Night shift hell. Tips to beat stress
Ever felt really stressed and overwhelmed at work?
Too much going on and not sure what to do?
Last year, it’s estimated that work-related stress, depression or anxiety accounted for a staggering 51% of all work related illness.
If you're one to get stressed often then read on.
In this article I’m going to talk about my experiences with stress during a night shift (and how I survived). I’ll talk about the methods that I used that might be helpful if you find yourself feeling stressed.
I was starting one of my first ever night shifts as a doctor. I didn’t really know what to expect. I wasn’t particularly tired when I started the shift. I asked a couple of friends beforehand for advice and things to look out for. They mentioned that staying up late the previous night can help as you can then sleep during the day and then start work in the evening. Hopefully without feeling too sleep deprived.
I should probably mention that at night, the staffing levels are skeletal.
You’re covering more wards and more patients with a variety of conditions ranging from minor ailments to life-threatening emergencies.
As the night went on, the pace of the shift increased, with patient after patient needing attention. Luckily I had support from a small team which included a registrar who I could call for advice if I was struggling with something.
I felt like I was in a perpetual state of motion, running from one ward to the next, trying to prioritise patients based on need, prescribe medications, taking bloods and chasing scan results requested from the day team.
As I rushed from patient to patient, I felt that my body was in a constant state of high alert.
At times I could literally feel my heart racing. I felt on edge but relatively focused in the first 6 hours of the shift.
As the night went on my focus was waning and I could feel myself slowing down, especially around 4-5am where I was at the point of circadian low.
Yeah, you could say I was pretty stressed.
Maybe you’ve felt like this at some point in your life?
It could have been something at work, maybe you got some bad news or you could have just been super stressed with multiple things to worry about at the same time.
It can get quite overwhelming.
Before I go into the specifics I think it’s important to know what happens to our bodies during stress because understanding the science can help you to develop effective strategies for managing stress and promoting your well-being.
The stress response is a complex physiological process that is designed to help our bodies respond quickly to perceived threats or danger.
You probably know this but when we experience stress, our bodies go into "fight or flight" mode, which is a survival mechanism that prepares us to either confront the threat or run away from it.
The stress response begins in the hypothalamus, a region of the brain that is responsible for regulating lots of functions like the endocrine system and appetite control.
- When the hypothalamus detects a potential threat, it signals the release of a hormone called corticotropin-releasing hormone or CRH.
2. CRH then travels to the pituitary gland, which is located at the base of the brain.
3. The pituitary gland releases adrenocorticotropic hormone (ACTH).
4. ACTH then travels through the bloodstream to the adrenal glands, which are located on top of the kidneys.
5. The adrenal glands then release the stress hormone cortisol, which helps to increase blood sugar levels, blood pressure, and heart rate.
Cortisol also suppresses the immune system, which is why we are more susceptible to infections and illnesses when we are under prolonged periods of stress. In addition to cortisol, the adrenal glands also release adrenaline and noradrenaline, which help to increase heart rate and breathing rate. This is what makes us feel the "fight or flight" response.
At the same time, the stress response suppresses the parasympathetic nervous system, which is responsible for rest and digestion. This can lead to symptoms such as decreased appetite, digestive problems, and difficulty sleeping.
Whilst the stress response is designed to be helpful in short-term situations, prolonged or chronic stress can have negative effects on our health. Chronic stress can increasing the risk of cardiovascular disease, metabolic disorders and mental health problems.
Back to the night shift and being mega stressed. What actually helped me in that moment of pressure?
I did a few things... Hopefully these 5 tips can help you when you’re stressed too.
The first thing I tried was to take short but regular rest breaks.
Short breaks can help you to take a step back from the situation, even if it's just for a couple of minutes, it can help provide a mental break and reduce stress levels.
Try do something calming like going for a walk, reading, stretching, or listening to music.
I don’t really have the luxury of these things at work but I’m happy to take a short break when time allows.
Second thing might sound a bit odd but try to practice self-compassion.
I remember I was taking a blood gas from a patient at around 5am because their potassium levels were high and we had to keep rechecking it quite regularly.
A blood gas is a relatively straight forward blood test where you can get useful information about the carbon dioxide and oxygen levels as well as the pH and some electrolytes like potassium. They were really dehydrated so it was difficult even to get a few drops and we really needed the results.
I tried a couple of times and I couldn’t manage it. But I had already succeeded a couple of hours prior to this. I didn’t want to call the registrar and bother them because I knew they were super occupied at the time with pressing tasks and sick patients.
I could feel myself getting frustrated. I knew I was tired and my focus was waning but I didn’t want to blame fatigue. I should be able to do this. I literately did this earlier and it was fine. I managed to get it on the 3rd attempt and I felt a swarm of relief. I was actually quite self aware of my emotions at that point. If something is not going your way it’s easy to get frustrated. We’ve all been frustrated.
What changed this time was that I could feel myself become more and more annoyed at myself. I was self aware. (I think meditation I’ve been doing maybe helped in that moment?)
The jobs were piling up and I should’ve been quicker with it. I took some breaths and calmed myself down. The patient, bless him, also encouraged me, I think he knew that I wasn’t happy with myself for trying so many times.
It was okay in the end.
We got there.
Reflecting back, it’s actually okay to feel overwhelmed and stressed during high-pressure situations. Blaming yourself for things going wrong and being overly harsh on yourself can make the stress worse. Practicing self-compassion can definitely help.
Be kind to yourself.
Third thing is to make sure you stay well nourished.
Eating well and staying hydrated can help you maintain energy levels and focus, especially during long shifts.
It’s quite a weird feeling at 4:30am when you’re absolutely starving and you just eat a regular dinner.
It is important to eat balanced meals, have snacks and drink lots of water. Your body needs good, healthy fuel to operate properly.
Fourth one is avoid rushing and prioritise your tasks.
This ties into the night shift. The sheer number of demands of my time and attention were staggering. When the brain is bombarded with too much information, it can become overwhelmed and struggle to process everything efficiently. This can lead to feelings of confusion, frustration, and exhaustion, which can further exacerbate stress levels.
When facing a high-pressure situation, it’s important to prioritise tasks and organise them by urgency. This can prevent you from feeling overwhelmed and keep things under control. When the tasks kept accumulating, I made a to-do list of jobs. As I progressed I crossed them off and that can help with motivation and give you the feeling that you’re making some progress.
One step at a time.
Ok so now for the final strategy I thought I’d list some quick tips that I think are just as important.
- If you’re feeling stressed. Having a support system is essential. Seek support if you need it.
- Meditation and mindfulness. Give it a try. It might help you.
- Stay connected with colleagues, friends and family.
- Get enough sleep. It can make the difference.
- Lastly spend time in nature because it can help promote relaxation.
A quote from a great
Have a stress-less day,
Z
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