Tips for Night Shift Nursing

Shift work generally refers to “any work schedule that falls outside the hours of 7 a.m. and 6 p.m.,” according to the Sleep Foundation. A 2019 report from the U.S. Bureau of Labor Statistics (BLS) revealed that roughly 16% of U.S. employees work some form of shift work, including 4% who work the night shift (11 p.m. or later).

The night shift is particularly prevalent in healthcare, a reflection of the need to provide 24/7 medical care to patients. Since nurses are primary care providers for many patients—most notably in areas with a shortage of physicians—it’s especially crucial for them to work the night shift.

Night shift nursing can be challenging and pose potential health hazards. The nontraditional hours may disrupt the body’s natural circadian rhythm (sleep-wake cycle), a disruption that can lead to other negative health impacts such as:

• Sleep deprivation and fatigue
• Mood alteration
• Poor dietary habits
• Diabetes
• Cardiovascular disease, including heart attack and stroke

Nurses can employ different strategies to manage the risks and rigors of night shift work from practicing self-care to healthy eating habits. If nurses mitigate or avoid the potentially adverse health impacts of this type of work, the night shift can have many advantages.

What Do Night Shift Nurses Do?

Night shift work in the healthcare industry ensures continuity of care. As the nation’s largest healthcare profession—with more than 4 million employed across the country, according to the BLS—nurses are pivotal to providing round-the-clock patient care.

Nurses of every position work the night shift from nursing assistants to nurse practitioners. Night shift nurses work in any healthcare setting where patients remain overnight, including hospitals, nursing homes, and long-term care facilities.

The responsibilities of nurses on the night shift are dependent on the specific setting in which they work but aren’t all that different from the responsibilities of nurses on the day shift. Their job description entails:

• Providing and coordinating patient care
• Performing diagnostic tests
• Administering medication
• Operating and monitoring medical equipment

While a nurse’s fundamental duties are virtually identical regardless of shift, the way that they’re performed may vary. For example, nurses sometimes spend more quality time with patients during the night shift than during the day, when they may have many different responsibilities besides direct patient care.

As in other nursing roles, work hours for a nurse on the night shift can vary from 8 hours to 10 to 12 hours. A typical night shift may begin anywhere from 7 p.m. to 11 p.m., depending on the shift length. Nurses who work longer shifts often have a three- to four-day workweek.

A primary difference between night shift nursing and other nursing shifts is that the pace tends to be slower and the environment a bit quieter. Physicians generally perform tests and procedures during the day, and patients usually rest at night. This often allows nurses to execute their duties with minimal disruption, making the night shift an ideal option for nurses just starting their careers.

Night Shift vs. Day Shift Nursing

Those exploring a career in nursing should weigh the advantages and disadvantages of working night shift vs. day shift nursing. Some people are better suited to one or the other, while others may like the variety of working both shifts. Determining which one is the right choice often depends on an individual’s lifestyle, work setting, and career goals.

Day Shift Nursing Pros

Day shift nursing can offer numerous benefits, including normal sleep habits and skill development.

More Traditional Schedule

Day shift hours align more closely with the body’s natural sleep cycle. Nurses who work during the day generally don’t have to adjust their sleep-wake habits to accommodate this schedule. As a result, nurses on the day shift may feel more rested and energized to do their job.

Quicker Pace

Because an increased number of tests, procedures, and other patient-centered responsibilities are conducted during the day, day shift nurses generally experience a more lively work environment than their colleagues on the night shift. They often have more tasks to complete during the course of their shift that makes time pass quickly.

Learning Opportunities

Day shift nurses typically work alongside a more diverse group of medical professionals, such as doctors and surgeons, giving them the opportunity to learn about different aspects of healthcare. By observing and working with physicians and other important medical staff, nurses can learn skills related to making diagnoses and improving bedside manner.

Day Shift Nursing Cons

Although working the day shift has its benefits, it also has some potential downsides.

Extremely Busy

While the dynamic nature of day shift nursing offers a quicker pace and greater learning opportunities, it may create more stress for nurses. Those on the day shift often are pulled in different directions, striving to accomplish a range of tasks for their patients and supervisors. This can be challenging, particularly for less experienced nurses.

