Mark Aitken: Hello! And welcome to the Nurse and Midwife Support podcast, your health matters! I’m Mark Aitken, your podcast host for today. I’m the stakeholder engagement manager with Nurse and Midwife Support and I’m a registered nurse. Nurse and Midwife Support is the national support service for nurses, midwives and students. The service is anonymous, confidential and free. You can call us anytime about any issue you need support in relation to: 1800 667 877. Or contact us via the website at nmsupport.org.au
My guest today is Amy Benn; registered nurse and director and editor of Wholeheart Magazine. Hello, and welcome Amy!
Amy Benn: Hi Mark, thank you so much for having me here today!
MA: Our pleasure, it’s great that you came along to talk about all things managing shift work, sleep and self-care! Which I know is dear to your heart, and mine. Amy, can you please tell our listeners a little bit about your background? And the work that you currently do as a registered nurse, as well as Wholeheart Magazine.
AB: Thank you Mark. So, my background has always been in nursing. I wanted to be a nurse since I was 12 or 14, so it was a no-brainer for me. I went straight in and after my graduate year I decided that I wanted to pursue ICU nursing, which was wonderful. I did that at a major metropolitan hospital in Victoria. Whilst I’m so passionate about nursing, I also have Crohn’s Disease, which put a few more obstacles in the way of me fulfilling my duties. Particularly all that shift work and everything in ICU. So, what I have really done is dedicated a lot of my personal time to improving my own health and wellbeing. That was how Wholeheart Magazine came about, because I really wanted to share everything that I had learnt with my colleagues.
MA: That’s fantastic Amy, thanks for sharing that. What were some of the challenges that you faced, while nursing and living with Crohn’s Disease? What was the important part of your journey? In regards to empowering yourself, to take action regarding chronic illness?
AB: There were many challenges along the way. If I reflect back now, it wasn’t one thing but what the most difficult thing was at that certain time. There was a time where I wasn’t getting outside a lot, so I started walking and running in nature and that served me well for a good period of time. Then for another period of time I was running myself into the ground, working very physically and running too many half marathons and things. So, you know, I really had to bring it back. And then I started lifting weights, getting really strong and building up my metabolism. There have been lots of different obstacles at different stages. I think really getting to know yourself is the best thing that you can do, because then you know where you’re at and what your biggest problem is. Then you can put an intervention in there to help yourself.
MA: Great advice for our listeners. Fantastic that you were able to go on this journey, and that you’ve come to a place where you’re in charge of your life and your disease and managing to live your best life. So, congratulations!
AB: Thank you! It’s really fun.
MA: We don’t hear many nurses or midwives, or at least I haven’t, who actually start magazines. So well done, why did you decide to do this?
AB: This was such a far-fetched idea, and I’m so glad that it’s actually come through. What I did was when I decided that I really wanted to look back and I had done all of these things, and I was living so well, I didn’t want to leave my colleagues behind and I really wanted to help everybody. So, what I did was I wrote down all of my skills on a piece of paper. I thought about how I could take all of the things that I love and put it together, and somehow make it worthwhile someone else. We all sit down in the tea room, sometimes we sit down and its Mother’s Day. It’s Sunday night and we’re missing a beautiful family dinner at our nan’s house, so I thought if I could put some beautiful writing and some beautiful pictures in a beautiful magazine that a nurse could read (in their own time) that was just for them. So, it wasn’t for patients, it wasn’t for their other relatives, it wasn’t for their families. It was just for them. That’s why I thought that a magazine was a good idea.
MA: That’s fantastic. And you’ve got some great resources in your magazine. If people want to have a look at it, how can they find it?
AB: They can find it at www.wholeheartmagazine.com. Of course, we have Instagram and Facebook. We’re very active there.
MA: Oh yes, I follow you on Instagram. You’ve got some great photos, posts and advice. Part of the advice and recources that you provide to nurses and midwives are around getting enough sleep, because a lot of shift workers (including me, when I do it) struggle to get enough sleep. So, what do you think are some of the challenges for some of the nurses and midwives in relation to this?
