Career Pathways & Education

Night Shift Nurses: Sickness Doesn't Sleep

Sarah Gray, RN
February 5, 2019
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Nurses are no strangers to becoming creatures of the night, whether we like it or not.

While some of us are lucky to have control over our shift preference, scheduling and requirements can really vary — even unit to unit. It comes with the territory, just as working holidays and weekends does. But the repercussions of working night shift extend far beyond missing Christmas or sleeping in on Sunday.

The toll it takes on the circadian rhythm alone is taxing. On top of that, the lack of resources, patient and family demands, effects on personal relationships, and the need to remain alert and attentive given the unpredictable nature of sickness, night shifts can be costly. And some nurses will tell you, not always worth the extra money.

Especially when it comes at the price of what money can’t buy.

Night Shift Nursing

There is no shortage of research relating to the relationship between night shift and poor health outcomes. Sleep disorders are the obvious and expected. But more seriously, risk for cardiovascular disease, depression, obesity, and breast cancer are just some others that increase with night-shift work.

Nurses risk their own health for the health of their patients.

Does it have to be this way?

Not if nurses have something to do with it!

Humans are not meant to be nocturnal, no matter how many napping hours are squeezed in before a night shift. Nurses are no exception.

There comes a time, typically between 2am–4am when the body needs reprieve. Concentration is blurred. Thinking is slowed. And when coupled with a lack of stimulation, delirium sets in.

Most night shift nurses achieve some form of a nap on their break, if they’re lucky enough to get a break. Due to the taboo and lack of support of this practice, it typically results in make-shift beds, sleeping on floors, in cars, or in a break room littered with light and noise.

Nurses can only endure so much before they become advocates for themselves. When nurses don’t get what they need to deliver the highest quality and safest care for their patients, they take matters into their own hands.

dark hospital hallway at night night shift nursing shifts

Night Shifts and the Napping Pilot Project

Nurses researchers implemented a napping pilot project. Napping protocols were carried out and analyzed over a period of 3 months. With the average nap lasting just 31 minutes, nurses reported in 52.6% of cases feeling “alert and refreshed” and scored the naps an average of 7.3/10 on a scale of helpfulness.

Based on the results this pilot project has lead to an ongoing (3 years) hospital-wide implementation and a revised HR policy. There continues to be more research being done around night shifts and napping in a variety of medical work environments. And it’s nurses that keep moving the needle, not management or administration. In the pilot project, nurse managers of three of the four units not included “declined to participate before presenting it to the staff or attempting implementation.”

Nurses need to continue taking matters into their own hands to bring the science to the bedside.

With all that being said, some nurses prefer night shift. And the negative aspects and obvious need for change don’t leave the experience without insight. Nurses always find the silver lining. Straight from the horses’ mouths.

What You Learn Working Night Shifts (Beyond What Sheer Delusion Feels Like)

  • 3am is extremely peaceful. And also the longest hour of all time.
  • Your GI system is definitely not nocturnal…
  • …but a lot of patients are.
  • You can survive on a lot less sleep than you think.
  • 4 nights off is not nearly the same as 4 days off.
  • You can, in fact, develop some form of night vision.
  • And master silent breathing.
  • Quality sunglasses and blackout curtains are priceless. And there’s a real science to utilizing them (and mimicking night time).
  • DWT(ired) should be taken just as seriously as DWI.
  • Taking a child’s vitals without waking them can make you feel superhuman.
  • You gain encyclopedic knowledge of every breakfast spot nearby.
  • The only way to sleep is semi-dehydrated… once you’re up at noon to pee there is no more hope for deep sleep.

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