Night shift can play havoc with your sleep patterns. For nurses juggling shift work and busy lives, here’s what you can do to make sure you maximise your quantity and quality of sleep.

Research shows the average night shift worker loses around one to two hours of sleep every day. Humans are not naturally nocturnal, and constantly switching from day to night duty can result in poor-quality sleep that can lead to health problems.

‘The most important thing to realise is most people don’t really adapt so they don’t become nocturnal,’ says Dr Delwyn Bartlett, co-ordinator of medical psychology at the Woolcock Institute of Medical Research.

‘The average person is sleepy at night and more alert during the day. Anecdotal evidence of case histories suggests it takes 70 days and 70 nights for the average human to become nocturnal so the average person won’t do it, even if they are on full-time night shift because they have a day off, so they are constantly pushing against their sleep-wake clock.’

To sleep at night you need a falling body temperature, but anyone who has done night shift knows that towards the morning you get cold and sleepy and find it hard to concentrate.

‘By the time night shift workers go home in the morning they are starting to wake up,’ says Dr Bartlett. ‘Even though they are exhausted, their brain is telling them to wake up for the rest of the day.’

Night shift workers miss out on the lengthy sleep that comes after doing day shifts. This is due to the body temperature becoming warmer as the day goes on and also because external noises are likely to disturb sleep.

So what can nurses who are rostered on night duty do to maximise the quantity and quality of their sleep?

‘It’s good to get an afternoon bright light so go for a walk in the late afternoon after you have woken up if you can because it delays sleep onset,’ says Dr Bartlett. ‘You want light at work too – bright for the first half of the shift and in the latter half the perfect circumstance is reduced light.

‘When going home in the morning you should wear sunglasses because light in the morning is not helpful for you. If you can, don’t do the washing or take the kids to school. The optimal situation is for you to go home and go to sleep straight away while your body temperature is cool.

‘Use sleep masks and if the room gets a lot of light, blue-tack some black rubbish bags to the window to make it as dark and as cool as you possibly can. Use white noise such as a fan, unplug your landline telephone and turn your mobile off,’ says Dr Bartlett.

Dos and Don’ts

DO:

· Make your bedroom as dark and cool as you can

· Wear an eye mask

· Wear ear plugs

· Use a fan or set your air conditioner to turn on at lunch time

· Go for a walk in the late afternoon

· Wear sunglasses when you leave work

· Turn your phones off

· Eat healthy food and drink plenty of water at work 

DON’T:

· Answer the phone

· Check your email when you get home

· Drink tea or coffee or eat junk foods on night duty

· Organise too much activity during the day.

What other tips do you have to share with us? What makes it easier for you to sleep during the day?

Image credit: Night Time Road by eVo photo, via Flickr

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It’s now mandatory for nurses and midwives to clock up 20 hours of Continuing Professional Development (CPD) each year.

This requirement has been in place in other Australian states for some time, but is a first for NSW.

Nurses may feel daunted at the prospect of trying to squeeze another layer of work into their busy lives, but don’t worry. Fulfilling your CPD requirements is a lot easier than you think!

Stressed out?

CPD is about developing your professional skills. This can be carried out in a number of ways, including attendance at conferences such as the NSWNA Professional Day, online self-directed learning tutorials, reading The Lamp, mentoring others in the workplace, writing CPD articles or attending workshops or seminars, such as those held by the NSWNA each month.

All mandatory education is counted towards CPD. Competencies such as manual handling, infection control or drug calculation, for example, are mandatory for nurses and count towards CPD hours. And anything that is mandatory can be counted in both midwifery and nursing CPD hours.

In addition to mandatory competencies, nurses and midwives also need to complete specific topics related to their speciality.

How do you go about doing your CPD?

Look at your learning needs. You need to do mandatory competences, plus if you’re a renal nurse you need to do specific education in renal nursing. Work out a learning plan, how you are going to address your needs. After completing your CPD courses, you then have to reflect on what you’ve learned – so how it affected and improved your work and what you will take back to your organisation.

ANF online tutorials

The ANF has a number of online tutorials, which NSWNA members have access to at the discounted price of just $7.70 per tutorial, as well as a free online professional portfolio where all CPD – whether it is completed with the ANF or outside – can be logged.

The tutorials range from wound care and asthma management to palliative care and emergency drugs, in addition to mandatory topics such as manual handling and advanced life support update.

The ANF tutorials offer the convenience of completing CPD requirements at times that suit busy nurses and midwives.

As well as being cost-effective, the ANF tutorials offer the convenience of completing CPD requirements at times that suit busy nurses and midwives. Once you have purchased a tutorial, you have access to it for 12 months, meaning it can be used as a reference tool in the workplace for that period. You have three attempts at the assessment section in order to achieve the highest mark.  The ANF is continually adding new modules. Modules are available here

NSWNA seminars

If you prefer hands-on, face-to-face teaching, the NSWNA runs a number of workshops and seminars each month. These include basic foot care, legal and professional issues for nurses and midwives, and forums for nursing specialities such as mental health, aged care or Nurse Practitioners. Check out The Lamp’s ‘What’s On’ section each month for details.

