Nurses’ sleep-psycho, sorry, sleep-cycle’

One of my BFFs suggested the book ‘Furiously Happy’ by Jenny Larson. Not only does it detail someone’s lifelong and inspiring battle against mental illness, but it does so with some side-splitting anecdotes, and midnight-black humour, as the author faces each day with the sort of challenges many of us can recognise.
It also has a grinning, dead, taxidermied raccoon on the front cover. And as a fan of these silverbacked, bushy-tailed, night-time thieves, and the owner of several stuffies, it really is the topping onto of the trifle. It turns out the raccoon is an actual thing, too. Run over by a car, and then brought back to life by a friend of the author, Rory now has a second life as a friend of the family, and a party piece, to include in Skype conference calls and cat-riding fashion shoots.
Seriously, read the book.
But my empathy with mental-health issues, and a love of raccoons, aside, what this got to do with sleep? Well, one specific chapter deals, hysterically, with Larson’s sleep concerns, and it made sense with me, and the whole sleep issue in general.
The sleep of the nurse on the late-early split.
Late-early splits are as disjointed as they sound. you get home, tired and often late (because what is a good vocation if the overtime is actually paid? This is your life’s work; you should be paying us!). Make food, wash up and try and live some kind of life before bed and the inevitable next day rolls around.
[by the way, this is the experience as told through the eyes of the childless. Those of you lucky enough to have littles, more power to you, and patience, and extra liver space for the extra wine needed to survive suicide/homicide hour]

My biggest problem is switching off.
Gone are the days when I can of rice pudding or a bowl of B&J will suffice as food. Not if you want to experience a sugar high at 4am. What I’ve found now is it’s best to stick to the savoury, either that or forgo food altogether. You might wake feeling shitty in six hours, but at least you won’t feel bloated, dehydrated or have a breakout from hell.
Now, with everything clean and prepped for the following morning, bed is calling you. Let’s face it, nursing is hardly a career where sitting is a majority pastime. So you duly oblige and roll under the duvet, either alone or with someone else. You read a chapter of a self-help book, or try a Sudoku and eventually turn off the lights.
At which point your brain throws an impromptu slumber party.

Option #1
Think about something boring. Lying in bed, staring at the ceiling, or that scary-ass shaft of moonlight, or just the inside of your own eyelids, is tedious. Emptying your mind is about as plausible as shoveling sand back up inside the hourglass. That sand is only going in two directions, and whatever you do, that ain’t going to change. I’ve thought of TV shows, celebrities, histories, things I did, things I have to do, my brain’s synapses firing in random and haphazard ways, confusing and time-consuming, but not exactly as stupefying as I hope.

Option #2
Who here’s eaten leftovers at 3am on a Wednesday morning, raise your hand?
At 2.30am, the hunger bites down, hard. *
And standing in the kitchen, everything illuminated by the fridge light, as you eat pastrami from the packet and worry about tooth decay. Or cookies, or low fat yogurt if only for something to do, and watching the rest of the world snore around you, the only thing awake being the streetlights, the occasional car rolling by and the sporadic fox or raccoon looking, also, for a free meal.
Now, if the UK had raccoons I wouldn’t mind so much. But like all things British, compared to our ex-colonial brethren, we get the stoic, regal, slightly repressed first-edition, compared to America’s high-fat, high-sugar, flashing neon sign affair. It’s like comparing a Victorian statue to a wibbily-wobbly inflatable arm man. Only one is fun at parties.

*I also drink gallons. It makes me pee, but the alternative is I rise as dehydrated as a corpse, and I think the lesser of two evils is the drink, because diapers are always easier to purchase and dispose of than emergency IVs.

Option #3
Medication. Ahhh, the pre-prescribed pills of goodness. As Leo tutors in ‘The Wolf of Wall Street’, pills are used for recreational reasons because, well, they’re awesome! I subscribe to this theory. Pills are the best thing to happen to me, and my creaking, curving L1-L2 disk space, in the last five years.
Pills come in two forms. Those that knock you out, and those that keep you out, after you fall asleep under your own power. The first ones, the most powerful, distributed under the closest supervision and containing the strongest side-effects, I save for special nights. Nights when I feel I have to unplug from the world.
Pharmacology is a key component in all nursing and medical training, and in the same way that most of drivers only use the ten-and-two technique when it comes to hand placement, during their driving lessons, healthcare workers quickly learn the shortcuts when it comes to managing their own pain issues. Knowing what you can and cannot mix is the first lesson. Obtaining it is the second, which leads it to the second of the two pills.
Amis, my own bedtime friends, are sneaky so and so’s. And they are paradoxically transparent in their duplicity. They don’t help you sleep. The stress, exhaustion, and adrenaline high is still there, as your brain rockets round your skull like a two-year-old riding a quad bike around a Wall of Death, that just happens to be their bedroom. You wait and pray they tire themselves out. When you eventually sleep, either ten minutes or two hours later, its formless, as anyone who’s been sedated can attest [sticks hand up]. And when you do wake up it’s in a sedated, lethargic fug, that often lasts to lunchtime and makes interaction with any other living thing about as meaningful as an argument with your average houseplant about postmodernism.

I am aware a house plant is, by definition, a living thing, but it can hardly counter-point a statement that most postmodernism is finite beyond a certain degree of rationale continence, so it remains a point to me.

Anyway, regardless of how little sleep you get, the alarm still trills at 5.30am and you drag your shattered, medicated carcass off the mattress and sleepwalk to the bathroom. And you remain under this mental cosh until sometimes around lunchtime, which is when the rest of you manages to drag itself off the same mattress, bypassing the bathroom entirely and slithers inside your meat carcass, hopefully without no one else noticing.
The real fun comes the following evening.
All medication has side-effects, but Amis claim to fame, aside from the dehydration (see previous side-note*) is that the stimulation of the part of brain that controls dreaming.
No idea which part, do I look like a brain surgeon?
I like to think of it as a dream stream.
The ami blocks the stream, like a boulder squatting right in the middle of the bed, and the water starts to build up behind it, like a blocked firehouse, the pressure building until…
This isn’t hyperbole. My dreams go whoosh, over subsequent nights. Vivid, colourful, dramatic. Not nightmares per se, but I feel a lot more. everything becomes passionate, tender, honest and more real than actual reality, because causality in dreams often gets thrown out the window, along with the baby, the bathwater, and the rest of the bathroom toiletries.
So what’s the catch?
Why not take it all the time, especially on the late/early shift from hell?

Simple, and relative to Leo’s situation in the movie ‘Inception.’
After the whoosh, the initial bump, when you go cold turkey and the drug devolves, nothing.
You don’t dream.
Like chasing the dragon; after you stop, the numbness can be as painful as the abstinence.

So what’s the answer? I’m afraid there isn’t one. it’s just one of those things all shift workers have to deal with. We find out the combination that works best for us. And we do the best we can.


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