Night Shift - What You Didn't Learn in Nursing School

Nurses generally start their careers working night shift. Some stay forever and others move to day shift as soon as possible. Let's take a look at what you didn't learn in nursing school about working the night shift.

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Night Shift - What You Didn't Learn in Nursing School

 “We hope you’ll be able to make it to the birthday party Saturday. I know you work Saturday nights, but it’s at 2 pm, so you’ll have plenty of time before your shift starts. Hope to see you then!”

“Sorry, but I also work Friday nights, so 2 pm will be right in the middle of my time in between shifts.”

“Yeah, but you get off Saturday morning and then don’t have to be back to work until Saturday night, right? So you have ALL day off.”

“Yeah! I’ll be sleeping during that time! When do you think night shift nurses sleep?”

When do people think night shift nurses sleep? Do you ever run into this above scenario with friends and family? Working night shift for the last 15+ years, I’ve heard it all. People expect you to attend birthday parties, holiday parties, dinners with family, and other events. Even after explaining that you have to sleep, it’s hard for them to comprehend. Yet, if you schedule lunch at 2 in the morning, it would appall them. “BUT, I’ll be sleeping!” Exactly!

The night shift: Why do we do it? The night shift is often the first shift most of us work as a new grad. But, some of us stay on it for years. Why? There are bad and good (yes, even good things about nights!) aspects to consider.

Bad news first (the cons):

Strain on family/relationships

This can be a challenge, especially when you work nights for the first time. It’s especially difficult if you have a partner and family/friends that have never worked nights themselves. Going back to the above scenario, they will expect you to be at functions, without considering your sleep. They will have a hard time empathizing. They rarely do it to be mean, it’s just a genuine lack of understanding on their part. Be upfront with them and explain it. Protect your sleep! Communicate with them you are unavailable at certain times, and there is no compromise; be consistent with this.

If everyone else in your household is on a day schedule, then working nights will limit your time together. You’re sleeping while they are working, and they’re sleeping while you are working. It can be a bummer and feel lonely. Working as a nurse, however, gives us the advantage of working three shifts per week. Enjoy those days off with your partner and family/friends. Go out during the day and live those days off like you’re a normal day person. Enjoy the sunshine with your loved ones, but don't forget your sunglasses, it's a bright world out there for night shift workers!

Quality of Sleep

Let’s face it, sleeping when the sun is up isn't natural, so our quality of sleep may suffer (you know, circadian rhythm and all). Also, dealing with bright light and noise are things that work against us while trying to sleep during the day. However, there are some measures that we can take to improve these things. I highly recommend investing in good blackout curtains, or at the very least, a sleep mask. Try to minimize as much noise as you can by not scheduling service people during your stretch of shifts, sending the kids to daycare, and reminding your family not to disturb you while you’re sleeping. That’s not always possible, so get a pair of earbuds or better yet, a good sound machine with white noise. Set your phone to “do not disturb” (you can allow calls from certain numbers even when in this mode - outstanding feature!). Again, protect your sleep!

Downtime

Sitting around watching movies, playing cards, reading books while eating junk food. Wait, what? No, not that downtime. I’m not talking about the downtime that some people think we have on the night shift since all the patients are sleeping all night - ha! In this case, I'm referring to downtime scheduled for upgrades or maintenance. Another part of the night shift is dealing with the downtime procedures for the EMR, phones, plumbing, power, generator re-load tests. Thankfully, these aren’t too common, but still another thing that just makes your shift that much more challenging during these times. 

Health

Working nights can be especially bad for our health. There are many times we feel tired, exhausted, rundown, sick, or drained. Studies have shown that night shift workers are at higher risk of illness. The lack of adequate sleep contributes to our weakened immune system, which makes us more vulnerable to getting sick. This makes it even more crucial to take care of our health. Eating healthy, taking vitamins, drinking water, and prioritizing sleep - these are all more important than ever.

The good news (the pros):

Shift differential

Nurses tend to start on nights, that’s just the reality of starting a new nursing job. But why do so many of us continue to work nights, even if we have been able to move to day shift for years? MONEY! Yep, it’s all about the money. At least for some. Differentials vary, but I’ve seen them range from 10 to 20% (18% for most of my night shift career). There may be a night shift differential equal to an entire shift per pay period. I knew experienced nurses that worked nights part-time, rather than going to days full-time.

Less administration

This pro is up there with the increase in pay; two major advantages to working at night, more money and less management. Who wants to have to deal with all the suits and upper management? “Hide your coffee and put away all your snacks. The suits are here!!” Yeah, no thank you! 

Camaraderie

During the night, there aren’t as many resources available. You don’t have as many supervisors or support to help when the crap hits the fan, so to speak. Therefore, you work well with your night shift co-workers. Since you have fewer resources, you check in with each other and help when needed. You form a strong bond with your fellow nurses working alongside you.

It’s Quiet(er)

Ah, not the “Q” word! It's not "quiet" in the sense that nothing is happening. We all know the patients and families keep us on our toes throughout the night. But, just like there is less administration on nights, there are just fewer people in general. At night you won’t find all the support staff, resident physicians, students, extended family members, and anyone else that you’ll find during the daytime. I’ve had plenty of parents tell me they enjoy staying with their baby at night because it’s quieter and has a better “feel” that they can’t quite describe.