AB: Oh gosh, where we start? I think, perhaps taking a step back and taking a different approach and not saying, oh my god I can’t sleep I can’t sleep. Look at the obstacles towards why you’re not getting a good restful night’s sleep is a really good thing. Understand that we work in such high, emotionally and intellectually intense environments, it would make sense that you can’t just make that transition from such a heightened state into sleep within an hour or two. What I thought is that I would just go through some amazing strategies that I’ve been using over the years.
Firstly, let’s talk about your physical health and addressing some body aches and pains. I know we work really physically. We’re up on our feet all day, so what I like to do is some foam rolling and some stretching. Even some self-massage, when I get home. So that’s a really good one. Jumping into the shower, perhaps some lavender oil or something that’s really soothing and calming can really help. What we can do as well is really looking at all of the lights and sounds that we expose ourselves to after our shift. We cannot help our environment while we’re at work, but as soon as we’re out of the hospital and in the car, that’s when we can play really soft music. Not dance music, but maybe turn on Smooth 94.5 or something that’s midway and getting you ready and calming down your nervous system so that you’re a bit readier to sleep. If you go to bed and you find that your mind is just racing, which is something that happens to me quite often, I like to keep a journal by my bed. Sometimes it’s just a matter of jotting down all of those spinning thoughts that are going around your head and getting them out and onto a page. It can really sort of solidify things and then you can put those issues to rest. Also, reflecting. If there’s an incident or a scenario that’s happened, doing a reflective practice and asking yourself questions around what happened? Were there any influencing factors involved? What could you have done better next time? Those are really good strategies.
Also, shameless plug, but if you really can’t sleep then definitely just give Nurse and Midwife Support a call on 1800 667 877 because there is someone on the end of the line waiting for you, 24/7. Definitely, utilise that resource. Another is using your breath. I use a couple of apps, one is called Box Breathing. You can definitely just pop this into the App Store on your phone. Another is called Calm, even if you’re a health professional, this one is free for you. I highly recommend using some breathing technics and some vital meditations to really calm your mind at the end of a busy day. Also, if you’re someone like me who wants to tick things off your list and is really passionate about what you’re doing then maybe just acknowledging yourself and writing down what went well that day. Preparing myself for the next day also gives me a lot of peace of mind. So, setting out my work-out clothes, my healthy lunch for the next day and making sure that everything is prepared in my environment. Maybe that’s my ICU Nursing giving myself away there, but those things really help, as well as writing into your journal. Those are some really helpful tips there.
MA: Great advice Amy, thank you! We love a shameless plug here at Nurse and Midwife Support.
AB: I thought you would.
MA: We also have some great website content that can support some of these tips that Amy has provided such as mindfulness and self-care strategies. So, take a look at those, but also as a part of this podcast we have a newsletter which will be our winter edition. The whole issue is tips and advice and support for thriving while doing shift work and managing sleep. So, take a look at those. Also, take a look at Amy’s website because I frequently have a look at Amy’s wonderful website called Heart Magazine which also has some wonderful blogs and tips to help support self-care. So, thank you. Amy, a part of what nurses and midwives often struggle with and call us about is getting their shift work routine right. This can be hard because some nurses and midwives work permanent nights, others work permanent day shifts, but many work rotating rosters or various shifts and that can change over time according to rosters. When I was doing shift work, as a nurse, I was always struggling with getting enough sleep after finishing an evening shift and then needing to be in the next morning at 7am. Really, I did struggle with that. And I’m not sure if I got the routine right, have you got any tips for our listeners around developing that routine and at least trying to get enough sleep?
