A number of factors can also determine how taxing a nurse’s shift is, including:
• Patient load and acuity levels;
• Amount of ancillary staff support;
• Documentation requirements;
• Level of co-worker/provider engagement;
• Ability to take breaks and make nutritious food choices;
• Personal health status;
• Ergonomics of the work environment;
• Type of flooring and shoes worn;
• Available patient handling assistance devices; and
• Shift schedule.
With so many factors at play, what can a nurse do to survive and thrive through a long and challenging shift? A panel of clinical health and wellness experts offer these tips:
1. Control what you can control
“While you may not have any control over your patient load or acuity, you can make use of any assistance devices available to you. You may not get to choose what shift you work, but you can do your best to maintain a regular routine. Likewise, you probably don’t get to choose the flooring at your facility, but you can invest in a good pair of running shoes,” remarked Dan Donahue, MEd, director of employee health and wellness at Providence St. Peter Hospital in Olympia, Wash.
2. Focus on eating and movement
“In order to keep their energy up, nurses should especially pay attention to their eating and their movement,” offered Cathy Turner, MS, director of health promotion at Virginia Hospital Center in Arlington. “It is ideal to eat both regular meals and to have an energy-boosting snack between meals, such as a piece of fruit and some cheese. I recommend that every time you eat that you include a protein source because protein takes longer to digest and it is what feeds our energy levels over the long haul.”
“Often people think they have to have a 30-minute, heart-rate-increasing workout for it to count for anything. But research is showing that just 5-10 minutes of exercise can boost your energy levels.” Turner explained. “There are yoga poses you can do at your workstation, do a quick stairs workout, or even some seated chair exercises if you just need to get off your feet.”
3. Be wise about caffeine and energy drinks
When it comes to caffeine consumption, Donahue said that moderation is key.
“In the right amount and time, caffeine can be beneficial and help improve mood, attention, concentration and energy levels. Too much sugar or caffeine [>400mg] early or through mid-shift will have a negative effect later when the consumer will experience a drop in their energy level. It's better to have a little bit throughout the shift,” he said.
“Nurses should be aware that energy drinks can also contain high levels of taurine and guarana and other ingredients that may boost the caffeine levels and have other undetermined effects,” Donahue added. “Instead of looking to caffeine to boost energy, nurses should be concentrating on staying hydrated. I recommend trying to drink 90 ounces of water a day.”
4. Realign your attitude, reinforce your team
“An important part of having a successful shift is about attitude and remembering what you are there for--your calling and desire to go in and help these patients,” offered Christine Slohe, RN, BSN, PHN, emergency room nurse at St. Mary Medical Center in Apple Valley, Calif.
“Also, I think it is often overlooked how important co-workers are to the success of a shift,” Slohe continued. “When I have some downtime, I go and help another team member, then they reciprocate later--it helps to keep the flow instead of having highs and lows throughout the shift. I am fortunate to work with a great group. Our motto is: If you see a need, fill a need.”
5. Make breaks count
While the “ideal” schedule for nurses’ breaks would be approximately every three hours throughout a 12-hour shift, Donahue knows that in reality most nurses try to work a break in whenever they can get it.
“The most important thing is they at least get some sort of break and it would be nice if they could remove themselves from their work environment and get their mind, eyes and body in a whole different state,” he said.
Turner recommends deep, mindful breaths as a way to come back to your center and to reenergize.
“When you are taking your break, it is a mental recharge to sit there and have your mind focus on something different,” reflected Slohe. “I like to go outside and get out of the enclosed environment. That is more rejuvenating than just sitting in the break room.”
6. Don’t forget the long run
Getting through a single nursing shift shouldn’t be the only focus, though.
“Nurses should be looking at their long-term health and energy levels and making an investment there, not just figuring out how to make it through the next shift,” encouraged Turner. “Being an effective caregiver means caring for yourself.”
“I always tell people to seek balanced input for the body, mind and spirit. I believe we need input on all three levels to feel whole and healthy and have a good outlook and positive energies,” Donahue said. “I believe we also need to schedule body/mind/spirit ‘time’ in order for it to consistently happen and to gain the benefits.”