Tired medical professional sitting on chair and sleeping in hospital waiting area
Are you a health care worker struggling to manage working overnight shifts? If yes… this article is for you!
For many new healthcare workers in a hospital setting, working night shifts is mandatory. Some people can easily adjust to this non-traditional lifestyle while others are not and experience negative effects on their mental and physical health.
Your body runs on an ‘internal clock’ that is also known as a ‘circadian rhythm’. This is a natural process that signals sleep and wakefulness in your body from the environment around you. When you start staying awake during nighttime and sleep during the day, your internal clock is interrupted.
Repeated interruptions in the circadian rhythm can lead to Shift Work Sleep Disorder (SWSD). This is a common sleep disorder that affects 10-40% of shift workers that work outside of the traditional ‘9 to 5 lifestyle’.
You may have SWSD if you are experiencing:
feelings of chronic ‘jet-lag’ or fatigue
insomnia or excessive sleeping
depression or anxiety
stomach or digestion issues
Don’t worry! There are ways to overcome this!
Practice Sleep Hygiene
Sleep hygiene is important so your body sticks to a regular schedule and sleeping environment. The body gets the best sleep when there is a dark, cool environment.
Schedule yourself time for sleep. Avoid stimulating activities at least 30 minutes prior to sleep.
Use blackout curtains or a sleep mask.
Sleep for at least 7 hours at a time.
Avoid caffeine at least a few hours prior to sleep.
Tell your family members when you will be sleeping so they can limit noise and distraction.
Place a ‘Do not disturb’ sign on your door.
Use natural sleep aids such as melatonin.
Make time for Self-Care
Good self-care practices can have a major positive impact on your mental health! Don’t forget to prioritize time for yourself.
Maintain a healthy diet.
Exercise.
Socialize on your days off.
Practice keeping a positive mindset.
Speak to a therapist or counselor.
Designate time for hobbies or activities.
Scheduling is KEY!
Routines are a great way to ensure that you are still allowing your body enough rest and nutrition. They allow you to block time for sleep, self-care, and socialization which are essential to living a healthy life.
If you’re still struggling to cope with night shift:
Attempt to find a day shift position within the hospital or at another facility. There are many different opportunities within healthcare.
Schedule yourself to have enough rest between shifts.
Speak with your manager about having a more consistent schedule or working less night shifts.
Harvard Medical School. (2023, February 28). Shift work can harm sleep and health: What helps? Harvard Health Publishing. 2023, https://www.health.harvard.edu/blog/shift-work-can-harm-sleep-and-health-what-helps-20230228289
Huang, L.-B., Tsai, M.-C., Chen, C.-Y., & Hsu, S.-C. (2013). The effectiveness of light/dark exposure to treat insomnia in female nurses undertaking shift during the evening/Night Shift. Journal of Clinical Sleep Medicine, 09(07), 641–646. https://doi.org/10.5664/jcsm.2824
For many people with serious illness there will come a time when medical treatments may no longer hold the promise of a cure or relief. When this time is recognized, hospice care becomes an imperative resource and guide through this difficult journey. Hospice workers provide incredible compassion and focus on the comfort, dignity, and quality of life for individuals with terminal illnesses. Hospice is often misunderstood but aims to provide a holistic approach to care for patients and their families during some of the most difficult times in life.
Shift in Perspective
Hospice care represents a shift in perspective. Shifting from aggressive, curative treatments to focusing on the enhancement of life’s remaining moments. Hospice acknowledges the fact that all curative options may have been exhausted, and the best option is now to focus on ensuring comfort and peace. Hospice care helps to define a patient’s values, wishes, and goals, empowering them to be active participants throughout their journey. This allows patients to spend their remaining time in a familiar and comfortable setting, surrounded by loved ones.
Multidisciplinary Approach
At the heart of hospice care is a team of dedicated professionals, each contributing a unique skill set to address the diverse needs of patients and their families. Doctors, nurses, CNA’s, social workers, spiritual advisors, Chaplin’s, and volunteers work as a team to provide holistic care. They ensure that not only the physical symptoms are managed, but also focus heavily on the emotional, psychological, and spiritual distress that can weigh heavily on those involved in end-of-life situations.
Support for Families
Terminal illness affects not only the patient, but everyone involved in supporting the patient. Hospice care recognizes this and provides comprehensive support to families. By providing education, resources, and guidance we can reduce fear and increase confidence in the people providing care during these difficult times. This support extends beyond the patient’s passing as the hospice team will follow up with family members to ensure that their needs are met throughout the grieving process. Additional support and resources are provided as needed.
