Shift work

We are going to establish a 3-shift-system on our Stroke Unit coming month. So I wondered what literature there is about the best way to implement it. Rumour and a few recommendations have it that a forward shifting system (morning, late, night) is better than the converse, yet there is scant data to substantiate it. Even less obvious is how many night shifts in a row are best for a) the hospital b) the doctor.

If you can come up with some evidence, pls let me know.

Otherwise we can just list a few myths that are supposed to help to cope:

How to stay awake during long nights:

  • Keep your room brightly lit and not too warm.
  • Use coffee not for staying awake but to get into the mood.
  • If you start to nod off, try a power sprint (100 m), get fresh air, drink and eat light.
  • If you feel a dangerous dip, try to make room for a power nap.
How to get to sleep after a night shift:
  • Make time for decompression after work before going to sleep
  • Find something easy to read in bed
  • No coffee 6h before going to sleep
  • Eat light 1h before going to sleep
  • Use helpers such as ear plugs, night covers, thick curtains etc.
  • Use a standard routine (same book, same muzak etc.)
  • Don’t force your sleep: Nothing more dangerous than calculating your lack of sleep while trying to sleep. If it doesn’t happen, so be it.
  • Avoid sleeping pills and alcohol.
How to resynchronize:
  • Use everything you would do for jet lag resynchronization.
  • L-melatonin doesn’t help, but the retarded form might. Just for 1-2 days – if you have big resync issues.
  • Get into the normal rhythm as quickly as possible.
How to make the best of it:
  • Do morning business (shopping, bills, buerocratic stuff)
  • Sports (skiing on tuesdays!!!)
  • Show up at your spouse’s work with flowers (if applicable)
  • Show up at your children’s daycare/school etc.
  • Don’t expect to be able to do more than before on your free days – you need them to recover!
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