More Disruptions

Day shift nurses are more susceptible to distractions and interruptions. Patients, supervisors, and peers often place greater demands on their time; this sometimes makes it difficult to get things done quickly.

Less Quality Time with Patients

Nurses generally have more direct contact with patients during the day than at night, when many are sleeping. However, the nature of these interactions may be less than ideal due to the fast-paced nature of day shift work, making it challenging for them to get to know patients.

Night Shift Nursing Pros

Night shift nursing offers many potential advantages.

Slower Pace

Though there’s generally more activity during the day, that doesn’t mean nurses have less to do at night. Night shift nurses often enjoy a quieter work environment, with fewer distractions and interruptions; this can make it easier for them to accomplish tasks in a timely fashion and allow more time for things like examining patient charts.

The night shift can be well suited for new nurses—who are typically assigned night shifts and rotating shifts as a consequence of seniority—because there’s more time to learn and get the hang of the job.

Higher Pay

Because of the nonstandard hours, many organizations compensate nurses who work the night shift at a higher rate than day shift nurses. According to the BLS, nearly 15% of U.S. employees in any occupation who worked the night shift cited “better pay” as the main reason for choosing it.

Increased Camaraderie

Nurses on the night shift tend to have more time to get to know their co-workers. This can create a positive work environment and improve morale, leading to greater job satisfaction. It can also enhance teamwork, which helps nurses do their job more efficiently.

Night Shift Nursing Cons

Although it can have many benefits, working the night shift can have drawbacks as well.

Unusual Schedule

A night shift schedule requires nurses to work unconventional hours, which can make it difficult to maintain an ideal work-life balance. It can interfere with their ability to engage in social activities with family and friends or even run errands.

Impaired Sleep

Working the night shift can disrupt the body’s natural sleep-wake cycle. This can lead to insomnia, fatigue, and other chronic conditions such as shift work disorder. These issues can, in turn, contribute to other adverse health impacts, which may ultimately impact a nurse’s job performance and the ability to provide quality care to patients.

Tips for Working the Night Shift As a Nurse

Working the night shift can present challenges, especially for inexperienced nurses who are new to shift work. One of the primary concerns associated with night shift nursing is that it can interfere with the body’s circadian rhythm.

The circadian rhythm is linked to the body’s sleep-wake cycle. In addition to sleep, it plays a role in regulating other important biological processes, such as heart rate, digestion, and body temperature. Environmental cues, particularly light, may influence the circadian rhythm; that’s why it’s closely tied to the cycle of day and night.

Shift workers risk disrupting this natural cycle, potentially leading to various health problems. One of the more prominent conditions associated with the night shift is shift work disorder: a circadian rhythm sleep disorder that causes insomnia and/or excessive daytime sleepiness. This can impair a nurse’s judgment and cognitive functioning and lead to errors, as well as negatively impact mood.

Night shift work and the toll it takes on a nurse’s physical and mental health also can contribute to burnout, a common problem for nurses that the COVID-19 pandemic has further exacerbated. A survey by Mental Health America revealed that 76% of healthcare workers reported feelings of exhaustion and burnout during the pandemic.

Nurses can follow many different strategies and tips for working the night shift to counteract these potential risks.

Develop Healthy Sleep Habits

Much of the time, night shift nurses have to sleep while the sun is up, which can be challenging. Maintaining a consistent sleep routine and going to bed at the same time each day—even on days they don’t work—can help nurses adjust to an atypical sleep cycle and ensure that they get enough rest.

Additionally, nurses can adopt several habits that contribute to healthy sleep hygiene, including the following:

• Use a sleep mask or blackout curtains to block natural light.
• Take a warm shower before bed.
• Meditate.
• Use earplugs or a white noise machine to muffle disruptive sounds.

Short naps taken during breaks over the course of a long night shift (10+ hours) also can help ensure that nurses are well rested for work.

Make Time for Family and Friends

Night shift nursing also can negatively impact the work-life balance, as it requires nurses to work while the rest of the world is sleeping and rest during the day when everyone else is awake. This may prevent nurses from attending important life events and engaging in social activities with family and friends. By scheduling quality time with loved ones on their days off, nurses can ensure that they’re not sacrificing their social life for work

If possible, nurses may be able to group longer night shifts together—working three 12-hour days in a row, for example—to allow for longer periods of time off to spend time with family and friends.