Celebration of Life
Many stigmas exist surrounding the term hospice, many people hear this word and assume that we are giving up and death is imminent. This is not true; we are not giving up but rather supporting our patients needs with a new perspective. The perspective shifts to ensuring comfort and adequate symptom management instead of curing a disease. Hospice care encourages patients and families to spend time connecting with each other and making the best of whatever time is left. By ensuring that the patient is comfortable and ideally at home, we can create a peaceful and familiar setting to reminisce and share memories during life’s final moments. Whether or not the patient can participate in conversation, our priority is to ensure a peaceful and fulfilling end-of-life experience for the patient and family to share stories and celebrate life.
The Gift of Dignity
Caregivers who work in the field of hospice are dedicated to their patients and work to maintain their dignity through the final stages of life. By understanding our patients’ wishes and connecting with family members to gain insight into what their needs are, we can establish a plan of care and begin educating and providing support that is most helpful to all those involved. By respecting our patients wishes and maintaining their comfort, we create a scenario where dignity is maintained through confident and effective caregiving.
A Lyme disease diagnosis can be frightening, especially if you start to search the internet for information. I spend a lot of time in the woods, and personally was diagnosed with Lyme disease in 2015, and even as a nurse, the misinformation and general information overload can become overwhelming. Everyone is saying something different! Even seemingly credible sources, like news channels, may share misinformation. So, what are the facts about Lyme disease?
What is Lyme disease?
Lyme disease is a bacterial infection caused by a bacteria called Borrelia Burgdoferi. The bacteria is passed from blacklegged ticks to humans from a bite. Lyme disease can cause mild to (rarely) more severe illness. The tick must be attached for 48 hours to pass the bacteria on to a human.
Source: CDC.org publicly available Lyme disease recource material
Did you know? Almost 470,000 people in the US were diagnosed with Lyme disease last year
What are the symptoms of Lyme disease?
“Bullseye” rash seen in Lyme disease
“Bullseye” style rash around a tick bite
Fatigue (tiredness)
Joint pain
Flu Like symptoms and Fever
Headaches
Facial paralysis/ drooping (Rare)
Source: CDC Lyme resources publicly available materials
Heart Problems, like an abnormal slow heartbeat and passing out (rare)
What about all these treatments you see online? What’s real? Whats Misinformation?
If you search for “Lyme disease” on Google, you will see many results. You may have seen blogs and ads for doctors offices offering “chronic Lyme disease” treatment, or videos from other patients about home remedies. The link below features a “Lyme literate” doctor who runs a blog.
This blog serves as an advertisement for this doctors’s practice, where he treats chronic Lyme disease based on symptoms alone, not tests. He uses a many therapies, including long term antibiotics. This can be a real issue. Read on to see why.
So-How is Lyme disease diagnosed?
If you have a bullseye rash, your doctor or provider will usually diagnose you with Lyme disease based on this symptom alone. This rash only happens in Lyme disease.
-Lyme disease is tested for using blood tests. The first test, called the ELISA, tests for antibodies to Lyme bacteria.
-If this test is positive, the results are confirmed with a second test, called the Western Blot.
According to infectious disease doctors, Lyme disease should never be diagnosed based on symptoms alone. The symptoms of Lyme disease are similar to the symptoms of many other illnesses, and unnecessary treatment with antibiotics could cause other health problems, not to mention a serious health issue could be missed.
(Source: Lantos et. al, 2020)
We all love YouTube, and it can be fun, but YouTube can have a lot of misinformation….
There are many videos about Lyme disease treatments on YouTube.
Look at this example of a news story from Boston. It is one of the first videos you find when searching “Lyme disease” on Youtube:
Here is another video that pops up near the top of the search results on Youtube:
Both of these videos are prime examples of Lyme disease misinformation. Why?
In both short clips, the people featured claim to be suffering from chronic Lyme disease. According to infectious disease doctors, some patients may rarely experience long term symptoms from Lyme disease. These symptoms are usually joint aches and headaches. This does not mean that they are still infected with the bacteria. Treatments like extreme hyperthermia (heat) therapy, which the teen used in the first video,is not a proven, safe or effective treatment for Lyme disease (Source: Lantos et. al, 2015). It can also be dangerous, as in the video the patient’s have their body temperatures raised to potentially deadly levels. In addition, the teen and her family were charged over 60,000 US dollars per day for this treatment!
