Winter Edition 2019

Shift work: A difficult recipe

Nurse & Midwife Support Stakeholder Engagement Manager Mark Aitken explains the importance of finding your own recipe to deal with shift work. Read more.

Settle your sleep debt: How to improve your sleep as a shift worker

Registered Midwife Celeste offers tips on how to retrain your circadian rhythm to function more optimally as a shift worker. Read more.

Taking control of shift work so that it doesn’t control you!

Registered Nurse and founder of Wholeheart Magazine Amy Benn shares her tips on managing life as a shift worker. Read more.

The 24-hour shift: Juggling parenting and shift work

Registered Nurse/Midwife Helen on how she juggled the demands of parenting and work. Read more.

Podcast: Managing shift work and sleep

Amy Benn joins Mark Aitken to discuss shift work and sleep in the Nurse & Midwife Support Podcast. Read more.

Shift work: A difficult recipe

By Mark Aitken, Stakeholder Engagement Manager, Nurse & Midwife Support

Greetings and welcome to the Winter Edition of the Nurse & Midwife Support newsletter!

This edition is dedicated to supporting you to thrive while doing shift work. We’ve got useful tips to help you navigate the challenges that shift work can present. Registered Nurse Amy Benn, Registered Midwife Celeste Pinney and Registered Nurse/Midwife Helen Pentecost join us to share the self-care routines that have helped them take control of their lives as shift-workers.

Many nurses and midwives do shift work. Some do it for their entire careers. For some it is a natural fit for others it is a means to an end. My sister, also a nurse, chose to do night shift for many years as it supported her family life. Some struggle to find the right balance with career and life outside work commitments. Helen’s story provides useful tips for nurses and midwives with child care responsibilities.

Recently I’ve met lots of nursing and midwifery students and graduates who are struggling to get the shift work recipe right. They feel stressed about stepping into this unknown territory and aren’t sure what to throw into the mix. My advice is: ease into it. We aren’t born knowing how to manage shift work. It can be a complex set of ingredients that enable us to get the recipe right. Unlike making the perfect cake, the recipe may change over time.

Nurses and midwives contact us seeking information, resources and support to manage the complexities that go with shift work. The issues include getting enough sleep, meal planning, stress, work-life balance, fitting in exercise and staying socially connected.

I was a shift worker for many years and wished I had the manual for how to live a balanced life alongside my shifts. Much of what I learned about thriving while doing shift-work resulted from trial and error. I never felt as though I got enough sleep. I finally worked out my shift work routine when I landed a job with regular hours! I always felt like I should share my ‘manual’ with other nurses and midwives but realised what worked for me may not work for everyone — because we all have our own lives with our own complex needs and priorities!

This edition of the newsletter provides a toolbox of shift work strategies. We encourage you to choose those you think will work for you. Develop your own shift work self-care plan, write it down and check in with it now and then to make sure it continues to serve you.

If you want a hand to work through your shift work plan call Nurse & Midwife Support. Our nurses and midwives have all done shift work and are available 24/7 to talk. We don’t just want you to survive while working shift work we want you to thrive. And we believe you can.

Listen to our podcast with the inspirational Amy Benn, Registered Nurse and Director of Wholeheart Magazine, dedicated to supporting the well-being of nurses and midwives.

If you have developed the perfect recipe that supports you to thrive while doing shift work drop me a line: [email protected]

Whether warm, cold or cool enjoy the winter in whatever part of Australia you live. It is my favourite time of the year!

Mark Aitken RN
Stakeholder Engagement Manager
Nurse & Midwife Support

By Celeste Pinney

Shift work is part of life for nurses and midwives. It can be taxing on the body both physically, mentally and emotionally.

I found night shift to be particularly difficult when I started my career as a midwife. In my first two years working I struggled a lot to maintain good health because I had such difficulty sleeping when I worked night duty. I would only sleep 4─5 hours after a shift, and wake up feeling groggy, flat and unable to think straight. I found it hard to concentrate at work and always felt behind the eight ball. It was difficult regulating my emotions, and I felt out of touch with my usual self.

I am passionate about health and have always prioritised my self-care.

I felt dismayed about night duty as I didn’t feel I could keep to my usual routine of optimal health maintenance. I realised there must be solutions or ‘work arounds’ to help improve my sleep and health during the time I worked a night shift. Being a health geek I did research regarding sleep and ways to lengthen and enhance sleep quality as this seemed to be fundamental to feeling better during night duty.