Support for Night Shift Nurses

Healthcare organizations play an important role in supporting nurses who work night shifts. In addition to the toll they can take on nurses’ physical and mental health, irregular scheduling and overly long shifts are associated with an increased risk of patient care errors.

To address these issues, organizations can employ several strategies to create a healthy and safe working environment for night shift nurses:

• Improve the design of work schedules to avoid long (12-hour) shifts and inadequate time off between shifts.
• Provide nurses with a consistent, predictable schedule, allowing them to plan ahead for sleep and nonwork activities and responsibilities.
• Allow nurses to have some control over their own schedule; this can help them better adjust to night shift work.
• Encourage breaks during shifts, and promote naps for those working shifts longer than eight hours.
• Conduct periodic assessments to examine the impact of work schedules on staff well-being and performance.

How to Work the Night Shift and Stay Healthy

Night shift work poses a risk to other aspects of a nurse’s health and well-being. Altered circadian rhythms caused by night shift nursing can change eating patterns and nutrient content, potentially negatively impacting health. Lack of sleep, along with the inherent rigors of the job, can lead to fatigue and take a toll on a nurse’s mental and emotional health.

Nurses can counteract these issues and learn how to work the night shift and stay healthy by employing a few simple strategies.

Nutrition for Nurses

Working the night shift can influence a nurse’s food choices and eating patterns, while changes to the circadian rhythm can impact various biological processes related to nutrition and metabolism. Consequently, night shift work is linked to various dietary health issues, such as obesity, diabetes, and heart disease.

A few simple tips can help improve nutrition for nurses and mitigate some of the potentially negative health effects of working the night shift.

Eat Lighter and Smaller

Nurses should eat lighter, healthier meals and snacks—such as fruits and vegetables, nuts, eggs, and salads—to boost their energy during the work shift. Foods that are high in fat or have lots of sugar and carbohydrates can cause fatigue and lead to energy swings that make night shift work more challenging.

Preparing a grocery list focused on low-fat, low-sugar foods and preparing meals at the beginning of the workweek can make it easier for nurses to practice healthier eating habits. Having meals at the ready can make the time just before a shift more relaxing and reduce the likelihood that they’ll buy food from vending machines or hospital cafeterias—where the food tends to be less healthy.

Develop Healthy Eating Patterns

Almost as important as what nurses eat is when they eat. Ideally, nurses should eat their main meal before going to work. A 2019 study found that eating a large meal during the night shift increased sleepiness and contributed to diminished cognitive performance.

Stay Hydrated

Drinking water is always good advice, but especially for nurses working the night shift. Staying hydrated can reduce headaches and fatigue and improve mental alertness.

Avoid Too Much Caffeine

Consuming moderate amounts of caffeine can improve alertness and psychomotor performance, important qualities in a healthcare setting. However, caffeine can disrupt sleep, reducing its efficiency and duration. Nurses can have caffeine but should consume it judiciously.

Self-Care for Nurses

Self-care for nurses helps improve mental and emotional health, as well as contribute to better physical health.

Exercise

Regular exercise, whether by working out at a gym or simply taking a walk, can help nurses sleep better, reduce stress, and enhance mental clarity. Exercise also can counterbalance poor dietary choices if night shift nurses are struggling to maintain healthy eating habits.

Mindfulness

Practicing mindfulness and meditation techniques, particularly as part of a before bed routine, can help nurses reduce stress and get better sleep.

Bond with Co-Workers

Because they have more time to get to know each other, nurses working the night shift together often have an increased sense of camaraderie. These close relationships can help ease stress and improve morale, potentially benefiting job performance and patient outcomes.

Providing Round-the-Clock Nursing Care

Night shift nursing is crucial to ensure the continuity of patient care. Although night shift work can be challenging—posing potential risks to nurses’ physical, mental, and emotional health—many strategies exist to help nurses manage these issues. By using these strategies, and with proper support from leadership at their organizations, nurses may find that the night shift suits them.

An advanced degree in nursing, such as Norwich University’s Master of Science in Nursing program, can prepare students to work any kind of nursing shift and help them develop the necessary skills to support other nurses.