In the second video, the woman was treating herself with bee stings. According to some infectious disease doctors, this is becoming popular online. This treatment is also unproven and can be dangerous and painful. There are other home remedies seen on the internet, like urine therapy, lasers, oxygen, herbal supplements, drinking bleach solutions, and hormone shots. A team of researchers who looked into these therapies were unable to find any studies or evidence to support them. (Source: Lantos et. al, 2015)
There are safe and effective treatments for Lyme Disease that are covered by insurance.
You are probably asking- how is Lyme disease treated by doctors?
Lyme disease is cured with antibiotics. For most people, this mean a short course (3 to 4 weeks) of antibiotics taken by mouth. For almost all people, symptoms get better with treatment. Usually, the antibiotics used are doxycyline or penicillin.
Rarely, some people may experience inflammation of their heart, called Lyme carditis. If this rare condition occurs, antibiotics are given in the hospital by IV line, usually for a week and then followed by oral antibiotics.
For some people, symptoms (like joint aches) may continue after treatment. This does not mean an infection is still present. Long term antibiotics are not recommended for this reason. If symptoms continue, see your doctor or healthcare provider. If Lyme disease is treated early with antibiotics, the chance of developing long term symptoms decreases.
Watch this video to learn more about how Lyme disease is treated:
For more information on Lyme disease, please visit the Centers for Disease Control Lyme Resource page at https://www.cdc.gov/lyme/index.html
The Good news is that you can take steps to prevent Lyme disease. Here’s how:
If you are going outside into wooded areas:
-Wear hats and long pants tucked into boots in wooded areas, in light colors
Source: CDC publicly available Lyme disease education resources CDC/org/lyme/recources
-Use a bug spray containing DEET (at least 40%) or picaridin
-After being in a wooded area, remove all clothing and perform a thorough check for ticks.
-If you find a tick, remove it immediately with stiff tweezers, grasping near the tick’s head. Do Not use jelly, oil or cream to massage the tick, as this may further spread Lyme bacteria. If you cannot remove the tick, see medical help at your doctor’s office or walk in clinic.
-Try to remove ticks as quickly as possible, this can help prevent Lyme disease. If a deer tick was attached for more than 48 hours, see your doctor.
-If you are concerned about a tick bite or any of the symptoms listed on this blog, please see your doctor.
Sources:
Baarsma, M. E., Claassen, S. A., van der Horst, H. E., Hovius, J. W., & Sanders, J. M. (2022). Knowing the entire story – a focus group study on patient experiences with chronic lyme-associated symptoms (chronic lyme disease). BMC Primary Care, 23(1). https://doi.org/10.1186/s12875-022-01736-5
Halperin, J. J., Baker, P., & Wormser, G. P. (2013). Common misconceptions about lyme disease. The American Journal of Medicine, 126(3), 264.e1–264.e7. https://doi.org/10.1016/j.amjmed.2012.10.008
Lantos, P. M., Rumbaugh, J., Bockenstedt, L. K., Falck-Ytter, Y. T., Aguero-Rosenfeld, M. E., Auwaerter, P. G., Baldwin, K., Bannuru, R. R., Belani, K. K., Bowie, W. R., Branda, J. A., Clifford, D. B., DiMario, F. J., Halperin, J. J., Krause, P. J., Lavergne, V., Liang, M. H., Meissner, H., Nigrovic, L. E.,…Zemel, L. S. (2020). Clinical practice guidelines by the infectious diseases society of america (idsa), american academy of neurology (aan), and american college of rheumatology (acr): 2020 guidelines for the prevention, diagnosis and treatment of lyme disease. Clinical Infectious Diseases, 72(1), e1–e48. https://doi.org/10.1093/cid/ciaa1215
Lantos, P. M., Shapiro, E. D., Auwaerter, P. G., Baker, P. J., Halperin, J. J., McSweegan, E., & Wormser, G. P. (2015). Unorthodox alternative therapies marketed to treat lyme disease. Clinical Infectious Diseases, 60(12), 1776–1782. https://doi.org/10.1093/cid/civ186
Willis, S. J., Cocoros, N. M., Callahan, M., Herrick, B., Brown, C. M., Kruskal, B. A., & Klompas, M. (2022). Assessment of antibiotic prescriptions for lyme disease after modification of reporting language for positive screening test results. JAMA Network Open, 5(1), e2144928. https://doi.org/10.1001/jamanetworkopen.2021.44928
