I recently volunteered to exclusively work in our main adult COVID ICU (on my old general care peds unit). There are multiple COVID-19 ICUs and moderate care floors throughout the health system. It is terrifying to see two critically ill adults in each room when there used to be one isolette or crib for relatively healthy children. Every night I learn how to do more and more ICU care to help the primary nurses as much as I can. My first night I helped get a bagged body ready for the morgue. My second night I saw family come to the bedside of a man in his 30s to be with him before he passed. Most patients are intubated and several are on continuous renal replacement therapy (CRRT). None of this is fair. None of it seems real. It is very surreal to see room after room with patients maxed out on ventilator settings, sedation, pressors, and barely surviving. In some rooms you can hardly move with all of the IV pumps, machines, supplies, and equipment. I cried the first time I walked the RICU halls, but now feel somewhat immune to the trauma we see at work or watch on TV every day. Then, I find out patients I helped bathe, turn, or draw labs for died that next day and I break down again. My emotions, probably like yours, are all over the place. I can’t always label them but I do know a lot of what I’m feeling is grief. Grief from what our lives were supposed to be like this spring, grief from cancelled events or missed trips, grief from not seeing friends/family, grief from actual death around us, and grief from our old way of life as we transition to a ‘new normal.’
I am thankful however, to have all of the PPE I need to safely enter patient rooms. The entire unit is negative pressure too. This is NOT the reality for many nurses across the US and now some are even getting fired for refusing to work without N95s. While we did sign up for this job to help others, we did NOT sign up to do it without the equipment needed to protect ourselves. Our country was completely unprepared for this pandemic and its essential workers are feeling its detrimental effects the most. The good news is that the curve is flattening thanks to successful mitigation. Please continue to do your part by STAYING HOME until it is deemed safe to leave. You are helping save the world by doing so and the frontline can’t thank you enough. The next time you venture out don’t forget to thank our other crucial frontline staff ~ grocery store employees, postal carriers, truck drivers, bus drivers, chefs, janitors/EVS, and more! Stay strong, we will get through this.
African Americans represent 40% of COVID-19 deaths in MI but only represent 14% of our state’s population. The reasons for this can be attributed to multiple social determinants of health such as having a job that doesn’t allow ‘work from home’, lower income, fewer community resources, comorbidities etc. (this is Nursing 101)!
Proud of our Governor for creating a task force to help understand why these racial disparities are occurring and how we can remedy them.
Please remember you don’t have to be productive during quarantine. We are experiencing a trauma and your only job is to stay home and take care of yourself. Mental health is as much of a priority as physical health so don’t feel pressured into doing anything you aren’t comfortable doing right now. Two articles helped me understand this:A Trauma Psychologist Weighs In & Don’t Feel Like ‘Getting Things Done’?
I’ve only ever worked night shift (7p-7a or 11p-7a) and have slowly gotten used to the lifestyle. I also don’t anticipate switching to days before I graduate. The most asked questions I get are “how do you sleep?” and “how do you stay awake?” I have to preface that I only work two 12-hr shifts per week now. I used to work 40 hours, then 28, and now 24. So naturally your routine will be different depending on how many nights you work. However, I never stayed on a night schedule. In other words, I always switched back to being awake during the day when I was off. My best advice for switching is going to bed right after work and waking up in the early afternoon if not back that night. That way, I’m usually still tired at a normal hour at night. In addition, try to cluster your days so you work several nights in a row to reduce having to switch back every few days. Obviously, this isn’t always up to you but try to request it if you can. I’m a pretty sleep-dependent person so I don’t even try staying awake the whole day after work. What probably makes me so tired is that I don’t sleep or nap before my first night on. I’m up early in the morning (sometimes even go to class all day, sadly) and then stay up all night. I can’t say this is safe or smart, but it’s what works best for me. I am then exhausted and could sleep all day. Thanks to my Fitbit, I know I get an average of about six hours of sleep in between shifts (~ 9a-3p).
Is night shift awful? No. I do miss out on a lot, especially working weekend nights. On my floor we are required to work every other weekend. Yet, it is when my friends work and sometimes gives me enough downtime to do schoolwork. There is a shift differential $$ for working nights which helps make it worth it. I also don’t miss class or meetings since I am never scheduled to work during the day. We do have more patients and a lot less resources though. I also can’t say I haven’t started to fall asleep on the way home. It is terrifying and always makes me say a prayer when I get there. The best way to stay awake in the car is to open your windows and call someone! Call your mom, a coworker, friend, or anyone who will talk to you to make sure you’re still awake. It is also nice for venting after a rough night. Loud music and snacking on something can help too.
How to stay awake at night?
Drink a lot throughout your shift. A nice cold drink every few hours, I like ice water with a Pedialyte powder packet, will keep you hydrated and going to the bathroom. 😉 Coffee, pop, or an energy drink can also help but may give you a crash in a few hours. I always start my shift with a large coffee but switch to water/Gatorade later on!
Walk around. I like to walk for the steps and sometimes (rarely) will do all twelve flights of stairs down and back up. Walking almost always leads me to other people on the floor who I can sit and chat with for a bit too.
Brush your teeth. It keeps me feeling fresh and like I just woke up. It also helps me forget that I’ve been awake for over 20 hours.
Do a quick mini workout. Whether it’s five push-ups or ten jumping jacks, do what you can to get your heart racing.
Don’t study too much. When I’m already tired, reading or trying to focus on anything other than work will almost always make me close my eyes. Maybe online shop instead? Jk…😊
Bring snacks. I am notorious for bringing a small breakfast-like meal (usually only oatmeal) to eat around 1-2 am. Working for 12 hours is like a marathon so bring enough fuel to get you to the end. Especially if you might end up working for 16, small protein-packed snacks are essential. Try cheese sticks, protein bars, almonds, or espresso beans.
How to sleep during the day?
Blackout blinds! This was one of my first work purchases and one of the best things I could have done for my sleep schedule. I got mine here and thought they were super easy to set up and use right away. If these blinds don’t work for your bedroom aesthetic or you prefer natural light, get a sleepmask. They are cheap and often work equally as well.
Melatonin and an antihistamine. I use Nature Made Melatonin (5 mg) and Zyrtec 10 mg when I really need to sleep. Some of my friends take up to 15 mg of Melatonin and others take Benadryl. I don’t use them every day, but they work when I do. Fun fact, Zyrtec will make you drowsy, so we give it to our kiddos at night and pilots aren’t allowed to take it for that reason. If it has “day” or “D” after the name then it is non-drowsy and will not have the same effect.
Shower before bed. I can’t imagine a lot of people don’t, but I need to emphasize it. I use the best body wash from Bath and Body Works, “Stress Relief” (sage & cedarwood). They also have a “Sleep” aromatherapy collection with lotions and pillow sprays that I’ve heard work great. The new ones are Lavender Vanilla and Black Chamomile. Treat yourself to a relaxing, smell-good shower after a busy shift.
Minimize noise if possible. I personally don’t like white noise or the sound of a fan but know there are several phone apps that create these sounds. I also keep my phone on Do Not Disturb until I wake up. Give your friends and family a heads up when you are on a stretch, so they don’t flip when you don’t answer their texts or calls all day. I can never get back to sleep if I’m up halfway through looking at my phone, so I try to minimize sleep disturbances at all costs. Unfortunately, this is easier said than done.