“The aim of CPD is to keep nurses current in their practice,” — The Lamp.

NSWNA General Secretary Brett Holmes urged members to embrace the opportunities provided by the requirement to complete CPD rather than feel overwhelmed.

“CPD is all about self-determination. You decide what you will complete and how many hours you consider the particular activity took you to complete. As long as you have identified your learning needs, developed a learning plan, participated in CPD to meet your learning needs and reflected on the value of the activities to your practice and recorded it, you’ve completed the requirements.”

Are you nervous about how you’ll fit in your CPD requirements? Do you have any other concerns? Raise them in the comments section below! 

Image credit: Josh Fassbind via Flickr, NSWNA

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As nurses, a part of your every day job is to inject or give needles to patients – so what do you do when your patient is terrified of needles?

A past blog written on this topic describes ‘needlephobia’, according to Google, Needlephobia can be defined as a fear of sharp objects such as pins or needles. Believe it or not, it is now recognised by doctors as a very real condition.

Needlephobia mostly affects children but it’s not uncommon to see a grown up man (or should we say tough aussie bloke!) faint at the sight of the dreaded needle.

What are your tips for helping needlephobes?

Calming the patient by talking to them and explaining how the procedure works may help. Having them lie down before giving the injection will help prevent fainting. With children, having a parent beside them may give them a sense of security may help.

How about you? Are you a needlephobe? Or as a nursing student, while training to give injections were you a bit squeamish?

Do you have any other tips and strategies to help your patients be more comfortable with the needle?

Image credit: worms&germsblog.com.

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For those nurses that have trouble sleeping after a night shift do these suggestions in the below You Tube videos help you? How do you get to sleep after a night shift? Do you fall asleep as soon as your head hits the pillow or do you have some secret tips for drifting off?

Taquita Love is a pediatric hematology oncology nurse at Los Angeles Children Hospital, and a travel nurse. She regularily works night shifts in both roles. Taquita records nursing tip videos for Expert Village.

Tips for relaxing and getting to sleep after finishing a night shift.

Share your tips with us!

Image credit: Jeff Hill Photos.com via Flickr

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Becoming a member of Nurse Uncut and participating in forum discussions is easy!

All you have to do is visit www.nurseuncut.com.au and click on the ‘TALK‘ tab.

Once here you simply click on ‘Register’ and the follow box will pop up.

Here you enter your details, choose a username and password and click register.

After you have done this you will be sent a confirmation email and that’s it!

You can log in and start participating in forum discussions and leaving comments on the blog.

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Another nursing tip from YouTube. This one is on central line dressing changes. What are the differences between this protocol and the one used at your hospital?

What are the rules and regulations for Australian dressing changes?

Tell us below!

First of all let me say, I’m no expert. Most of us aren’t.

Most of the skills we have surrounding death and dying are developed throughout our lives, we learn from our families, our teachers,  our friends and our community. How death and the dying person is managed and addressed across different cultures can be astoundingly different and are ability to adapt and work around these is often crucial to provide patient-centred care.

So I have some suggestions:

Patient

Ask them what they want.

Ask the relatives to leave so you can ask the patient what they want

If you can’t ask, non-verbal clues are a good sign of discomfort or pain, often even in an unconscious patient you can tell whether they are comfortable or not

Advocate for them. If the patient told you one thing, and the medical officers another; Tell them!  Sometimes patients feel that they have to continue down a ‘treatment’ path, and find it difficult to say no to their doctors.

Family

Let them know that they are doing a good job

If they are distressing the patient, then gently suggest that they look tired and should go and get some rest

Let them know that you are there for them too. Often social workers, psychologists, chaplains or even a volunteer often will spend time with the family, away from the patient, to allow them to cope with the news.

Medical Staff

When a patient is dying, this is probably one of the most crucial times that patient advocacy comes through.Clear, succinct communication with our medical colleagues makes this whole process easier. Make sure you ‘check in’ with them regularly to make sure everyone is working towards the same goal and has the same expectations for that patient

Let them know when they do a good job. I work with some fantastic doctors and often I forget to tell them that. Tell them, they’ll appreciate it.

If the expectations for a patient from the nursing staff and the medical staff clashes; TALK ABOUT IT! Call a patient conference or have a family conference, ask them why they want something different. Communicate! Often its due to information one side is not aware of. So seek clarification.

Other Nursing Staff

Keep an eye on them. Look for signs of burn out. They are your allies. And to work effectively as a team you all need to take care of each other

Some nurses do get too close. Tread carefully but if you are concerned, try to talk to them first about it and if you are unable to do that, ask a senior colleague or your NUM to investigate it.

