Wednesday, February 10, 2010


I've been very tired lately. It's very hard to work nights. Sleeping during the day is not as restful as sleeping during the night. When the rest of the neighborhood is calming down, succumbing to their sleepiness into warm, dark beds, you have to inspire yourself to be energized, dressed in scrubs, and driving in the cold to work under fluorescent lights, met immediately by never ending demands from patients who seem to have no idea that midnight is the opportune time to sleep.

The only patients who do seem to be deeply asleep at midnight are the ones who are supposed to get medication at midnight. It is next to impossible to get someone to swallow a pill when they are sleepy. It's also very difficult to wake up anyone over the age of 85. My favorite is when the outgoing evening nurse tells me, "I just gave Ms. Smith her sleeping pill, so don't wake her up." This implies that I cruelly go around the unit waking people up for no reason other than to be mean. When I tell her that I have to wake up the patient because she has medication due, the nurse usually says, "Oh. Can't you just wait until morning?" Well, no. The midnight meds fall on the "every six hours" schedule. I can't hold a 12 a.m. med until 6 a.m. because then I would be doubling the dose. I also can't hold the medication and write, "Held because sleeping." If I can't wake someone up, it looks like they are in a coma or dying, and I'm supposed to take vitals, call the MD, transfer to the hospital, etc. Except for antibiotics, most other 12 a.m. meds do not need to be scheduled at 12 a.m. Yet when I endorse to the day shift to contact the doctor for a readjustment in the schedule to facilitate the patient's sleep, the response is the same: "Night shift is so lazy. They think it's terrible if they have to give out a few pills when they get here." So I continue having to wake up patients.

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