Sleep

I really enjoy working night shifts, but I hate the lack of sleep part of it all.  I never pulled all nighters in college and I didn't enjoy lock-ins in high school because I don't sleep well during the day.  The thought of being in bed while the daylight hours are burning is beyond me.  So here I sit with a lot of hours of work behind me and several more ahead of me trying to understand why my body thinks its okay to only have three and a half hours of sleep.  Its beautiful outside, but judging the fact that last night I had to do jumping jacks in order to finish my charting, I don't think I should be too ambitious about getting much done.

Hence, today I am thankful for sleep.  I am not thankful for it because I've had a lot of rest the past few days.  I am thankful for it because I miss it, value it and can not wait to catch up on a little of it someday soon.  After all, once this baby arrives all hope for sleep will be lost anyways, right?

I have always been a notoriously bad sleeper in any situation aside from laying in my own bed at night.  My parents have many stories of trans-atlantic flights with a sleepless toddler.  In fact, the first trip we made to the United States was when I was two.  Our family here had never met me and anxiously awaited our arrival.  Despite my parents valiant efforts I didn't sleep for the duration of the trip.  However, upon reaching our destination and eager family, I promptly fell asleep and didn't wake until the next day.

I couldn't help but think of the many stories of sleepless nights that my parents still love to tell as I cared for a sleep deprived patient the other night.  There were many statements and pearls of advice that I heard flowing from my mouth that night that sounded strangely similar to the advice my parents would patiently give me as I lay thrashing in beds in hotel rooms during family vacations.

The ICU environment is awful at promoting sleep.  There is absolutely nothing restful about it.  Unfortunately, people are admitted to the ICU because they require close and frequent monitoring.  On our unit we work primarily with the brain.  While some measurements can be taken while patients rest,  much of our clinical information comes from a patient's orientation to their environment and how their body is moving and feeling.  This requires us to frequently wake patients up to do our assessments.  Therefore, optimizing their rest schedules as best as possible is often on the top of our priority list.

Every once in a while though we get those patients who, like me, are convinced they "just can't sleep and there's nothing that can be done about it."  It was this type of patient that I cared for Sunday night.  The kicker was that she was doing nothing to help herself.  I walked into the room at ten at night to find her on the phone, lights on, tv blaring and her sister snoring on the couch.  Knowing that this patient had not gotten adequate rest in several days, I began the process of slowly weaning her off her stimulation.

First, I had to calm her down over her frustrations with dietary.  Then I explained the importance of sleep in such a stressful situation.  Finally, I told her that the tv would not be allowed to be on throughout the night, unless she wanted to watch the station with peaceful nature scenes and classical music.  I turned out the lights and left the room.  I peeked in a few times, to find her resting.  When I returned an hour later for my assessment she awoke and stated that she had had the best night's sleep ever.  I informed her there were many hours left in the night.

She then proceeded to make several phone calls.  I waited, and when there was a break informed her that it was time to turn the phone off for the night.  She stated again, "I can't sleep.  I am not tired and there is nothing in this room for me to do."  Then it happened, my mom's voice shot through me as I said, "Well, you can't fall asleep if you're talking on the phone.  Now I am going to turn out the lights and you need to get some sleep."  At first, I was a little taken back and not quite prepared to sound like my mom just yet.  However, it worked and the patient was snoring before I even left the room.

As I sat down to chart, I stared down at my growing belly, and told my unborn child that there is more where that came from.  I feel quite convinced that there will be pay back for the ease of this pregnancy.  My mom has always insinuated that she hopes that I get a little pay back for the troubles I caused growing up; and given the stubborn, opinionated genes that have been contributed to our child's genetic make up, I feel confidant that parenthood should be a wild ride.  I guess in terms of sleepless nights and the "I can't believe I just said what my parents used to tell me" moments, I am ready.  Now I just need to multiply everything like ten times...or so I hear.