Tuesday, April 19, 2011

The Federal Aviation Administration suspended a controller for watching a movie during his shift. This is another incident to add to other suspensions, mostly for sleeping on the job. Who's at fault: the controller or the system in which the controller works? Although workers may focus better at their daytime job, night work offers a challenge: how do you stay awake when you are alone and when you are not so busy? 

Aside from studying long hours into the night during high school or medical school, the first times I had to seriously work overnight were during my early residency years. Although training as a doctor is physically, intellectually, and emotionally demanding – we make decisions that impact upon life and death – it was always easier to stay awake and active through the night. Night shifts with occasional demands would activate an on-off switch: tons of adrenaline when an emergency occurred, and boredom and sleepiness when things were too quiet. I would rather stay busy all night than have two or three activities with no action throughout the night. In an attempt to improve the quality of care, thirty-six or more extended hour shifts were cut down to a maximum of twenty-four-hour shifts for medical residents in this past decade.

How can you maximize your overnight work and stay awake and alert?

1. Scheduled activities: After studying the frequency of activities, as in flight control – there are some pre-scheduled arrivals overnight - you may proactively anticipate what to do. If you know you will have assignments every two hours, get ready for action preparing for each event. At the same time, you need to ensure you are also ready for the unanticipated event. Design ways in which you stay awake and alert: you may have a system of checking on different areas at work, complete pending paperwork, or start new projects. Remember, even if you multitask you can only focus on one thing at a time.

2. Occasional activities: You may not be able to anticipate what's happening next, as in the emergency room, switchboards, or call centers. Although busy ERs are non-stop, your direct responsibilities may be on-off. If this is the case, consider taking turns with your teammates or assign specific activities to stay busy between high-intensity responsibilities.

3. Constant activity: If you need to monitor activities throughout the night, as in flight control or cardiac or epilepsy monitoring, you need to find ways in which you can stay focused. Some people resort to coffee, others rely on software alerts that track frequency or activity changes, and others benefit from keeping company.

4. Avoid too much coffee: While some coffee may help you stay awake, too much coffee will give you tense energy and will "wire you." Many people who feel tense will try alcohol or hypnotics to sleep later, further contributing to this negative wake-sleep cycle. Try healthier alternative ways to stay awake and to sleep.

5. Stay healthy: Night shifts are hard on our circadian rhythm: although some people only work nights, many others work days with occasional night shifts. Schedule regular wake, break, and sleep times in as disciplined a routine as possible. Exercise daily and keep your meal routine at similar intervals and schedules. This will help you work either days or nights while staying alert, focused, and relaxed.

Gabriela Cora, MD, MBA. Dr. Gaby Cora is a leadership and well-being consultant to corporations in critical situations and to transitioning leaders of multi-million dollar family businesses. Some of her clients include the Coca-Cola Company, Pfizer Pharmaceuticals, Blue Bunny, Home Financing Center, and Universal Group. She's the author of ExecutiveHealth.com's Leading Under Pressure (Career Press, 2010).