Adjusting health care work as a newly qualified registered nurse can be challenging for many reasons.
While adjusting to the professional role is difficult in its own right, add in the extra element of shift work and it’s not surprising that the words ‘culture shock’ are often used to describe the new grad experience. There really aren’t many professions like nursing that have such a difficult pattern of shift work hours. Even compared to other shift workers, nursing shift hours in acute and aged care stand out as being some of the most difficult to manage. It is common place to see weekly rosters with mixes of morning and evening shifts. Night shifts provide another layer of complexity. Other professions with a requirement to provide services 24/7 have moved over to a slightly more palatable shift pattern where weeks of early shifts, late shifts, and night shifts are sequentially rotated. Not nursing. For the most part our shifts remain jumbled together and provide little opportunity for establishing routine.
Quite understandably, many newly qualified registered nurses find that the adjustment to shift work, especially night shift, is the most difficult element of their first year. They may find that it’s rarely talked about or the difficulties acknowledged. It’s not that no one cares or is not experiencing the same level of work / life chaos. It’s just that experienced registered nurses who have done shift work for years have probably become somewhat desensitised to the overwhelming exhaustion that comes with being in a constant state of sleep deprivation and severely disrupted circadian rhythms. After a while, even the abnormal starts to feel normal.
The key to surviving shift work is sleep, good quality sleep is vital for those required to do shift work. The focus must always be on getting enough good quality sleep to avoid severe fatigue. Many nurses who work night shifts have developed a range of techniques over that time that can help to achieve good quality sleep during the day. As we all sleep better at night, most nurses who do shift work would agree on some basic strategies to aid day-time sleeping.
Most nurses who do shift work find that it helps if the room you are sleeping in during the day is dark. Black-out curtains are best, but some find eye masks can create the same effect. It can also help if the room you are sleeping in during the day is cool. As body temperature naturally drops at night, making the room as cool as possible can re-create a more ‘night-time’ sleeping environment.
Some nurses also swear by actively tricking the subconscious brain into believing its night-time. I’ve known nurses who eat the equivalent of an evening meal and drink a glass of wine after a night shift. Many other nurses watch typical night-time TV programmes before drifting off to sleep. It may take some time to develop coping strategies for adjusting to shift work, however like everything related to the new grad experience, things do tend to improve with time.
Kath Sharples is the owner of Health Education Consultants Australia