AB: Isn’t that just the most amazing question? I think everybody has got some different techniques. In taking all of the information that I’ve just said as well and working out a routine that works for you. Choosing one thing that really, really calms you down after your afternoon shit. Just doing that really regularly, perhaps playing a particular song on Spotify. Or, I like to use these things called Binaural Beats. It’s where you put on your noise cancelling headphones and there’s this app called Binaural Beats and it puts beta or delta waves, or the sound of them, into your brain. I find that that one really helps as well, I’m out within 10 or 15 minutes after those. Also, I think that nutrition is a really big thing that we need to talk about as well. Making sure that we’re adequately fuelled and hydrated throughout our shifts is really important. Whether we’re hydrated, or whether we’re not, if that’s the difference between getting to the park after work or getting to sleep after a shift the little things really add up to being big things. Really paying attention to those things and improving those as well.
MA: As you say, it’s about developing what works for you. When I worked in intensive care, many years ago now, I did a lot of night shifts as many of us intensive care nurses and many nurses and midwives do. I always tried to establish a routine that worked for me. What I was saying to myself was that there’s a whole toolbox of strategies, each individual needs to choose and decide what might work for them to get a bit of balance. What works this week, may not work the next time that you do shift work. So, you do need that toolbox. We provide tips in our newsletter and Amy has spoken about them wonderfully. My key was always going to bed at the same time and waking up at the same time while I was doing night shifts (and late nights) and no oversleeping prior to days off. I really connected recently where you posted something on social media about that, and how in the end you’d only had a short amount of sleep but you would make up for it that night. We may not get enough sleep today, but we can make that up tomorrow. But, don’t let that sleep bank run completely dry because that’s when individuals can run into difficulty. Mine also involves a lot of exercise, as does yours Amy, and eating well. I love to eat toasted peanut butter at 4am in the morning.
MA: And at the time I think we didn’t know as much about that as we do now, but I thought, well maybe there’s too much fat in that. But it turns out I was doing the right thing. What do you think about establishing that individualised routine while doing a block of night shifts?
AB: I find there is so much that you can do on a block of night shifts. I go in with a forward plan of attack, the day that I’m going onto night shift I never set an alarm in the morning. I always just sleep as much as I possibly want or am able to. I know that there are people who say up late and try and set their algorithms beforehand, but the trouble with that is if you don’t get a really good sleep the next day that you’ve already had two days of really bad sleep and you’ve only done one shift. You may be on for four in a row. I think, always starting really well rested is really important. Starting really prepared as well.
On my night shifts, I use beam frequencies to flip my metabolism on night shift. This is a strategy that I’ve learned with my personal training goals and things like that were you can actually put really good, solid meals into your body and your body thinks that it’s daytime during the night. This is just sort of substituting those things that I guess we snack on, or the nibbley bits. Instead of having those throughout the night because we’re not hungry enough for a full meal, actually sitting down every four to six hours and making sure that you’ve got a good meal in you which has a good source of carbs. It’s going to keep you going, it’s a good source of protein so it will keep you full and a good source of fat which is really going to help you with your whole nutrition going forward. I like to have a nice and healthy dinner with my husband, before I go to work, and then around 9 o clock I’ll definitely have a smoothie or a piece of fruit or something.
Then between 11pm and 1am I’ll have another full meal. So even if I’m not hungry for a meal, having a nice pot curry or something (even if it’s really small) will stimulate my body and give me that wakefulness from the nutrition and the energy that I need to make those executive decisions during the night. It really helps me sort of respond, really quickly, to what’s going on around me in my environment.
It’s so funny that you mention the 4am peanut butter toast, because I’ve been tracking my sleep for the last 18 months and I’ve noticed that between 2am and 4am is when I go into the most beautiful, deep and restorative sleep which every body really needs. I can really feel those waves coming through my body at that time. That’s a time that I like to just chill out for a little bit, hopefully go on break, but always make sure that I have another decent wholefood meal in that time as well.
