Emergency room physicians in New York and New Jersey are offering a simple message to the millions of Americans dragging through their workdays: the fix for afternoon exhaustion isn’t more caffeine or a miracle supplement. It’s the basics, done consistently.
Three ER doctors described the habits that get them through demanding 12-hour shifts where lapses in focus aren’t an option.
Dr. John K. Riggins Jr., medical director of the emergency department at NewYork-Presbyterian Allen Hospital, said he avoids heavy or sugary meals that trigger a crash. “I think a plate with protein, a large quantity of vegetables and a small portion of carbs is ideal to get me through a long shift,” he said. He recommends prepping portable, high-protein snacks like Greek yogurt, hummus with crackers, or almonds ahead of time to cut down on decision fatigue and keep blood sugar steady.
Use Caffeine Carefully
Coffee has a near-religious following in New York, but the doctors warn against overdoing it. “Caffeine is a tool, not a strategy,” said Dr. Anand Ramnarine, chairperson of emergency medicine at Glen Cove Hospital, Northwell Health.
Dr. Alina Mitina, an emergency medicine doctor at Hackensack University Medical Center in New Jersey, said the goal is balance. “You want enough to keep you awake, focused and sharp, but not so much that your hands tremble when you need to do a procedure,” she said.
The FDA recommends healthy adults stay under 400 mg of caffeine a day, roughly four 8-ounce cups of coffee. Mitina suggests capping single doses at 200 mg, and for the afternoon slump, taking smaller amounts of 50 to 100 mg every few hours rather than reaching for an energy drink — an approach backed by research from the Harvard T.H. Chan School of Public Health. She also advises a firm caffeine cutoff at least six hours before bedtime.
Before pouring another cup, though, check your water intake. Mitina said much of the mid-afternoon crash people blame on low caffeine is actually dehydration, and recommends reaching for water first.
Take the 60-Second Reset
An hour-long break isn’t realistic during a busy shift — or a busy workday. Ramnarine said his ER relies on what they call the “Mindful Minute”: 60 seconds to pause, breathe, and reset between tasks. That might mean a walk to the water cooler, a few deep breaths, or a quiet moment in the hallway, which can interrupt the body’s stress response.
Riggins said managing stress before it builds up matters more than any single trick. “Sustaining your composure and stamina is 95% mindset and 5% everything else,” he said. He also recommends small moments of self-care throughout the day, like sitting quietly or sipping a hot drink.
Build Routines, Save Your Mental Energy
Constant decision-making wears down focus. Mitina said she handles that by putting small daily choices on autopilot. “Create routines for the small things, like what you eat, your favorite exercise or how you start your day, so you can save your mental energy for the decisions that actually matter,” she said. When work gets overwhelming, she suggests slowing down and tackling one priority at a time.
Riggins summed up the approach: “People often search for complex biohacks or magical supplements, but staying energized through a marathon shift really comes down to the basics: drinking enough water, eating real food and taking brief moments to catch your breath.”
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