5 tips for night shift success from the American Medical Association

Rough night? Veteran nurses on how to bounce back after a tough shift

To the rest of the world, "There's always tomorrow" is just a nice little song from “Rudolph the Red-Nosed Reindeer.” For nurses, though, it's a critical career skill. Regardless of your expertise, rotation or location, tough shifts come with the job and being able to rebound is a must. Whether your particular brand of bad day involved bureaucracy, a toxic co-worker or a patient lost, there are tried-and-true ways to make a comeback, right in time to start work tomorrow.

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Veteran nurses can only speak to what works for them personally, but you may be able to borrow something from their approaches. As the saying goes, it's not how many times you get knocked down, it's how many times you get back up again.

These fellow nurses have been there, done that and clocked in the very next day:

Let it all out, but briefly

On your worst days at work, it's great to have what Patricia Dewer calls a "battle buddy" on the job. "That's the nurse you can go cry it out with for a few minutes, then get it back together and step back into your nurse role at work." A cardiac nurse at Piedmont Atlanta and Piedmont Fayette, Dewer says she rarely needs the outlet, but it's all-important to know her buddy's there if she does.

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Debrief so you can de-escalate

When a shift's been rough for the group as a whole, Elizabeth Binsfield makes sure to reach out before the close of day. An RN for Homecare Assistance of Virginia, Binsfield uses the strategy so everyone can learn from mistakes or affirm that they made the right choices together. "Replaying the sticky points and exploring whether there were other options we had can be helpful," she says.

Take the long way home

Binsfield, who lives on a hobby farm in Central Virginia, soothes away a tough shift with a leisurely drive down back roads. "I'll either play something soothing and instrumental on the radio or leave it off altogether. Sometimes we don't realize how much noise the day exposes us to until we're alone," she says. "The silence can be deafening. And very, very peaceful."

Keep calm and shower

Once Binsfield arrives at home, she limits all stimuli for a while to keep recouping. "A long walk with my dogs, a nap or reading something simple and calming helps bring me back to balance. A shower cleanses the remainders of the day off and readies me for sleep."

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Tap into your emotions

What doesn't work on the job can be precisely what you need to rebound after a tough shift: connecting with your emotions. "Nursing is physically and emotionally demanding work which is also why nursing is so rewarding and meaningful," notes Ann Stinely, an RN at WakeMed Health & Hospitals who lives in Cary, North Carolina. "So how to remain engaged and present without becoming a bitter, burnt-out, robot? I have a routine which helps me. First, I try to recognize how I'm feeling. This sounds like an easy thing to do, but really isn't. I've been suppressing my feelings all day so I can take care of or be prepared for overwhelming emergencies all day."

Try to break into your own thoughts

Stinely says disturbed sleep and repetitive thoughts are common after an extra-stressful day. Her first line of defense is simply accepting that she's stressed out. She follows that with quiet time. "If I can't concentrate to read I do a sudoku or crossword."

Staying active also helps Stinely get it back together before returning for another shift. "I go to the gym," she says. "Long walks really help. I go birdwatching. There is no panacea, but some time doing these things always gets me on an even keel."

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If management is approachable, seek them out

Instead of stewing over a bad shift in isolation, Stinely recommends talking over the day's events with a trusted colleague in private. And if, like her, you're fortunate enough to have approachable managers, check in to clear the air and get back on track. "I'll drop in the next day to chat with them if I need to," Stinely says. "What I don't do is drink alcohol, take drugs or overeat. I don't stay in my jammies and watch TV all day. I try not to dump all my stress on my spouse. Those strategies just don't work."

Look forward

Dewer likes to remind herself that the next day of work might be the opposite of the awful shift she just had. "In my experience, I might have the worst day for whatever reason and the following shift might be completely different," she says. "I also keep in mind that it's just 12 hours, either way. The next day is always a new day."

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