from lark to owl
tonight is my last night shift of my ED month! of course, after spending 4 of the past 5 nights at work, i have just now finally gotten acclimated to the backwards schedule. for the first time, i was actually awake and feeling functional all through the wee hours last night (actually, i guess that was this morning!), and i'm now sitting here comfortably sipping coffee and blogging as though that was the most natural activity to be doing at 5:21 pm.
next week i'll be back on mornings -- ouch! fortunately, i will have several days to get things switched back around. i have friday (after my shift ends at 7 am) off, plus saturday, sunday, and then a late clinic on monday. all the back-to-backs will have paid off as i enjoy this little minibreak!
now, while i've suffered through (far too) many 30 hour overnight calls, i'm no expert in the shift-work lifestyle, which is actually quite different (and much better). lucy, martinidad, and sharon are all much more seasoned at flipping their days upside-down! but here is what i figured out works for me over the past 2 weeks, in case any burgeoning med students/nurses/call girls (sorry) are interested in some tips!
the ghost world guide to not feeling worthless at 3 AM
✔ maintain a consistent structure to your schedule. it might work to constantly switch things around when you are doing just 3 shifts a week, but with 6 that doesn't fly! i tried to follow this tenet by staying up late on my night off and sleeping in as much as i could.
✔ naps before your shift help as you are getting acclimated. i felt like a million bucks (or close to it) on a busy shift last night after a 1 hour nap from 9 to 10 pm! i think it really helped.
✔ black out the light with some curtains! unfortunately, i haven't followed this guideline, but i KNOW it would have helped me a great deal with my daytime sleep. next time!
✔ caffeine is your friend. at least, it's my friend. i've been drinking one mug at around 4 pm after i wake up and sipping on another while at work starting at around 11 pm. this is not ideal (i usually like to stick to just one cup), but it's been a lifesaver.
✔ relax before your shift, and SLEEP after! don't make the situation worse by staying up once you get home -- get in bed already!
✔ avoid alcohol. i know martinidad is not on board with this one, but unfortunately i know that i need to make my sleep the highest quality possible. and despite his experiences to the contrary, i cannot fathom the idea of a beer at 8 AM. makes my skin crawl just thinking about it!
✔ work out/run in the evening, ie, after the 7+ hour post-shift meganap. coffee + endorphins are the ultimate kickstart to your day, even one that begins after the sun goes down.
✔ space out your meals accordingly. i've also been making some meals smaller and snacks larger -- it just seems to work better with things turned around. generally, i've been doing something like:
8 am (post-shift): hearty breakfast (so i don't wake up 4 hours later hungry!)
4 pm (post-sleep): smaller-than-typical lunch, with coffee as shown below.
yes, i broke into the pacific soup already! review to follow when i've tried a few varieties!
9 pm (pre-shift): dinner
throughout 11 - 7 am shift: 1-2 substantial snacks, like yogurt + trail mix or cracker/cheese/veggies
bringing some chocolate to work also helps with morale. just saying!
practicing what i preach
so, i need to finish this post so that i can get to the gym! i'm actually not dreading my shift tonight, thanks to my new backwards body clock. i'm eager to get it started so that i can start my massive block o' weekend and get back in sync with the rest of the world!
yesterday was actually SUPER busy, which was stressful but made the hours fly by. it wasn't a high-volume sort of night, but the acuity was up there! 2 LPs, a hypotensive immunosuppressed patient that i think was septic and in DIC, and a surgical abdomen were enough to occupy me for 8 hours, no problem. i think i admitted over half of the patients i saw -- i can count at least 5. whew! the poor ward teams . . .
it sounds bad, but i think i actually preferred the constant action to the facebook-fest i had the night before, watching the minutes slowly tick by on the computer screen. interestingly enough, there's no time to be anxious about what MIGHT come in when you're busy dealing with what's there! hopefully tonight will be another 'in-the-groove' sort of a shift. we'll see -- the ED is always a big black box of surprises.
workout: interval run, 6 miles at average 8:30/mi pace. splits:
warmup mile: 8:55/mi
interval mile 1: 7:49/mi (recovery 0.25 mi @ 9:38/mi)
interval mile 2: 7:43/mi (recovery 0.25 mi at 10:14/mi)
interval mile 3: 7:45/mi (recovery 0.5 mi @ 9:46/mi)
cooldown mile: 8:57/mi
i think 3 x 1 mi might be my favorite workout. a challenge without being torture! i was happy with my consistency on this run.
doin' time: MMMM! LOVED this pre-shift dinner of tostadas salsa verde. i poached a chicken breast and shredded it -- i like this method for 'pulled' type chicken to use in soups or mexican dishes. then, the rest was a cinch! here's my tostada, pre-toppings . . .
and then fully adorned.
yes, that's a purple sweet potato on the side! purple is IN this season, you know. eaten while watching desperate housewives online (josh was on call). i was impressed at how crispy the whole wheat tortilla got from being oven-baked! i would definitely make this again.
reading: the latest peds in review summary on asthma. the current viral milieu is wreaking havoc on our population of wheezers. flu + reactive airway disease really don't mix!