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Wednesday, April 27, 2011

Dead of Night shift

http://en.wikipedia.org/wiki/File:DeadOfNight1.jpg
After six years of being a day walker I have returned to my origin as a night shift healthcare provider. I enjoy the pace and the autonomy of night shift however, it is sometimes torturous. 
I feel like “Walter Craig” in the 1945 British film Dead of Night, in which the character experiences a recurring nightmare with the same cast of house guests. Instead of “Pilgrims Farm” I’m stuck in a hospital interacting with it's own recurring cast of personalities; the non-compliant patient, the substance abuse patient, the medical resident who thinks he’s M.D. “House”, the nurses who are fueled on cigarettes & Red Bull.  Yes, I’m dead of night shift; indifferent, cold, and apathetic. Additionally, night shift is slowly killing me.

Night shift work has been associated with a number of maladies including:
Metabolic syndrome [1& 2]
Increased vascular stress [3 & 4]
Induced Apnea [5]

In regards to me it is vitamin D deficiency. Yearly, I have a few blood tests performed to check for abnormal values. Before returning to night shift my previous vitamin D levels were normal, I lived in the Midwest, and had no additional vitamin D supplementation. After starting night shift I began supplementing my vitamin D intake with 1000 micro units/day & I also moved to the east coast (more sun), conversely my results were below normal. I always have these test performed in February, so the amount of sunlight/day/month is not a factor.

[1] Biggi, N. et. Al. (2008). Metabolic Syndrome in Permanent Night Shift Workers. Chronobiol Int.
[2] Pietroiusti, A. et. Al. (2010). Incidence of Metabolic Syndrome Among Night-Shift Healthcare Workers. Occup Environ Med.
[3] Lo, SH. et.al. (2010). Working Night Shift Causes Increased Vascular Stress and Delayed Recovery in Young Women. Chronobiol Int.
[4] McCubbin, JA. et. Al. (2010). Blood Pressure Increases During a Simulated Night Shift in Persons at Risk for Hypertension. Int J Behav Med.
[5] Laudencka, A. et. Al. (2007). Does Night-Shift Work Induce Apnea Events in Obstructive Sleep Apnea Patients? J Physiol Pharmacol.