The Nighthawk

I'm the night guy. For the last 5 years or so, I have worked exclusively nightshifts in the Emergency Department. I prefer the graveyard shift, the all-nighter, as opposed to the midshift that ends well before dawn. I initially gravitated to this shift for many reasons:

1) I found a particular cadre of nurses that I considered to be outstanding, and they happened to work nights. I arranged my schedule to work with that group. My enjoyment of this profession and the success with which I am able to accomplish it depend more upon my nurses than any other factor. Night nurses rock.

2) With a typical nightshift, we start off busy and it gradually slows down toward the morning. With a typical day shift, it starts off slow and is busiest at the end of a shift. In this respect, night shifts are more physiologic. Of course some examples of either shift are busy from start to finish, or hardly busy at all.

3) It's often easier to get things done at night. There are less administrative types running around bothering us. We can bend the rules to our liking. The lab and x-ray departments can be faster without the crush of "routine studies" that occur during the day (although this is staffing-dependent).

4) The ambient noise level is less at night. This is partly why night staff tends to be less neurotic than day staff, I suspect.

5) I've always been more of a night person anyway. It's always been easier for me to stay up late than to get up early.

6) I had difficulty adapting to staggered shifts. At times, I would "hit the wall" in the middle of the night and have to take a brief nap at the nurse's station desk. A couple of times I recall almost nodding off taking a patient's history at 4 am. It was routine for me to fall asleep at the wheel literally dozens of times (per trip!) on the way home from work, and I looked forward to stoplights as an opportunity to grab a minute or two of sleep. I adjusted my schedule to try to maximize my ability to stay awake at work and on the road. Later, I was diagnosed with obstructive sleep apnea and shift work sleep disorder, and the treatment has changed my life for the better.

7) In any job, I think it's a good idea to make oneself indispensable, or at least to have useful qualities that distinguish you from your peers. There is always going to be a spot on the schedule for a guy who will happily work the graveyard shift. More about this in a later post.

My circadian rhythm is now totally backwards from most people's: the time of day that I am most awake, and most hungry, is about 2 am. I prefer to sleep from 10 am to 4 pm, and I don't really wake up completely until about 7 pm. But now I'm wide awake for my entire shift. The problem is adjusting to off days.

Is it better to stay up all day and then try to sleep the next night or stay on my preferred sleep schedule? If I try to stay up all day, I am going to be dead tired and miserable all afternoon. If I'm going to have any meaningful interactions with my fellow humans, I've found it's best to try to take a short nap in the afternoon and then try to get on a regular sleep schedule. Otherwise I'll just sit up on the computer all night, by myself. At least it's quiet.

Recently, a couple of my partners have chosen the dark path as well, which makes it easier to trade shifts when necessary. Once the daytime guys start getting spoiled by not having to do as many nights, it's like pulling teeth to get them to work a night shift for you. As I mentioned, being a nighthawk is good for one's job security.