As we can see, there are advantages and disadvantages to working nights. I’ve known new grads that jump to days as soon as they can. On the other hand, I’ve known seasoned nurses that have worked their entire careers (think 40+ years!) on nights, and you couldn’t pay them enough to work days. Either way, I highly recommend finding support among your fellow night shifters; coworkers, friends, and family that also work these hours. These will be the people that understand your odd schedule. They’ll be the ones that can relate to you wanting to go get a burger and fries at 8 in the morning. Find your tribe.

How is the night shift going for you? Will you move to days as soon as it’s available? Or are you a long-time night shifter?

References:

More influenza-like and respiratory complaints in night shift workers in hospitals

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Nurse Writing Nook

About Nurse Writing Nook, BSN, RN

Registered Nurse and freelance health writer. I've worked night shift in the NICU for 15+ years at an inner city hospital.

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Specializes in Medical-Surgical.

I remember when I worked nights. The admins always call midday and expect a return call during working hours. They knew that I worked the night shift. Such a pain. When I applied for my masters, I thought it was a circus when they "try to accommodate" by reiterating a regular business hours schedule to me. 

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Specializes in NICU (neonatal).
3 hours ago, Blatant Shannon said:

I remember when I worked nights. The admins always call midday and expect a return call during working hours. They knew that I worked the night shift. Such a pain. When I applied for my masters, I thought it was a circus when they "try to accommodate" by reiterating a regular business hours schedule to me. 

Yes! Many times I'd wake up in the afternoon with missed calls/texts from work.

How did the  masters program try to accommodate your schedule? Did they actually try or was it just their attempt to make themselves feel better?

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I am struggling with the decision to leave nights. I have a love/hate relationship with nights and my schedule. One of my biggest struggles is I work weekend program so it is hard to reconnect with friends/family who work during the week. I could come off weekend program but then I will not be guaranteed 3 days on and 4 days off. 

I'd love to move towards a PM shift however at this time the only department that offers it is the ED or Urgent Care. Both departments require 1 - 2 years experience.

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Specializes in NICU (neonatal).
1 hour ago, TippyTappyMeow said:

I am struggling with the decision to leave nights. I have a love/hate relationship with nights and my schedule. One of my biggest struggles is I work weekend program so it is hard to reconnect with friends/family who work during the week. I could come off weekend program but then I will not be guaranteed 3 days on and 4 days off. 

I'd love to move towards a PM shift however at this time the only department that offers it is the ED or Urgent Care. Both departments require 1 - 2 years experience.

Do the other night shifters during the week not typically work their 3 in a row? We never had guaranteed schedules either, but they would try to keep the shift together for us if that's what we wanted. And luckily I worked with coworkers that would help out with trades if needed.

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12 hours ago, Nurse Writing Nook said:

Do the other night shifters during the week not typically work their 3 in a row? We never had guaranteed schedules either, but they would try to keep the shift together for us if that's what we wanted. And luckily I worked with coworkers that would help out with trades if needed.

To be honest I'd have start paying attention to their schedules more. I try to stay out of the scheduling drama unless someone needs a switch. It does seem like if nurses like to work 3 on they get it. The conflicting information may be if they get the 3 days they requested. I know our pay periods always are a source of frustration since it isn't a traditional Sun-Sat. Lastly, I'd say the staff who rotate between days/nights seem to have the most complaints. 

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Specializes in NICU (neonatal).
2 hours ago, TippyTappyMeow said:

To be honest I'd have start paying attention to their schedules more. I try to stay out of the scheduling drama unless someone needs a switch. It does seem like if nurses like to work 3 on they get it. The conflicting information may be if they get the 3 days they requested. I know our pay periods always are a source of frustration since it isn't a traditional Sun-Sat. Lastly, I'd say the staff who rotate between days/nights seem to have the most complaints. 

The rotating day/night shifts sounds terrible! I'd be a total mess ?

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
7 hours ago, TippyTappyMeow said:

. Lastly, I'd say the staff who rotate between days/nights seem to have the most complaints. 

Why are they doing this? This would never work for me.

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I worked evenings and nights .I'm retired now, about 10 years, and my sleep schedule is still messed up. I'm awake all night and sleep/ nap during the day . I wouldn't recommend staying with the night shift for an extended time . your going to retire or get another job someday. 

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Specializes in NICU (neonatal).
19 hours ago, SmilingBluEyes said:

Why are they doing this? This would never work for me.

Same. That would be so terrible for your internal body clock. I'd be sick all the time!

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Specializes in NICU (neonatal).
2 hours ago, LPN Retired said:

I worked evenings and nights .I'm retired now, about 10 years, and my sleep schedule is still messed up. I'm awake all night and sleep/ nap during the day . I wouldn't recommend staying with the night shift for an extended time . your going to retire or get another job someday. 

Interesting! Even after 10 years. Have you tried switching it around and it just doesn't work?

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On 7/28/2021 at 1:21 PM, Nurse Writing Nook said:

The rotating day/night shifts sounds terrible! I'd be a total mess ?

I was hired for a Day/Night position.  I thought it over and figured out that it sounded tremendously hard.  So I talked to the boss, who offered me what turned out to be a great thing - straight 3 pm-11 pm.  That turned out to be the most natural for me.  Didn't need an alarm clock.  Did my shopping, cleaning, gym, etc. when I woke naturally around 0900, got ready for work around 1300, left about 1415, worked my shift, rinse, repeat.

Evening shift is not good once your kids are older, busy with sports and other school activities.  You miss so much when they are older and you find it necessary to work either Days (perish the thought) or Nights so you can share life with them.

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