code blog: tales of a nurse

OB RN writes:

I've had sleep issues, MAJOR sleep issues, for forever it seems. I know how important sleep is. I am treated for my sleep disorders and Thank God!, because I was such a menace to society and myself. I do not take my sleep for granted anymore. It's not easy. I want to stay awake and work, and play and do things. Sleep seems like such a waste of time!

But oh the consequences of such thinking! I paid. I'm just lucky, very lucky that no once else ever paid in a major way. At least, nothing that I've seen. You never know how you may have effected someone unnoticeablly...read the book The Five People You Meet in Heaven to understand this concept.

Our unit just switched to 12 hours shifts. I work nights. After finally getting my sleep problems worked out, it's back to sleep problems again. How to get enough sleep in that little space of time that I am off? I'm not one to just go to sleep. Even if I wanted to I couldn't. It's not simple.

This is the other big problem: 3am to 5am. I hit a wall. That time used to be a minor part of my problem. Now I hit that time and I feel like a zombie. I can't react quickly. I am definitely impaired for this period of time. I was working in Special Care Nursery a few days ago. It was really busy. Days had it even worse; I was happy it wasn't me. I don't know if I could have handled it.

I was very busy when all of a sudden we were getting twins in a crash c-section... born at around 4 am. I got my twin which was thankfully term, but was definitely depressed upon admission to the nursery. Now, I'm not that experienced with newborn resuscitation. I still need lots of experience with the unstable neonate. That only comes with time, I know.

Anyway, I got this baby at around 4:25 am and my reactions were slow. Things I should have reacted to very quickly like getting that blowby 02 and suction going instantaneously didn't happen. I was just plain foggy. Like I was working in syrup or something. The NNP was there and she got things going and all was well but I'm still so bothered by this. I almost dropped a pulse oximeter on the baby's table since I had moved the monitor that is usually there, closer to the Isolette that I had to put another baby in. Motor slowness and clumsiness. That really freaked me out. It didn't happen but it could have and I felt, again, one of those times that I'm thinking "what am I doing in this crazy profession?" Why am I taking these risks with lives? I would just die if I ever hurt a newborn. That would be it for me...my life would be over.

Then I read an aritcle in Medscape about how we CAN'T adjust our body clocks. It's intrinsic, and 3 to 5 am is when we absolutely should be sleeping. Our body doesn't know any differently. Before I saw this, I was thinking...pondering... on how I am really having a hard time between 3 and 5 am. I had those exact times worked out. 3 to 5am. It's especially difficult because I've already worked an 8 hour shift by then. This is the absolutely worst time to tackle twins amidst an already busy assignment. All I can do is learn from this. I need to be more prepared and I'm anxious to get time in the delivery room to really learn neonatal rescusitation.

I've been a nurse since '81 but I'm just learning in this SCN (Special Care Nursery) environment. And I haven't been saturated in it like most of the other nurses who work it. I've just been dabbling in it until now. Just when needed, but now my role is expanding. This is a scary job. My point? Who knows...just something about acknowledging that it's not natural to fight mother nature. We do it all the time though.

Indeed we do, but it's also important to recognize our limitations. If you aren't a night person to the point that you're actually regularly impaired for a certain part of your shift, you need to get another shift. The situation you described with the twins would typically induce adrenalin production - doesn't sound like it did with you :-) Good luck.