Modafinil, caffeine, and Nicotine are pretty much the heavy hitters. I can't imagine you'd find much success with the others if those aren't working. As far as other stimulating Nootropics, Phenylpiracetam and Theacrine are worth a shot for sure. If you're attempting to push yourself past exhaustion and perform on little sleep nothing short of the really traditional stimulants are going to cut it. In that line you can look into 2-FMA. If Modafinil isn't working you can try Armodafinil, Flmodafinil, and Adrafinil.
If you want my personal opinion you're setting yourself up for serious burn out, but I understand you gotta do what you gotta do. The Modafinil and 2-FMA are great short term. One tip for Modafinil is take it a few hours before your last shift so it has time to wear off, it's something I would take at the beginning of your day, not at the end as its very long lasting. For the pressure and headaches be sure to stay hydrated, some people find taking a small amount of Choline helps. Nicotine patch is good short term, but as you noted the effectiveness wears off rather quickly and tolerance builds up fast. It's also too addicting to be regarded as a sustainable solution.
Optimizing whatever small amount of sleep you're getting is also a good idea. The problem with these more hardcore stimulants is you rack up a sleep debt very fast, and they may prevent you from falling asleep when you need to do so. Then you find yourself in a vicious habit of getting maybe only a few hours of sleep and taking stims to compensate.
Maybe try some 1P LSD and meditate on your future...lol. I'm kidding, but also not.
If you want my personal opinion you're setting yourself up for serious burn out, but I understand you gotta do what you gotta do. The Modafinil and 2-FMA are great short term. One tip for Modafinil is take it a few hours before your last shift so it has time to wear off, it's something I would take at the beginning of your day, not at the end as its very long lasting. For the pressure and headaches be sure to stay hydrated, some people find taking a small amount of Choline helps. Nicotine patch is good short term, but as you noted the effectiveness wears off rather quickly and tolerance builds up fast. It's also too addicting to be regarded as a sustainable solution.
Optimizing whatever small amount of sleep you're getting is also a good idea. The problem with these more hardcore stimulants is you rack up a sleep debt very fast, and they may prevent you from falling asleep when you need to do so. Then you find yourself in a vicious habit of getting maybe only a few hours of sleep and taking stims to compensate.
Maybe try some 1P LSD and meditate on your future...lol. I'm kidding, but also not.