Stretch! And other ways nurses can avoid the mid-shift slump

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On Wednesdays, nurses on the oncology unit at DeKalb Medical know their mid-shift slump won't last. That's the day Unit Nurse Manager Regina Duncan selected to include a break at 3 p.m. where the nurses gather for 15 minutes to drink coffee or water and sit around and talk about everything or nothing. "It's, 'How are the kids?' and 'When's the next trip?' No work talk is allowed," says Duncan. "Sometimes we have more than others. But it's so important to take a break. You think you don't have time, but you're spinning around, not getting your work done if you don't."

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Those nurses who don't have Duncan offering the golden opportunity to look up in the middle of the workday can take strides of their own to counter that drained, draggy feeling that tends to hit between 1 and 4 p.m. But first, you should know it's a real thing with a physical explanation.

According to the science-based sleep education and advocacy group, the National Sleep Foundation, "if you tend to suffer a sleepiness attack in the mid-afternoon, it's not a fluke. Many people experience a noticeable dip in their alertness, energy level, and ability to concentrate in the afternoon."

We're born this way, says Northwestern Medicine neurologist Ian Katznelson. Part of the mid-afternoon brain and energy drain is physiological. "Our normal circadian cycle dictates a period of sleepiness or decreased alertness in the afternoon," he says.

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It stems from a dip in core body temperature, according to NSF. "That naturally happens between 2 p.m. and 4 p.m.," the group says. "It's a dip that triggers the release of a snooze-inducing hormone called melatonin."

Of course, if your mid-shift hits at 9 p.m. or 3 a.m., you're not working against circadian rhythms to restore your pep. But you could still be susceptible to any of the other reasons the NSF provides for a mid-shift slump. They range from recently consuming a carbohydrate-laden meal like pasta, sitting still for hours or even the type of mild dehydration that leaves you surly and energy-deprived. So how can you snap out of it?

The NSF and nurses in the know offer these tips:

Forget the vampire routine.

Daylight is a powerful force in reminding your body that mid-shift is wakey wakey time, along with boosting your levels of bone-building vitamin D. "But it only works if you can see it," says. "Eat lunch outside, walk to a nearby café for a late afternoon snack, or at least sit near a window at work if you can."

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Keep a day brightener on hand.

Sorry, junk food snacks or caffeine-laden lattes don't do much to combat that zapped feeling that hits mid-afternoon. But there are other options that work as well, notes Fiona Crawford, an ICU float nurse at Erlanger Chattanooga. "I try to keep something in my bag that's just for me, like a nice-smelling lip balm or hand cream, or a very small portion of really good chocolate." She also makes sure she has a quick puppy compilation video on YouTube at the ready if she needs a boost in the afternoon hours, and she drinks sparkling water to rehydrate.

Move, move, move.

Activity helps, notes Katznelson. He recommends listening to upbeat music or going for a quick, but brisk, walk during mid-shift slump moments.

Check out for a few.

Amanda Moorhouse has been working as a nurse for 20 years, the past 10 of them as a nurse practitioner. Her top tip for fighting mid-shift slumps is to resist the nurse habit of forgoing breaks. "Even if it's just five minutes, step away from what you're doing, meditate, reflect or pray," she says. "We all need a physical time out."