Let them support you too. If you have looked after that patient for several days in a row and someone offers to take that patient, LET THEM.

You

Be self aware of what upsets you, and avoid those triggers

Even if you have a great rapport with the patient & their family, allow yourself to have a break sometimes and take a different patient load.

Be a professional. You are there to support them, the relatives shouldn’t have to support you

Find ways to de-stress, reflect and process your day. All these things help;

Clinical Supervision

Coaching

Acknowledge your own feelings. Say them out loud. Write them down. Acknowledging you feel sh*t about a situation in one of the 1st steps towards dealing with it

Participating in patient case reviews

Debrief with a colleague, Educator or other member of staff

Use your support systems; family, friends etc  You are allowed to have a crap time

If you do debrief  ’down the pub’ make sure the patient is not identifable to anyone listening.

Exercise; running, swimming are rhythmic and allow your mind to be free to THINK and REFLECT

Meditation, Yoga

I would welcome your thoughts and comments . . . What do you do to deal with dying patients?

Image credit: Bezene Aseel ‘When Angels Deserve to Die’

Do you think night shifts, or shift work in general, is linked to unhealthy eating habits?

Recent studies have shown that nurses are more likely to be obese than many Americans. In fact, a Harvard Nurses’ Health Study showed that about 56 percent of nurses could be classified as overweight.

Is this due to bad eating and snacking habits in the workplace such as too much caffeine, sugar and too much snacking in general? If so how do you break those habits?

What are your eating habits when you work nightshift? Studies show nurses and other people that work long hours often buy takeaways rather than make a home cooked meal.

A nurse we asked who has been doing nightshift for 20 years said she has always followed a three- meal a day schedule.

She will get home, have breakfast go to bed at 8am, sleep until 3pm. Eat lunch when she wakes up, eats dinner with her family at 6.30 or 7pm before going to work. She also snacks at night on sweets and drinks a lot of coffee and sucks sweets on her drive home to keep herself awake.

What is your schedule when working nights?

We did a quick poll on Facebook to find out what nurses favourite foods are, and also what their favourite takeaways are.

The winner is Thai takeaways, followed closely by Indian.

Other favourites are KFC/fried chicken, Chinese, and pizza.

Nurses favourite foods? Cheese, hot chips, snickers, coke, vanilla ice cream, mash potato…hmmm maybe there is some truth in these studies?

What are your guilty favourites? Let us know!

Image credit: zimble thimble, lisabatty

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Are you a charge nurse or a nurse manager? Or are you in a leadership position?Leadership development is often overlooked in nursing, and studies show charge nurses and nurse managers are often lacking training in this area.

What was your leadership training and development like?

Charge nurses or nurse managers manage the operations of patient care units during a particular shift. They assign tasks, workloads, and oversee the care provided to patients. But they also provide support, mentorship, and guidance to other nurses. Experts say these frontline leaders are the eyes and ears of the patient care operation. They are vital to ensuring patient safety, quality, and satisfaction, and staff retention.

HealthLeaders Media published this great article on charge nurse success tips. We’d love your feedback so leave a comment below!
Many organisations promote nurses into the charge position simply because they are good nurses and no one else wants to do it. But the charge nurse is crucial to the smooth operation of a ward.

Experts recommend organisations provide all charge nurses with an orientation program, which includes a preceptor and leadership development training.

1. Charge nurse orientation. To be effective, charge nurses must know their responsibilities. The best way to outline expectations and ensure competency is to spend time orienting them to their new role. Orientation can be accomplished in a one day workshop or through a series of training sessions. This is the time to cover the charge nurse role, regulatory requirements, coordination and delivery of patient care, patient safety, quality improvement, and leadership topics.
2. Charge nurse preceptors. Following the workshop, new charge nurses should be assigned a preceptor. Preceptors are routine for newly hired nurses and it’s a technique that works well for any new role. Preceptors not only show new charge nurses the ropes, they also serve as mentors who can support them in their new role.
3. Leadership development. The third part of the orientation program as a whole is the development of leadership skills. At a minimum charge nurses should receive training on:• Leadership
   • Team building
   • Conflict resolution
   • Communication
   • Developing talent

Organisations that do not invest in leadership skills for charge nurses will not get the most from them. The best charge nurses mesh administrative, clinical, and educational expertise with the ability to solve conflicts, reduce nurse-to-nurse hostility, improve communication, and ensure the smooth day to day running of the ward.

What are the training protocols at your hospital? Are they effective?

Have you been in a management or leadership position before – if so did you feel prepared?

Share your experiences with us below!

Big thanks to Rebecca Hendren, editor with HealthLeaders Media for the fantastic article.

 Image credit: Christiana Care

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