 80 hour continuous resident shift, from Friday morning to Monday evening. Then had 16 hours off and came back for a 32 hour shift.
I would have killed to be allowed a break and some sleep every 12 hours! You’ll find that once you’re fatigued and sleep deprived enough you’ll be able to fall asleep whenever your head hits a pillow. I used to fall asleep in the cinema as soon as the lights went down, occasionally dozed at the wheel of my car, and once fell asleep halfway through my dinner...

Goodness @Babdoc that sounds awful. I wouldn't feel safe to practice like that.

I am envious of your ability to fall asleep anywhere though!

I’m a stmw too - it WILL get better.
My first few nights I thought I would have to leave as I could not see myself doing it long term. But it does get easier. It really does.

Putting you on 6 weeks of nights and not even consecutive is a bit mean though I think. I’d speak to whoever does the rota, hopefully they will be helpful.

💐💐💐💐

Ah @LittleLapwing thank you. I'm so glad to hear it gets easier. It can't come quick enough!

There’s no longer a requirement to work 40% of your shifts with a mentor, so I’d absolutely change to someone else for one shift and do consecutive.

I’m fairly newly qualified and trust me when I say keep those nights - those will be when you get your catches! Get them in the bag early and you take a lot of your pressure off. You do get used to the nights. The worst pattern I had was night shift, off, night shift, off, night shift, off, night shift, off. My whole week was written off.

You’ve got this. Feel free to message if you need a hand hold

@kittensmittens1 your assessor needs to have done to online conversion course from mentor to assessor so she should know. There is also an elearning for supervisors but all registered nurses or midwives can be a supervisor they dont have to have done the teaching in practice module.
There isnt actually a specific requirement for how many shifts you have done with your assessor anymore but if you were to go by old standards it would be 40% of your placement. Hope you get something sorted! Nights arent that bad consecutively, you get in the swing by the third and fourth!

I think if you are working consecutive nights you would find it much more manageable. I have done nights as a junior doctor always in blocks of 3 or 4 in recent year. If you can get a good day time sleep after the first night the second won’t feel too bad.

Different things work for different people but when I worked my last night shift of a block I would sleep for a few hours after and make myself get up by lunch time. Then I would go to bed at a normal time in the evening. This helped me readjust quickly back to normal hours.

I used to work nights on a rotation years ago- but they were usually consecutive! Some of my tips:

• Make your bedroom as restful as possible. Get a well fitted eye mask and ear plugs if you don't have proper black out curtains. Many 'blackout' curtains still leave a halo of light around the window which is SO annoying when trying to sleep in mid summer

• In winter, I used to sleep on a sheepskin underlay which was cosy. I used to look forward to snuggling into it and in my mind, made sleep more inviting

• In the days leading up to the shift, I would stay up later and later and ease into the nights. The 1st shift was usually a killer, but if you can maintain even half night shift hours on your days off (say stay up as late as you can and sleep in till noon) if will help a great deal

• On my actual shift, many people used to bring in home-made cakes, sweets, crispt etc. We used to have a code on the tannoy when the food trolley was wheeled out which we could all help ourselves to. Try to still eat healthy and dont fall into the trap of convenience foods/unhealthy options. If you take something healthy with you, make sure you eat it. If you then do grab a few snacks, you've at least have a proper meal, and not just eaten crips all night.

• Make sure you drink water. It easy at night to forget to drink. Take a large bottle with you so you can track what you drink

• For a treat, I'd sometimes take in coffee bags, mocha sachets or hot chocolate. Unless its changed, the instant coffee in hospitals is vile, so a special coffee or something different at night was a welcome distraction. The caffeine also helped me keep going. I used to stop caffeine after about 1am though, otherwise I couldnt sleep once home.

• Depending on your hours, try getting some natural sunlight before your shift. It helps set you clock into 'thinking' its daytime. Equally, try to avoid too much sunlight in the morning when heading home to sleep. In summer, I used to wear sunglasses heading home (I was abroad, so not as unusual as in the UK!)

• Another option if you arent sleeping, is to get a SAD lamp and sit with it in the room 30mins before your shift.

Best of luck OP xxx

That is an absolutely TERRIBLE shift pattern. It would be bad enough if you were a full member of staff but as a student it is incredibly unfair. As others have said, you don’t always have to work with your mentor. This really should be changed for you but unfortunately might involve you having to ask repeatedly for this to happen, especially if they are not even sure who is your mentor and / or assessor. Agree with PP who suggest escalating this if the midwife you are working with can’t help you.

Thank you so much all, I am going to email the team manager to clarify a couple of points and ask if it would be possible to make my nights consecutive.

I honestly don't mind doing all nights for the whole placement, it's part of the job, but the schedule is really making it difficult for me.

I don't know if it's tiredness, anxiety or hormones (probably all 3!) but I've had a very tearful night so hopefully will get sorted this week.

@Eleoura thanks so much for taking the time, I'm pleased to say I'm doing most of those things!! I've actually been driving home in sunglasses because I read it online 😂

@BuntyCollocks that's lovely, thank you! X

Also might be worth looking into Bimuno, I have had sleep issues for years been taking this for over a month and sleep feels much easier to come by. Worth a Google anyway.
Also melatonin (not OTC in the UK) can be helpful as it basically signals to your brain 'sleep now'.
Wishing you luck, I become a complete basket case after interrupted sleep.

You should speak to your uni placement co-ordinator because in the trust I work for a first year student wouldn’t be expected to do all 6 weeks of nights, you should have a co-mentor who you could do some days with. This isn’t on at all.

Op I’m a student nurse in my final year so I’ve been where you are. You 100% don’t have to follow the exact shift pattern, we have been told we don’t need a supervisor AND an assessor due to staffing pressures brought on by the pandemic and in fact in my last placement I wasn’t with an assessor or supervisor as all the ones on the team were off sick. I would definitely speak to the ward manager, PEF team or personal tutor at uni. I don’t know anyone who’s done permanent nights on any placement I 3 years. I too really struggle with nights. I get very teary and can’t seem to find a routine with them. Try and relax for a hour when you have your break even if it just means putting on some rain noises on your phone and closing your eyes and try to keep the carbs down as they always make me sleepy on nightshifts (although the last night I did the nurses ordered a dominos so that almost made me pass out😂). But yeah definitely speak to someone about it. Good luck