I discovered that you can retrain your circadian rhythm to function more optimally by adopting the following approaches. I found these were the best ways to boost my sleep:

• Wearing dark sunglasses or orange glasses on the way home from work, right up until getting into bed. Sunlight tells your body to wake up and suppresses melatonin. Blocking out light signals your body to go into sleep mode.
• Keep the bedroom dark with blackout curtains and/or an eye mask.
• Eat a healthy low GI meal before going to sleep. The meal should have a combination of complex carbs, fat and protein such as eggs on toast or porridge with nuts and yoghurt.
• After eating, go straight to bed. Avoid other activities as they further stimulate the brain to be in ‘awake mode’.
• If you wake after 4─5 hours, don’t get up. Lie in bed, try to relax and breathe deeply. Generally, you can fall back to sleep after 30─60 minutes. If you aim to sleep 7─9 hours your health will be much better, and you will feel a lot more human.
• Upon rising, expose yourself to light. When the days are longer, you can go outside for at least 30 minutes. If it’s winter you can use a light box to tell your body to wake up.
• Try to exercise for 20─30 minutes after waking up. Research shows exercise improves all aspects of health during night shift.
• Eat healthy meals — lots of fruits and veggies, good quality protein and fat. Avoid sugary processed foods.

If you are experiencing sleep problems it can be helpful to access information and support. If you would like to talk to someone you can call our confidential support line 24/7 on 1800 667 877.

We also have information on our website to help if you are concerned about shift work and sleep.

By Amy Benn RN, Founder of Wholeheart Magazine

I found it challenging to manage my health and well-being while I pursued my chosen specialty, Intensive Care Nursing in one of Melbourne’s major metropolitan hospitals and worked towards becoming a teacher of the nursing profession. Alongside my post-graduate training in nursing, I studied Meditation, Fitness and Nutrition — all in the pursuit of implementing positive lifestyle habits in my own life to improve my own health.

All of these strategies help me to thrive while doing shift work. They work for me, but they may not work for everyone. It’s a process of trial and error for all of us. Choose the strategies that you find connecting and develop your own routine that serves your individual routine and well-being.

Shift work and sleep patterns

Aim to get quality sleep where there is optimal time spent in deep and REM sleep. Adopt a regular routine. It can seem impossible, but you can achieve this even alongside shift work.

Encourage yourself to not fall victim to shift work, but instead use my tips to see how you can structure your daily routines to thrive in life despite your busy schedule.

Keep regular sleeping and waking cycles

Keep your sleeping and waking times within two-hour windows.

For example, if you go to sleep at 10pm on a day off, make a conscious effort to go to bed between 9pm and 11pm when you are on shift.

If you wake up at 5am for your early shift, then sleeping in no later than 7am on a day off or afternoon shift will keep your routine in check.

Optimal napping

It is possible to nap strategically to “catch up” without compromising the quality of your night’s sleep. Continue to wake up within your 2-hour cycle, and take a 20–40-minute nap mid-morning or mid-afternoon. Your nap can be before an afternoon shift, midday on a day off, or as soon as you get home after an early. I know it can be difficult, but avoid sleeping for longer than 40 minutes. Going for a walk and rehydrating afterwards will help you get to sleep that night.

Perk yourself up naturally

You can arrive happy and productive for your shift and feel ready to take on the day’s problems if you stimulate your mind and body by creating morning rituals.

My suggested morning rituals fall into three categories:

Health: Prime your ‘physical’ self

1. Hydration: Drink a mug full of water before your morning brew to rehydrate.
2. Nourish: Stimulate your digestion and fuel your body with a wholefood meal (or smoothie). Fire up your metabolism and enjoy sustained energy.
3. Movement: Moving your body is a great way to wake up. You could try a 10-minute brisk walk from your car, or try two sets of 12 squat-jumps while the kettle boils. Try yoga flows or dance and stretching accompanied one of your favourite songs.

