Caring! Whether you are a mother, sister, or employee, does true caring mean meeting every need for the other person, while ignoring your own? As introduced in last month’s article, I have called the relationship between how you serve others while providing for your own self-care, The Caring Quotient. Within this article, we will explore some of the ways that nurses (and other shift workers) can get The Caring Quotient in their life back into balance.

When I was young, my oldest brother taught me that if I wrapped up something I found on the side of the road and gave it away, that didn’t make it a present. In fact, he challenged me to consider that maybe a gift wasn’t truly a gift if it didn’t cost me something. Once I understood that concept, I grew up expecting that when I gave of myself, there would be a price, in time or money. And I carried that belief into my nursing career.

My very first day on the job at the hospital, the patients’ needs were so daunting that I was being called to assist in another room before I could hardly finish with the current care. When my boss found me still running at high speed at 2 pm, she pulled me aside to ask three simply questions: When did you last take a break? When did you last go to the bathroom? When did you last have something to eat or drink?

I was puzzled by her questions, but then I realized that the answer was the same to them all: at home, many hours ago. She escorted me to the restroom first, then ice machine for water, and finally the breakroom. As she handed me some peanut butter and crackers and opened a can of chicken noodle soup to heat, she informed me that the cafeteria had already closed, so this would have to get me through the rest of the shift. She proceeded to explain, firmly but kindly, that if I didn’t attend to my own personal needs as a nurse, I was doing a disservice to everyone involve. I was taken back. In fact, I was shocked, for I had thought I was being a good nurse by putting the patients’ needs ahead of my own. I had heard nature calling many times throughout that shift, but I kept putting nature off due to the urgent needs of my patients. Although I heard the words my boss was saying that day, it would take me many more years to start applying those simply truths to my professional role.

While I found the hospital staff to be kindred spirits, all seeking to serve unselfishly to promote the best outcome for the patient, I found out immediately that getting adequate sleep between shifts was a challenge to both the novice and the expert nurse. While we all experienced how our hospital shift-work interfered with our ability or opportunity to sleep, no one realized that eventually it would catch up with our bodies, physically. Though research had yet to be done on this topic at that time, the challenge and consequences of sleeping have now been identified as the Shift Work Sleep Disorder (SWSD).

The American Nurses Association has since identified some steps to help address such issues as SWSD, and they have created modules for purchase on the topic. Harvard Health and other authors, in reviewing the importance of sleep hygiene to overall health, have recommended the avoidance of blue light (emitted from phones, tablets, and computers) for three hours before bed, stating those blue light emissions can interfere with the body’s ability to fall asleep. Most authors also recommend keeping a sleep diary, and as I mentioned it my last article, that was one of the ways that I identified the issue.

By far, my favorite resource for nurses and other shift workers includes not only the sleep diary as an evaluation tool, but so many other components that are especially applicable. The Center for Disease Control (CDC), in combination with the National Institute for Occupational Safety and Health (NIOSH), created a free nurse training program, but it is available to anyone as a wonderful resource who needs to evaluate if their sleep is being sacrificed at the expense of their health, hence if their own personal Caring Quotient is getting out of balance.

This particular program explores many ways to improve sleep and has specific sections for the day shift worker, as well as night shift employees. They also present evidenced-based information that you might not have previously considered. For example, if you are a shift-worker that drives to and from work in the dark, do you find yourself yawning frequently in the mornings but don’t know why? Could it be that your body is being robbed of the natural ability to trigger the right hormones for that time of day? Within this set of modules, they bring up lights in the morning using a dimmer switch that slowly brightens the light over 15-20 minutes before your awaking time, so your eyes will interpret the events as the sun arising. As the sun arises, melatonin, the night hormone, should be turned off (and hence, the yawning should dissipate), and cortisol should turn on, to give you energy for the day. In the evenings, a reversal of that action (dimming the lights in your bedroom, slowing down your activities before bed) should then switch your body back to your internal production of melatonin and turn off the cortisol. Then your body could go through the natural drowsiness, preparing for sleep.

The program also presents multiple strategies about how to best promote your own natural circadian rhythm or pacemaker, even on your days off, as well as the placement of naps and exercise to help promote a more natural rhythm. As you take the time to dig through these modules, I believe you will find some nuggets for yourself that will help you navigate some of the hazards or minefields of doing shiftwork within a service profession.

One particular module from the CDC-NIOSH series also advises to “avoid a high-carbohydrate lunch…to avoid a drop in alertness” during your shift. So, that begs the question. If sleep is at a premium because of your current work schedule, after you’ve taken all of the recommended steps to improve your sleep hygiene, could it be that there is another system of the body that could help balance The Caring Quotient equation? Next month, we will explore that aspect of this topic.