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The Night Shift

The Night Shift

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I have been working night shifts on and off for a decade now. During that time I’ve noticed a peculiar culture fostered by those rostered to work outside of normal hours, a set of customs which passes over the heads of my more diurnal friends. There’s a definite spirit of the night shift, one you wouldn’t recognise having spent your life only contracted from nine until five. I am fond of the night shift, though the relationship may be hard to justify

As I settle into reversed sleeping pattern, a more contemplative mood emerges. In the quiet hours I see a more reflective version of myself. Even on the commute both ways I’ll have a little sonder at the people I’m sharing a train carriage with or waiting beside at the bus stop. It’s probably the cotton wool brain and perpetual jetlag, but I do find myself wondering who these people are and what are they up to, especially if they’re on the way into work as I am.

There are many methods of easing yourself into the routine ready for a run of nights and I think I’ve heard them all. If you’ve the time, you can adjust your body clock gradually and if you haven’t, you might have to power through it with a lot of coffee and hope for the best. That usually works for the first one. After that you have to pray that you can catch enough sleep during the day to allow you to function overnight. This is always the first question on any night shift worker’s lips, it is the way we greet each other; ‘Good morning (at eight pm). How’d you sleep?’. When we part until the following night, almost universally we wish a good rest for each other instead of saying goodbye. We become obsessed with comparing four or five hours of slumber snatched between building work or childcare.

One of my colleagues used to employ a technique, garnered from some Harvard Medical School study, which purportedly reset the body’s cortisol level by fasting for sixteen hours. I found that this works for getting into the reversed cycle, not so much for getting out of it and it is always more difficult to re-adjust to daylight. The morning after the shift is a wash, it is best to accept that early on and snooze on the couch only for a short while if you want to re-adjust your body clock. Some people go out for a boozy brunch. I’ve tried both and can see the merits in both approaches.

A few nurses I have worked with lived in perpetual darkness – they woke up in the afternoon, picked up the kids from school, made dinner then went to work a full shift before coming home to do the school run and then bed, sometimes maintaining this astonishing routine for years.

André Hofmeister via Flickr

Most of my night shifts have been spent in hospitals, already curious and superstitious places during the daytime. If you don’t believe me, talk to any Emergency Room nurse about the full moon effect then wish them a ‘quiet shift’ and ready yourself for wailing and the gnashing of teeth. Hospitals at night are liminal spaces. As the bustle and action in the wards settles to a quiet, we hunker down and carry the fire through the wee hours until the day shift pitch up to collect it from us. Emergencies aside, nothing happens overnight. The job is by nature transitional. Tasks are divided into what needs to be done now and what can wait until morning.

That’s not to say that these shifts aren’t busy, far from it. With fewer services and supportive staff around, you are forced to be more independent. As the stewardship of these situations is yours, so too are the decisions. If something can’t safely wait until morning then it is down to you to sort it out or find someone who can. The night shift can be make or break for healthcare workers. Some dread them. It is when your honed skills and knowledge are put to the test as you struggle to remember guidelines and drug doses at 5am.

Stranger issues tend to crop up overnight. It is when the bizarre misadventures arrive in accident and emergency. What drives someone to eat fifteen packets of silica gel or insert a light bulb into their anus glass end first? In the service industry it was when the stranger customers started to pitch up. The daytime clientele are distinct from their crepuscular counterparts, those with strange dress and stranger habits from another walk of life. Like Chris Rock said, no-one ever needs anything good from a cash machine after three in the morning.

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The upside to this dichotomy of acute situations only after hours is that all of the daytime bureaucracy melts away. The dullest tasks are those left for the day shift as by their nature they are the least important. Your time is for emergencies and excitement. For good reason too; one of my bosses used to say that working overnight was like trying to do the job after two pints, which is obviously preferable. She was right, your brain isn’t in tune. This is why insomnia is carefully regulated by the logistics and airline industries, though sadly healthcare has yet to catch up.

Otherwise, if the night is a peaceful one, then you have time to read, listen to music, even watch some YouTube. If I can, I choose to write, leaving editing for sunlight hours. You can gather in a staff room or office under some blinkering neon lights which dry your eyes out and sit with your colleagues and get to know them better over a takeaway – another preserve of the night shift. The night shift draws out a different side of people. I am convinced that this is the frontal lobe going to sleep. Once they lose their executive function, you see them as they really are. The mask slips with delirium. I have had some of the most thoughtful and revealing conversations with colleagues due to this frontal lobe dieback.

Sit down with a good book and a cup of tea to greet the sunrise. You watch the clock while the dawn chorus starts. When the day team arrive, you pass the torch, either cackling at the mess or in a fugue from exhaustion. Then, as is the privilege of those folk who keep the lights of society on while everybody else gets to sleep, you’re free to walk out from the shift and into the daylight, feeling as though you’re ten feet tall.

Cover image courtesy of yi zhao via Flickr

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