Mind: Prime your ‘mental’ self

1. Mindfulness practice: If you’re not ready for meditation, try five minutes of mindfully sipping your favourite hot drink as you gather your thoughts in silence.
2. Breathing techniques: Breathing exercises are a wonderful way to distance yourself from the busy thoughts of your brain. Great techniques include alternate nostril breathing, box breathing and slow deep belly breaths.
3. Connection: Connect with somebody you love. Feed your fur baby or give them a pat. Offer some kind words and a kiss to your loved one. Even just writing a little note, or getting their favourite coffee mug out.

Passion: Prime your ‘spiritual’ self

1. Gratitude: Connect to YOU by either saying or writing 3 things you are grateful for.
2. Goals: It’s useful to have dreams, broken down into meaningful, achievable steps you can take each day. Even if it is to face a problem that needs to be solved. Setting your intention is powerful.
3. Inspiration: Top yourself up by reading or listening to something interesting or inspiring. Perhaps listen to a podcast on your way to work, or even just read a page of an inspiring book.

Naturally calm yourself down

I don’t think I’m alone in saying that sleeping after a shift, particularly an evening shift can be difficult! Lying in bed, counting down the hours till you have to get up again for a morning shift can be agonising. Spend time getting to know what works for YOU! Explore the obstacles in the way of naturally falling asleep. Once identified, you can implement strategies that will work for you.

Calm your ‘physical’ self

1. Body aches and pain: Aches can impair sleep, particularly when we work physically. Do some foam rolling, stretching or self-massage.
2. Wash away the day: Take a warm shower, lavender oil is great for relaxation.
3. Limit light and sound: Dim the lights or just use a lamp. Listening to some slow instrumental music or binaural beats are good for slowing your mind.

Calm your ‘mental’ self

1. Journal: Writing down the thoughts that are spinning around in your head can be beneficial. Having a to do list next to your bed can help place your mind at ease.
2. Reflect: If you find yourself replaying the events of the day or the shift in your mind, ask yourself questions like:
   • What happened?
   • Were there influencing factors involved?
   • What could I have done next time?
   • Or call Nurse and Midwife Support on 1800 667 877 if you need extra guidance!
3. Breathe: Use breathing practices. They calm the nervous system by stimulating the parasympathetic nervous system. Try Box Breathing or the Calm app, which has free membership for Health Practitioners.

Calm your ‘inner’ self

1. Acknowledgment: In your journal, tick off the goals that you achieved that day.
2. Preparation: Set your intention and make life easier by packing healthy food for the next day, laying out your workout clothes and having your journal nearby.
3. Give thanks: Write what you are grateful for, what you learned that day.

Take control of shift work so that it doesn’t control you. This will assist you to live a balanced life and enable you to live your BEST life.

Amy Benn
Registered Nurse
Director and Editor Wholeheart Magazine

I was never a natural parent. Some people are. You know the ones I mean. The ones who smile at babies in the supermarket queue and who think their little Johnny is the smartest, cutest, most perfect child placed on this earth. They make it look easy.

I love my kids but it didn’t come comfortably.

I went back to my job as an ANUM in oncology at five months, leaving my partner to pick up the parental role. I needed the stimulation of adult conversation and to be back in control of me, because when you have a small child, you are never in charge of anything in your life anymore.

With the return to work came many other unpredicted expectations and questions: “who’s looking after little Johnny?”, “oh, is Tim playing Dad today?”, “have you weaned him early?”

There is nothing like the guilt of a new Mum who has returned to work.

Working shifts and parenting are tiring separately. When they are combined, they can be overwhelming, exhausting and hard to maintain. Many nurses and midwives work a 24-hour clock: they care for their children during the day and then work a full night shift caring for the needs of patients. When I worked nights, my kids knew not to wake me unless they could see blood, bones or brain matter — this is the invisible work of the parenting shift worker.

Unlike some other professions nurses and midwives are usually unable to work from home or use flexi-time arrangements to juggle their responsibilities. Nurses or midwives who are parents might find they are expected to make sure little Johnny is presentable for class, bake cakes for fetes, do reading with the prep class, prepare meals, and attend parent teacher interviews all day, then keep patients alive in ICU, hang chemotherapy or deliver one-on-one supportive care to women in labour.

Childcare is another significant issue. How many childcare centres cater for shift workers? I was very lucky to have my two children in a centre that opened at 0600 and closed at midnight. They were set up for shift workers, and sometimes kept children overnight in a homely environment for the night shift folks. They would take my roster as I knew it and changed the bookings per week to suit my needs. I was very fortunate. Having great childcare made such a difference to how I could do my job. Knowing that you don’t have to be constantly worrying about children makes your working day so much easier. It can be hard to find childcare for shift-workers, but it is out there!

