“Most people want day shifts, but not me. People have a hard time sleeping during the day, but I never had a problem. I can sleep anytime. 4-5 hours of sleep is enough for me. Night shift is just convenient for me”
– Donald, an ICU nurse.
Adulting is difficult. For me, the hardest part has been trying to get the recommended 7-9 hours of sleep each night. With my eyes wide open after five hours of sleep, I admittedly have forced myself to make it to the 7-hour mark. Since I have begun my work in the field of sleep research, I am more conscious- rather anxious- about hitting that magic number. I won’t label myself as a “short sleeper,” but we can safely say that I can rise and shine with 5.5 hours of sleep unless I have spent 4 hours playing badminton the day before.
With 7-9 hours of night sleep recommendations making headlines everywhere, I talked to Donald, a night shift nurse expecting him to vent about his poor sleep. My bias facepalmed within minutes of our conversation.
“Most people want day shifts, but not me,” said Donald while explaining that he chose to do the night shift. “People have a hard time sleeping during the day, but I never had a problem. I can sleep anytime. 4-5 hours of sleep is enough for me. Night shift is just convenient for me,” he added.
Going Against the Rhythm
Donald’s convenience was determined by getting enough time to pursue the hobbies and activities he valued. He came across as a very energetic and arduous person, radiating enthusiasm, and zest for life. While many night shift workers, rightfully so, struggle to maintain a social life or carve out personal time, Donald was a contrast. He reminded me of Alexis from Schitt’s Creek- hearing his list of interests and hobbies, which unfolded as we chatted more. He plays badminton, hikes on sunny days, socializes with friends, loves biking, and gardening and is learning Portuguese.
Working night shifts gives him more choices and freedom to pursue these hobbies at societally determined active hours. He added, “For me, working 12 hours during the day would be the hardest part because there are not many activities that I can do after or before work. Also, there is always a shortage of nurses to work nights, especially those returning from maternity leave or sick leave. It is a happy coincidence that very few people want it and I love it. It facilitates my life. I love to be against everybody’s rhythm.”
While talking about his productivity he said, “For me, getting stuck in traffic or having an unproductive moment is more of a pressure because I know I could be doing so many things I enjoy. Night shifts allow me to optimize my time.”
“Free Time” After Night Shifts
Donald’s schedule involves working 12-hour night shifts, clocking in a total of 80 hours divided unevenly across 2 weeks. The first week has five shifts and the next has two shifts. The 4-5 days off every 2 weeks is a bonus for Donald. “I easily do 40-60 hours overtime per week. Right now, I am doing 50-60 hours as I am going on a vacation and want to compensate for those hours”. He added, “My main job is in the hospital. But for six years I have also been working in an addiction centre in South Shore. I work for 8 hours there, sometimes after my night shift at the hospital. Sometimes I go directly back to my hospital work. During vacation, I cover more shifts because of the staff shortage.”
This meant that sometimes he worked 36 hours consecutively on 2-3 hours of sleep. While my brows were stuck high up on my forehead, Donald spoke with an equal level of nonchalance and shoulder shrugs as if this was easy and ordinary.
Donald works in the addiction centre to feed his curiosity and passion for the field. “For me, it’s easier to do two different things. Even though it’s nursing, it’s a different type. My body doesn’t feel as tired compared to when I do the same thing for a long time,” he said excitedly while talking about his work at the addiction centre.
Likewise, during the peak of the pandemic, Donald picked an extra role in the vaccination centre. “There was nothing much you could do outside of the job. I wasn’t allowed to go to the addiction centre for two years.” He would get off the night shift at 7:30 am and work here at 8 am. “It was perfect for me. Sometimes I would go directly to night shift work after my work at the vaccination centre.”
An Age-Old Habit
With my bias hovering in the conversation, I was surprised that Donald could sustain this without feeling significantly tired. Rather than accepting his need, I wondered if his body had simply adapted overtime. So when he said, “Before the nursing job, I worked night shifts in the housekeeping at CBC, finishing at 6 am,” I thought there it was. Now he will rant about sleep issues because he was new to that schedule. But instead, he said, “Adapting to the first night shift job came naturally to me. After reaching home, I would bike or hike as the sun was up. Many people at that job had issues falling asleep in the day but I could sleep anytime I wanted.” So, he continued this schedule in his nursing career.
Donald shared, “I have realized that if I had set number of things to do, staying awake is easy. In the housekeeping job, I had many tasks to do- same in nursing. I feel like I don’t have enough time to get things done. So, I would not stop. If I have to do something every 20 minutes, 12 hours pass by quickly. It’s easy.”
A Versatile Sleeper
The night shift didn’t affect Donald’s sleep. He never had sleep complaints. “I fall asleep quickly and find that 4-5 hours of sleep is enough. I feel fresh.”
“[Growing up] I wasn’t someone who would go to bed early. I would sleep by 11 pm or 12 am and would wake up at 6 am because my school would start at 8 am. It took an hour to commute. I was getting almost 6 hours, which was sufficient for me.”
