Transitioning between Day and Night Shift as a Doctor
Updated: Apr 7, 2021
Shift work can seem daunting when you have never done it before. As an intern, I remember being so worried about how I was going to go from working 7 am-6 pm to 6 pm to 7 am with just a few days in between. I am totally a morning person, so this whole scenario stressed me out. I learned by trial and error, so I want to bring you my top tips so that you can transition with ease.
Many of you will need to do shift work transitions in your 4th year of vet/medical school, as an intern, or even as a budding emergency doc. Never fear because Dr. Gray is here to take the stress out of the equation for you!
Tip #1: Perfect that sleep environment!
Your goal is to make your bedroom a sleeping paradise during those bright daylight hours. It is not manageable to sleep during the day otherwise...unless of course you can literally sleep during the movie Twister like my sister or can sleep standing up. Some things I have gotten to help me include...
- Sleep mask. This one by Manta is my absolute favorite.
- Black out curtains
- Something to drown out sound...My dogs love to bark at anyone who walks by our house. I find a sound machine or ear plugs can be very helpful.
- Relaxation apps before bed. I LOVE this one here!
- Melatonin. Start it a few days before your shift starts, continue daily during your shifts, and take for a few days after your shift to get back to day walker. I take 1 hour before I want to fall asleep.
Tip #2: Create a transition regimen.
This has proven to be SO helpful to me! it makes it much less painful when I transition over. What I do is I will stay up progressively later the nights leading up to my shift.
Here's an example schedule to go from day to night:
Tuesday: I work 7 am to 6 pm. I will try to stay up until at least 11 pm or 12 am that night after work.
Wednesday: Off. I will stay up until 1-2 am.
Thursday: Off. I will stay up until about 3-4 am.
Friday: Working 6 pm to 7 am. Sleep as late as possible that morning/afternoon. If you wake up at 1 pm wide awake, then just wake up and do a few things so that you can attempt another nap later before work. Once you do a full night shift, you will find you fall asleep much easier the next morning.
As you can see, you can modify this schedule based on the amount of time you have off between shifts.
Now, here's an example schedule to go back from night to day:
Friday: Working 6 pm to 7 am.
Saturday: Working 6 pm to 7 am.
Sunday: Working 6 pm to 7 am.
Monday: Off at 7 am. I will go to bed for a few hours and plan to set an alarm for about 12-1 pm. From there, I will make myself stay awake as late as possible...usually until about 10-11 pm and will try to go to bed as usual. DON'T take your melatonin until you go to bed that evening because now you need your internal clock to change back. Often, I sleep through the night. If I don't, I will read for an hour or get up and move around for 1-2 hours so that I tire myself back out. The last thing you want to do is just toss and turn in bed... Just find a way to relax again, and you will be back to sleep before you know it.
Some jobs will let you sleep on the job if it is not busy. This is great but can mess up your regimen. What I often do is just lay down and read so that I am resting. I will sleep for maybe 1-3 hours from like 3 am to 6 am'ish so that I am able to easily sleep at home that morning. When this can be beneficial is if it is your last night on. That way you can sleep as much as possible, and then push through that following morning to transition back to being a day walker more efficiently.
Remember to listen to your body, but know that you do have to push through a little if you are going to make it back to the opposite routine.
Tip #3: Perfect a "night routine."
This is confusing because it really is just a sleep routine...but they are dubbed the same thing! It is the routine you pick in order to decompress after a long shift and fall asleep efficiently. Stay tuned the next two weeks for some great blogs coming up from both of us on our night routines.
There are a few tips I wanted to put here that are specific to helping you fall asleep after a busy overnight emergency shift.
- Eat something before you go to sleep...even if you are not hungry. There is nothing worse than waking up 3 hours later starving!
- Journal or meditate before you go to sleep. This will help you to unwind after a shift because we all know emergency can be draining. That dog that would not stop seizing or stressing over that splenectomy you performed will haunt you if you don't find a way to clear your head before bed. This is one of my favorites because it cracks me up while I go through it. If you are more of a classic, go with this one.
VOTR fam, I put these tips to the TEST again the last few months as I transitioned from day to night and back again PREGNANT! If I can do this pregnant, I promise that you can do it too. I honestly love night shift because it feels so intimate working with a small crew, and you often get downtime in the early morning hours that you may not get on busy daytime ER shifts.
I can't wait to see what you think of my tips as you put them to the test too. Do you have any further tips you want to share?? Comment below.