Here are some tips that helped me to keep it together!

• Be organised: have bags packed with spare clothes, nappies, wipes — always.
• Meal prep: have a big cook up on your days off and fill your freezer! Buy some bento-style lunch boxes and have them stocked with the basics that you can add to (for you and the kids). Foods such as egg muffins, taco-boat quiches, and homemade fruit roll-ups all freeze well and can be prepared well ahead of time.
• Enlist help if you have any available. If you are lucky enough to have friends or relatives offer to help out, let them. Being super-Mum-or-Dad is overrated. If they don’t offer, don’t be afraid to ask! You could even talk to your child’s daycare educator, teacher or principal. They may have some resources that could assist you. Sometimes people just don’t realise you could use the help.
• Nap when the kids nap, or during school hours — the house tidy can wait. Forever, if necessary.
• Consider outsourcing some of the housework, the money for a cleaner or gardener can be worthwhile to offset stress.
• Enjoy your children when you can. On your days off, get out into the fresh air, feed the ducks, take the dog for a walk, and meet other parents. Children are small for such a short time.
• Learn to say no without guilt. Sometimes you have to admit to yourself that you can’t do your job and volunteer at the school canteen, and that’s ok.
• Accept that if your kid is alive and not in moral peril, you’re doing fine.

Parenting has brought me so much joy over the years, and I look back to the times when my children were little with so much pleasure. My work is such an important part of my identity and I consider myself very fortunate to have been able to juggle both responsibilities of parenting and career, managing to survive and thrive.

If you need support to juggle parenting or other care commitments and shift work, give Nurse & Midwife Support a call on 1800 667 877. We’re here for advice, referrals, or just a willing ear to vent some of the steam that might be building between your ears.

If you need to talk, our service provides free and confidential support 24/7 to nurses, midwives and students Australia wide. If you would like to speak to someone call 1800 667 877, or you can request support via email.

If you’d like to know a bit more about the service before getting in contact — take a look through accessing support.

You can order promotional materials from [email protected]

I love making these podcasts! I get to talk to inspirational guests who share their expertise, knowledge and wisdom with nurses and midwives all over Australia. In this episode, I talk to the inspirational Amy Benn, Registered Nurse & Director of Wholeheart Magazine. 

Amy was diagnosed with Crohn’s disease at age 14 and was inspired to become a nurse by the care she received as a teenage patient. She knew she would have to balance her health alongside the demands of shift work. I asked Amy to share her tips on how she achieved a state of well-being while doing shift work. She is now medication-free and in remission and enjoying the best health of her life. Her tips include restorative practices such as sleep, rest and mindfulness, eating more healthy whole foods, exercise, connecting to nature, your community and those close to you.

I also worked shift work for many years and know that getting this recipe right can be challenging. After 35 years working as a nurse and sharing advice with my nursing and midwifery colleagues, I have a fair bit of wisdom to pass along myself!

This is a conversation worth listening to because YOUR HEALTH MATTERS!

Mark Aitken RN
Stakeholder Engagement Manager

Guest: Amy Benn

Amy Benn is a Registered Nurse and Director of Wholeheart Magazine.

Amy became very health conscious, at age 14, after a diagnosis of Crohn’s disease. Inspired by the care she received as a teenage patient, Amy knew she wanted to help others and naturally gravitated towards nursing. Managing health and well-being became challenging for Amy as she pursued her chosen specialty of Intensive Care Nursing in one of Melbourne’s major metropolitan hospitals, and becoming a teacher of the nursing profession. Alongside post-graduate nursing study Amy studied Meditation, Fitness and Nutrition. All in the pursuit of absorbing more knowledge and understanding to enable positive lifestyle habits to improve her own health.

Amy’s vision is to equip nurses, midwives and students with the knowledge and understanding to cope with the demands of working in health care, and to enhance their own lives through great health and well-being.

Amy is medication-free and in remission from Crohn’s Disease and enjoying the best health of her life

Amy believes our biggest opportunities lie in our challenges. And, the greatest investment we can ever make, is one in ourselves, and our wellness.

Listen to Episode 10 Sleep and Shift Work