Be sure to get your sleep

The sound of the helicopter signaled the arrival of a patient with a life-threatening condition. Whenever a helicopter team is called, it means that the situation is critical. Only the girls in the Patient Transfer Department and our triage nurse on the phone knew the severity of the patient’s condition and his/her destination.

The time was 0400 hours. A call from Triage confirmed that the patient was coming to my department. I already felt sorry for the patient’s family.

I was working my fourth 16-hour shift in as many days, and I was tired. By midnight, I had already been at the hospital for 8 hours. There were 4 hours remaining in my shift. With the arrival of a new trauma patient, it was doubtful that I would be leaving when my shift ended at 8am.

I was so busy caring for my patients that I neglected to stop to drink water, eat lunch, or break for a snack. I noticed a tray of cookies and two boxes of cold pizza in the staff lunchroom. My colleagues are regularly known to eat on the run. They pick up a food item, pop it in their mouths, then return to their assigned work areas. No one had time to sit for a proper meal. Nevertheless, I continued to bring my own cooked food from home with the hope that I would not take it back home at the end of my shift as I had done so many times before. (For five years, I have followed a gluten-free and lactose-free diet, and I would not eat either the cookies or the pizza.)

As you may have guessed, I am an orthopedic trauma nurse, and I work long hours often without eating or sleeping sufficiently. I routinely eat a big meal when I get home from work. Then I go to sleep. This habit has produced my current 45-pound weight gain on a medium-sized frame. I am also frequently tired with no energy for exercise. I know that if this continues, my health will be further compromised. This is a recipe for disaster.

For more than 10 years, I have worked and adjusted to the night shift. For six years, I started work at 7pm and left at 7:30am. I enjoy certain freedoms when working the night shift. I rarely need to request time off to conduct my personal business during normal business hours. For example, I am free to schedule doctors’ appointments during the day when their offices are open, and I can attend to my children’s education by attending meetings during school hours.

By nature, I am a night owl. On one occasion, however, I tried to leave the night shift. I was newly married, and my husband had difficulty saying goodbye to me in the evening before my night duty began. To please him, I accepted a position as a case manager. This lasted four months only. I simply could not do it. Believe it or not, it resulted in my getting even less sleep. When I would often stay up late with projects, my husband would remind me that it was already 2am and that I needed to be at work by 8am.

I was not yet aware that the trauma patient assigned to my department was the victim of a one-car accident. It occurred while she was driving home with her ten-month-old child in the back seat and her mother in the front passenger seat. Both of her passengers were dead. Our entire staff cried when we heard the sad news. Now it was up to us to care for this patient who had undergone such horrifying losses.

She sustained multiple traumas to her body: - chest, hands, ribs, spleen, and one leg. Miraculously, she was fully conscious with no head injuries. She was a wreck emotionally due to the loss of her child and her mom. She was informed by the police that her mother sustained only one injury-a broken neck, and her child sustained head and spinal injuries that took her life.

This patient ‘s story became personal as it unfolded. When her work colleagues heard of the accident, they offered that this was not her first accident and explained why. She did not consume alcohol. As an attorney, she was known to work long hours, just like me.

On this occasion, she was due in court early tomorrow in another part of New York state. She had already worked a 16-hour day and, to prepare for her case, had little or no sleep the night before. After leaving work, she drove 1.5 hours to pick up her mom who would care for her child while she was away. Then, she drove back to The City to collect the child from daycare. She intended to drop her mom and the child at home before heading to the airport.

Tragically, her falling asleep at the wheel caused the death of the two most important people in her life-her mother and her child. From the police at the accident scene, I learned that she was tested for alcohol and drug intoxication. My department was tasked with sending her blood lab results to the police. They showed no signs of alcohol or illegal substances. She was, however, “under the influence” of sleep deprivation.

The reality of sleep deprivation resonated personally with me, as I was existing on very little sleep. Each day, at the end of my shift, I drive 35 minutes to my home. I must confess that there were times when I did not remember how I got home. In fact, one morning while driving home I found myself veering toward the highway divider. Fortunately, my vehicle’s lane departure warning system woke me up before a tragedy occurred.

I made a resolution tonight to sleep more. I will take my allotted 30-minute breaks at work. (In fact, I already programmed my smart watch to remind me to take a break 20 minutes from now.) After work, I will ensure that I get at least 7 to 8 hours sleep instead of looking for chores to do when I arrive home. I shared my new resolutions with my work colleagues, and we all have committed to get more rest and sleep. We will be accountable to one another every seven days.

I will tell you more about our trauma patient when I return from my 30-minute break.