Again, it can be the same thing, just a bit more of it. Some good protein, some good fats and also some good carbs for energy and plenty of water. This is your body trying to tell you that it wants to go to sleep, but if you want to keep it awake and keep responding to your environment and helping your patients then stimulating yourself with some nice, nourishing food is really helpful. As well as water, as well as your breathing techniques, as well as getting up and moving around. Getting up and going for a walk, lunging to the break room or doing something silly. Having a laugh at 4am in the morning, because what else can you do?
AB: It’s really important, and then the last thing that I want to say as well is always have something before you go to bed in the morning, and this will help flip your metabolism as well. If you go to bed hungry you’re going to wake up at midday and your body is going to think that it’s still lunchtime. To prevent yourself from waking up and eating some food at that time, have something as well before you go to bed so that you’ve got a nice long stretch. Your body will recognise that you’ve been eating all night and will interpret daytime as the time for sleep. You’ll get at least six to eight hours of some kind of restful sleep.
MA: And we’re not talking about Coco Pops for breakfast.
MA: We’re talking about sustainable, smooth foods that are going to give your body a sense of having enough nourishment and the right nourishment.
AB: That’s right, there are heaps of healthy foods out there but I have put down all of my recipes that I eat and enjoy and have used while competing in fitness model competitions on the Wholeheart Magazine website. Go and check them out, they’re all free and ready for you.
MA: That’s great Amy, and you’ve written a blog for our newsletter and there are some tips and tricks in there as well. You can, as well as hearing those on our podcast and finding them on the Wholeheart website, you can read them in our newsletter. Amy, I really love the social media posts about food preparation and you’ve got some great website information, as we’ve discussed. You really talk about what you need to thrive on night shift and taking control of this. I think that’s imperative here, so I would imagine that your advice is around being prepared through preparation. Some of those posts are beautiful, around what you prepare. You’ve got a line-up of your containers with your meals and so you think that’s really important for people?
AB: Absolutely, I mean, this all stems back to when I was doing so much work on my own nutrition but I was also doing full time shift work and nights leading up to this. So, it’s all about saving yourself time. Make the same meal and make it in a pot for six. Pop it in your containers, pop some in your freezer and some in the fridge. It doesn’t take long. Things that are really easy and convenient are vegetable sticks and cans of tuna. Things like yogurt and berries, things like this you can just throw together and they’re really simple and easy. Making sure that your fridge is stoked with frozen chicken and some steaks that you can thaw out during the day and really just being prepared. Making many meals at once and yes, it’s not that hard!
MA: Great advice. Amy, I know that exercise is a big part of your self-care routine. What tips do you have for a nurse or a midwife doing shift work who may feel exhausted after work and can’t find the energy to exercise, but really wants to?
AB: Look, this is a big thing because my exercise is my self-care. I would say to everyone, and I say this all the time, do what you want to do. Don’t do what you think you should do. I’m someone who will go to the gym and I will go to the freeweight section and I will put my headphones in and count the reps and the sets and weights and the numbers and I’ll give myself a really good high five when I’ve managed a good session and improved my technique. But you will not catch me in a group fitness room where there’s loud music and someone is yelling at me telling me to do things that I don’t really want to do. You don’t have to do the things that you don’t want to do, my best advice is that you really tune in and you think about the activities that you love to do that are physical, maybe it’s tennis, maybe its basketball, maybe its golf. Joining a club and making that a priority in your life, I really encourage you to have a chat with your manager. If that means that you have every Wednesday afternoon off, well, have that conversation. This is your wellness and this is how you need to take control of your life. It’s not only good for your mental health and wellbeing but it’s also good for your physical health and your injury prevention. So, yes. Do what you want!
MA: I think energising yourself, often I don’t feel like going to exercise, but every time after I’ve done it I feel better than before I did it. It’s that reward thing that you get, so it’s getting out the door. What I find is that’s it’s often better if I don’t go home first.
MA: I finish work, go and do my exercise then go home because if I go home first I often don’t want to go and do it.
