A Nurse’s Guide to Navigating Night Shifts

When my children were small, I worked nights to be present for after-school pick-ups and read bedtime stories before heading out the door. Nursing and shift work functioned well with family life, and it saved paying excessive daycare costs. However, it also meant learning to stay awake and alert during night shifts and left me struggling to sleep during the day.

Approximately 11 million people work night shifts in the United States. Some love it, others hate it—but most feel conflicted.

Most nurses have trouble adjusting to disrupted sleep patterns. It often leads to poor eating habits and contributes to the development of obesity and type 2 diabetes. Yet, safe and sustainable healthcare largely depends on nurses. We need our jobs, and our patients need us.

Is balancing work and life on night shifts even possible? Can we prevent the seemingly inevitable consequences of working nights?

The answers are yes and yes! Many healthy lifestyle options and changes can help night shift nurses everywhere eat better, sleep soundly, and stay alert on the job.

6 Advantages of Working Night Shifts

Working the night shift has advantages—whether you have children or not. Indeed, some night-loving nurses regularly offer to swap shifts to the delight of their day-loving colleagues.

Here are six advantages of working the night shift in nursing:

1. You have more quiet time with fewer staff and visitors around.

2. You score bigger paychecks because of shift differentials.

3. You pay less for childcare if your partner can care for the kids at night.

4. You can bond with your colleagues over shared hardships.

5. You can do more errands during the day as places are less crowded.

6. You don't have to fight rush-hour traffic.

Establishing a Night Shift Routine for Nurses

While the advantages of working the night shift are enticing, the urge to sleep when it's dark outside is one of the most powerful forces on the planet. So, how do you keep from nodding off when you sit down to chart? It starts with developing a consistent routine that helps keep you alert and energized at night, with the best habits focusing on sleep quality, healthy eating, and adequate exercise.

Night Shift Sleep Strategies

Quality sleep is essential to our physical, mental, and emotional well-being. Insufficient sleep is associated with obesity, chronic illnesses, work errors, and poor decision-making.

Human bodies have an internal 24-hour clock called the circadian rhythm that uses light and dark for a daily reset. Your circadian pacemaker is highly sensitive to light in the morning and evening.

If you sleep at night, bright evening light causes you to get sleepy later and wake up later. On the flip side, if you sleep during the day, bright morning light causes you to get tired early in the evening and wake up earlier in the morning.

Night nurses are at maximum risk for sleepiness from sleep pressure and low circadian drive for wakefulness at the end of a shift. In other words, you're at higher risk for a car accident due to drowsy driving.

A study involving 57 healthy full-time nurses working rotating shift schedules found that interventions based on evening light exposure may be a feasible and effective strategy to reduce fatigue and errors in night shift workers.

Setting a sleep schedule and developing sleep strategies will help you structure your time and establish boundaries for your sleep hours. Here are some basic night shift sleep strategies:

• Resist the urge to look at your phone after completing your shift to calm your brain.

• Dodge as much bright morning light as possible to avoid signaling your circadian pacemaker.

• Eat before you leave work to give your food time to digest before bed.

• Hit the sheets when you get home and consider a melatonin supplement for better rest.

• Trick your body into thinking it's night by creating a sleep-friendly environment that's quiet and cool and uses blackout curtains to prevent light from entering the space. (Light can pass through your closed eyelids during sleep.)

Grabbing extra zzzz’s before a night shift will add extra hours into your sleep bank. Napping tips for nurses include avoiding scrolling on your phone, sleeping when you feel the urge instead of finishing your chores and drinking non-caffeinated beverages.

Good Nutrition for Night Shift Nurses

Nurses often struggle with obesity because they use eating as a stimulant to stay awake and alert. In addition, research shows that night eating causes higher blood sugars. In contrast, nurses who eat regular meals during the day are more apt to maintain their glucose levels within normal limits. So, it's best to stick to a daytime eating schedule.

Healthy eating choices for night shifts are vegetables, salads, and fruit. Foods high in sugar and empty carbohydrates only make you sleepier. You should eat meals during the daytime, not between midnight and 6 a.m. Smart snacking means eating small, healthy portions more frequently instead of one large meal at midnight. 

You should also drink water before and during your shift to stay hydrated. Limit caffeinated beverages to the beginning of your shift so you can sleep when you get home.

Adequate Exercise for Night Shift Nurses

Your busy shift shouldn't keep you from going to the gym or engaging in other forms of physical exercise. Research shows that 50% of nurses don't exercise regularly, despite knowing it helps reduce stress and prevent obesity. 

Incorporating physical activity into your daily life can be challenging because disrupting the circadian rhythm makes you feel tired before and after your shifts. However, look for exercise opportunities to integrate into your day, such as climbing stairs or walking outside on your break. Go in pairs if you're nervous about stepping out at night.

Fitness routines for nurses should include stretching and cardiovascular fitness routines, such as running, skipping, and swimming. Guidelines for physical activity suggest that adults participate in 150 minutes of physical exercise per week.

Stress Management for Night Shift Work

Working night shifts demands resiliency, but anyone can experience burnout if they don’t care for their physical and mental health. Therefore, finding ways to manage your stress levels and preventing mental overload is essential.

Stress-reduction techniques differ depending on your personality and your likes and dislikes. You might deal with your stress by sitting on the beach and reading a book while someone else climbs a mountain. Enjoying the outdoors and exercising is an excellent stress-relieving combination.

It's also easy to become isolated when you work a lot of nights. Maintaining social connections is another way to help keep your stress at bay. You must intentionally balance your social life with night shifts since most of your non-nursing friends socialize during the evenings and on weekends. Why not book several evenings a month to spend with them?

Communicating with loved ones must also be intentional on your part. Many family members assume you work most nights and will leave it up to you to contact them. Staying connected is part of staying mentally and emotionally healthy.

5 Shift Rotation Tips

Current staffing shortages can pressure you into taking on more shifts than you want or feel you can safely work. Switching from days to nights can be difficult if you don't have recovery days built into your week. Not to mention, the circadian rhythm resists abrupt changes caused by shift work.

While some believe rotating schedules aren’t safe or healthy, it’s a common practice that’s not going away anytime soon. Remember that only you can advocate for yourself in choosing a healthy amount of work.

Here are some shift rotation tips:

1. Establish a separate routine for your day and night shifts and stick to them.

2. Take as much time off as you can between shift rotations to adjust to a flip schedule better. (Your circadian rhythm needs time to adjust to new sleep times.)

3. Consider working with ShiftMed if you don't have control over your schedule. Our nursing jobs app lets you work when, where, and how often you want.

4. Meal prep nutritious food and stock up on healthy snacks ahead of time.

5. Take breaks no matter how busy you are, and leave everything at the bedside.

Conclusion

For many nurses, the demands of shift work are not just a job requirement but also a carefully crafted balancing act between career and family life. While the extra income and flexibility that come with working non-traditional hours can be a lifesaver for those with young children, it's not without its challenges.

Night shifts can take a toll on your physical and mental well-being if you're not careful, and it's incredibly challenging to get quality sleep during the day when the world is bustling outside your window. But with the right strategy and discipline, staying awake and alert during the dark hours of the night is totally possible.

However, if you're literally and figuratively tired of working night shifts, download the ShiftMed app to start working days on your terms.

Alice Blackmore, MN, RN, Content Writer

Alice is a registered nurse and healthcare writer. She has more than 20 years of nursing experience, which ranges from labor and delivery to long-term care, with pediatrics, community nursing, and critical care sandwiched in the middle.