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Shift Fatigue: It doesn’t have to be part of the job

Since the beginning of recorded time, both plant and animal life, on Earth, has been affected by the daily cycles of light and dark. Almost all biological life forms become active in daylight, and dormant or less active in darkness.

Humans are well entrenched in that daily cycle; unless you are a shift worker. All our biorhythms are constructed around the light/dark scenario. Working nights and sleeping during the day messes with that cycle terribly.

What is Shift Fatigue?

According to the Sleep Foundation, Shift Fatigue, also referred to as Shift Work Sleep Disorder is a circadian rhythm sleep disorder characterized by sleep problems that stem from working long or irregular hours. The term “shift work” refers to any work schedule that falls outside the hours of 7 am and 6 pm. While any shift worker can develop symptoms, the disorder primarily affects employees with night, early morning, or rotating shifts. (, June 27, 2023).

If untreated, shift work disorder can lead to major health concerns. The condition may also negatively impact the worker’s professional performance and put them at a higher risk of committing an error or being involved in a workplace accident. Identifying shift work disorder symptoms and properly managing it is vital to the patient’s health, wellbeing, and safety

The Realities of Shift Fatigue

In the beginning a 24 on and 48 off schedule seemed amazing. Every day was Friday and, if you had a Kelly day, every three weeks you had a week vacation.  (Not so much for 12-hour rotations) But after a time you may have started to notice some of the effects of working those hours.

Shift fatigue isn’t just about feeling tired. It affects cognition, decision-making, reaction times, and emotional resilience. After all, trying to calculate a medication drip rate at 0300 hours, while bleary-eyed and bouncing down the road at 50 miles per hour, can be a challenge.

Understanding Your Circadian Rhythm

So how can you conquer shift fatigue? The first step is understanding your body and its circadian rhythms. Think of these rhythms like your body’s internal clock, regulating processes like sleep, digestion, and metabolism. As previously stated, these clocks are usually set to the rhythm of day and night.

Helpful suggestions

Light Exposure: When working night shifts, try to expose yourself to bright light during your shift and limit light exposure when you’re about to sleep. This could mean using blackout curtains at home or wearing sunglasses on your commute home in the morning.

These practices are common in the Polar regions where they experience 24 hours of daylight six months of the year.

  1. Sleep Hygiene: Even when your schedule is upside down, try to maintain good sleep hygiene. Make your sleep environment dark, quiet, and cool. Avoid caffeine and electronics close to your sleep time, and stick to a regular sleep schedule as much as possible.

This can be a challenge on days off when family or friends want your time and attention during daytime hours. After all, you are home during the day and available to run errands, pick up the kids, and do chores.

Healthy Nutrition

When we’re tired, we often reach for quick fixes like caffeine and sugar, but these can lead to crashes later. Instead, focus on:

  1. Hydration: Dehydration can worsen feelings of fatigue. Keep a water bottle with you and stay hydrated throughout your shift.
  2. Balanced Meals: This is a sore subject that is always a challenge in EMS but try to plan for balanced meals with a mix of proteins, healthy fats, and complex carbs. Try meal prepping to have healthy options on hand during your shifts.
  3. Avoid Heavy Meals: Large, heavy meals can cause lethargy. Instead, eat smaller, more frequent meals to maintain your energy levels.

Exercise and Movement

Exercise may be the last thing on your mind when you’re tired, but it can actually boost your energy levels.

  1. Regular Exercise: Try to incorporate some form of exercise into your daily routine, whether it’s a full gym workout, a jog, or a brisk walk.
  2. Movement Breaks: Take short breaks during your shift to stretch or take a quick walk. Even a few minutes of movement can help you feel more awake.

Mental and Emotional Care

Finally, remember to take care of your mental and emotional health. Shift work can be isolating and stressful, which can exacerbate feelings of fatigue.

  1. Connect with Others: Reach out to colleagues, friends, and family, even if it’s just a quick text or call. You’re not alone in this.
  2. Mindfulness and Relaxation Techniques: Practices like meditation, deep breathing, and yoga can aso help reduce stress and improve sleep.
  3. Seek Professional Help: If feelings of fatigue and stress become overwhelming, or start to manifest physical symptoms, it may be time to seek help from a mental health professional.

You don’t have to accept it

While shift fatigue can be a challenge, it’s one that we as EMS professionals can take steps to overcome. It involves understanding our bodies, taking care of our physical health through sleep, nutrition, and exercise, and maintaining our mental and emotional well-being. Even as you care for others, remember to care for yourself. Because you matter, too.