MA: You know what works for you. Amy, many of our listeners are students and graduates who are struggling to sort out shift work and their sleep patterns. So, it’s new and it’s an added stressor for most students and graduates. They might already be grappling with the enormous change they’re experiencing from being a student to a graduate in their lives, so what advice do you have around sorting this out and getting into a routine?
AB: If I could say anything, I remember in the first three to four months I’ve never felt so tired in my entire life. If I could say anything, the first thing would be that you will adjust. You will respond. But I guess what I would say is do your absolute best to stay within a normal sleep pattern. When I say that, I mean keeping your waking and sleeping windows within two hours of each other. If possible.
So, if you’re getting home from an afternoon shift and you’re getting to bed at 11pm, then if you’re on a morning shift then trying to go to bed at around 9pm. Also, if you’re getting up at about 5am on a morning shift then don’t sleep later than 7am. Keep that within the tightest window that you can because that’s going to improve the quality of your sleep, and that’s what’s really important. That you put yourself in a position where your body is in the best algorithm that your body can master and that your body dips into that beautiful stage four sleep that you need that is really restorative and repairing. So, keep that window there. Strategically nap throughout the day as well. If you’ve got a day off, there’s no shame in having a good half an hour or hour nap in the middle of the day. Try and keep it away from the evening and even if you need to have a bit of a nap before you go to work on your afternoon shift, mid-morning. If you can keep your sleeping algorithm within a tight range, and strategically napping either side of that. Plus, always keeping yourself hydrated as well. I’d say that would be the best thing.
MA: Thanks Amy. If you’re struggling to sort this out you can always call nurse and midwife support and talk to one of our nurse or midwife councillors about how to establish this routine and work through it, so don’t hesitate to give us a call on 1800 667 877. Amy, if you could go back and speak to the young nurse Amy just starting out about how to thrive during shift work and night shift, what advice would you have?
AB: I don’t know, I just saw that movie Avengers and they have a time machine. When I read into this I think how Wholeheart Magazine hasn’t been invented yet so I can’t tell young Amy that there’s a resource out there for her. All in all, there are resources out there for you, you just have to find them. That’s it. I guess, when I was doing my first round of night duty as a registered nurse I went to my favourite GNM’s on the ward and my favourite ANM’s on the ward and I asked them about what I should be doing and how I should be doing it. I found it so frustrating that we had such particular, stringent guidelines on how to perform skills and how to look after everybody else and such vague answers about how to care for ourselves. I thought that that was not good enough. If you think there is something out there that’s missing then go and create it.
MA: And it was a great motivator for you obviously to then go and create Wholeheart Magazine. So well done. If you’re listening and you would like to be a part of the story then get in touch with Nurse and Midwife Support, or indeed Amy through her magazine, and we would be really happy to have you blog or tell your story or provide your tips to us so that we create a whole community of like-minded people which I really believe is happening in nursing and midwifery. Go us, nurses and midwives rock! Amy, I can’t believe that we’ve come to the end of the podcast. We could talk all day about this, these are some really important issues.
So, today, we talked about:
- Nurse and Midwife Support
- Some of the challenges for nurses and midwives and students who do shift work, particularly night shifts
- We, and Amy in particular, provided great advice around tips in relation to thriving while you’re doing shift work and night shift
- Amy shared information about the important of healthy eating, meal prep and exercise as well as some very useful tips for sleep
- We provided some advice for students and graduates Is there anything else that you would like to add Amy?
AB: Thank you for the work that you do, it’s absolutely amazing. And yes, let’s all connect!
MA: Great, thank you Amy. Thank you very much for listening to this podcast. You can find out more about Nurse and Midwife Support and access some great content at nmsupport.org.au or at Wholeheart Magazine. What was your address again Amy?
MA: Or call us anytime on 1800 667 877 to talk to a nurse or a midwife about shift work or anything else you need support for. If you found this podcast useful, please share it with other nurses, midwives, graduates and students because your health matters. Look after yourselves, look after each other, and I’ll speak to you next time.