I had begun to wonder if Donald came from a family like the Johnsons, who helped in the discovery of short-sleep genes. He said, “I am the one who is a bit off [in my family]. My parents and brothers sleep at regular hours. They would be in bed by 9:30 pm and wake up by 6 am. I am different because I always find it easy to fall asleep anywhere. If I were the passenger in the car, I could sleep within a minute. So, I think I can catch up on my sleep in many fragments throughout the day and still be fine. So, I never really need 8 hours in a row. As far as I didn’t have to do it seven days in a row, I am fine.”
Reflecting on his sleep on workdays, Donald said, “Sometimes after my work in hospital I go to the addiction centre and back to the night shift work. Then between the jobs, I sleep for 2-3 hours. That’s enough.”
When asked what his secret was to feel rested despite this schedule, he said, “It’s important to be able to fall asleep. Some people will be in bed but cannot fall asleep. They have to be fully off before sleeping. I don’t have that problem- I can sleep anytime. I am very versatile when it comes to sleeping. If I don’t have time today, I will sleep tomorrow. If not tomorrow, it’s today. For many people, it is hard to say that they will sleep tomorrow.”
Donald’s flexibility and versatility when it comes to sleep have, according to him, allowed him to manage this schedule and enjoy his life.
Skipping Days of Sleep
After coming back from the hospital job, if Donald chooses not to work at his second job, he would sleep at 11 am, “Only if I must go back to work at night. If I am not going back and it is an off day, I start adapting to the day schedule. I stay awake the entire day doing activities so that I am tired until the night. If I sleep in the afternoon on my off days, I won’t sleep at night because my body naturally wants to stay up by night. In that case, I still have the energy to be awake but everybody else is asleep.”
This means that Donald skips at least a day of sleep every two weeks- while transitioning from the night shift to an off day and then transitioning back to the night shift from an off day. “By the second night of an off day, I am fully on a day cycle. I adapt fast. I sleep for six hours and I don’t need an alarm clock. It’s natural.”
He follows the same process when he goes back to night work after a day off. He stays on the day schedule, wakes up in the morning, then doesn’t sleep the entire day and goes to the night shift work. When he returns home, “My body is very exhausted. So, I sleep, and I am back on the night cycle. Sometimes I have performed well on no sleep,” he added.
Working at His Best
I was surprised to find that Donald was enthusiastically speaking with me at 10 am after finishing his night shift. “I have been doing this for 14 years. None of my colleagues would know if I have worked two consecutive jobs without me telling them because I don’t have trouble working at my best after 4-5 hours of sleep. I don’t look tired.”
During his night breaks in the hospital, Donald takes naps. “After the nap, if it’s a busy night,” he added, “my adrenaline naturally kicks in quickly. In the ICU, things can get worse quickly. I don’t have a problem getting into that mode.” For him, it can get tricky when it’s a quiet night and there is less work. “In that case, after a nap, my body wants to continue sleeping. This phase lasts for 1-2 hours.”
Interestingly, even though he hails from Haiti, where coffee culture thrives and he grew up drinking it, he is not a coffee drinker anymore. “I don’t need it [to stay awake at night]”, he remarked.
Experiences of Donald’s Colleagues
Donald shared his colleagues’ reactions to the night shifts. “Most people don’t choose night shifts because they struggle to fall asleep or stay asleep during the day, eventually they stop sleeping. So, by the first night shift, they get tired, the second night is worse, and on the third night, they have headaches, insomnia and difficulty focusing. They eventually go to the doctor who advises them to stop working nights. So, they eventually switch to day or evening shifts.”
He shared a few reasons why his colleagues were leaving or changing their jobs. “The new nurses don’t have a choice of shifts, and they have to try all the shifts or be on a rotating shift. Those who can’t handle it, give up their jobs after a year or get a medical note to work day/evening shifts. Most of my colleagues left because of their sleep issues or family issues or challenges to spend family time when they are tired.” On the contrary, he said, “People may prefer the night shift to take their kids to appointments or school in the morning.”
Call for Change
When asked for a call to action for organizations or the government for better sleep health of nightshift nurses, Donald expectedly didn’t have specific suggestions. However, he raised a pressing issue regarding access to hot meals for night shift workers. “The cafeteria closes at 7 p.m., and the vending machines only offer Coke and chips. Is this due to a lack of demand or supply? It would help if we had some meals available on-site. Some of us who work the night shift don’t eat until midnight, but by then, the stores are closed if we want to order food.”
After hearing from Donald, it seemed quite obvious that while hospitals operate 24/7, their cafeterias do not. Night shift workers must rely on home-cooked food or order takeout, which may not always be feasible for a multitude of reasons. It is important to fulfill these basic needs of a 24-hour society. I discovered a campaign which calls to address this issue called the No Hungry Staff campaign, for those interested in learning more about this initiative.
Talking to Donald made me question my own biases and opened my mind to understanding the flexibility and diversity in sleep needs and habits across individuals, cultures and societies. In some respects, I relate to Donald. My adrenaline kicks-in immediately after I wake up if I have work to do. I am fine with 5.5 hours of sleep, although my partner- a long sleeper- finds it annoying.
Donald recognizes that he is different from his colleagues. He jokingly said, “I invite my colleagues to play badminton after a night shift, but they never come. They cannot. They need sleep. But the way I see it is if I don’t do my activities, I won’t do it at all. If not now, when?”
Madhura Lotlikar, Ph.D. candidate, Neuroscience, McGill University