The Night Shift Nursing Guide: How to Survive Working Off-Hours

When starting out on the night shift, you might be nervous about staying alert and maintaining your ability to provide quality care. After all, no matter the hour, nurses must be reliable in administering medication accurately, monitoring patients’ conditions, and responding quickly in urgent situations. Taking the time to intentionally make changes in your life to adjust to working overnight shifts can help ease your transition. Whether you’re a seasoned nurse making a career change, a brand-new nurse just starting the night shift, or a nursing student on clinical rotations, we’ve put together our best tips for adapting to working overnight hours.

The Big 5: Night Shift Nurse Must-Dos

Even if you consider yourself a natural night owl, working through the night can be a challenge. A typical night shift for nurses starts at 11 pm and ends at 7 am, though some facilities schedule nurses in 12-hour shifts. According to the Bureau of Labor Statistics, approximately 16% of full-time workers are employed during non-daytime schedules. Working during nontraditional hours can negatively affect your sleep, concentration, and mood, so it’s important to prepare for the change. Below are five must-do actions for all nurses and nursing students who have visions of night shift success.

1. Get Quality Sleep

For nurses: Finding ways to get adequate rest is one of the primary challenges of working the night shift. Though it can be hard to sleep when the rest of the world is awake, aim for six to eight hours of sleep each day, and try not to stay up for the 12-hour stretch immediately before your shift. Lack of sleep can cause chronic health problems and impair cognitive function, potentially affecting both you and the patients under your care.

For nursing students: Since clinicals only last for a short period of time, it’s unlikely that you’d need to adjust your regular sleeping and waking cycles. However, you should still rest as much as possible during the day before a night shift, so you don’t start the night already tired.

Need help with sleep? Try these out:

• Find a happy place. Daylight streaming in through curtains, conversations in other parts of your home, or someone mowing the lawn next door can be distracting. Create optimal sleep conditions with a sleep mask or blackout curtains to keep the room dark, a white noise machine and ear plugs to block out unwanted noise, and turning off your phone to minimize interruptions.
  
• Master a “wind down”. Take a hot bath or shower, read, meditate to release stress, or stretch to find presence in your body. Some nurses enjoy journaling to clear their minds. Over time and with enough practice, performing these activities will begin to signal your body that it’s almost time to head to bed.
  
• Get a better rhythm. While it can be tempting to return to a more normal schedule on your days off to be with family and friends, it’s best to keep your regular night shift schedule as much as possible. Consistent sleeping and waking cycles help your circadian rhythm fully adjust to night shift life, making it much easier to stay awake and feel rested when you’re on shift.
  
• Take a nap. If you’re not able to get as much sleep as you’d like during the day, try naps for an energy boost. Some employers even allow nurses to take nap breaks while on shift. As long as it doesn’t interfere with your longer sleep schedule or leave you feeling groggy or disoriented, naps can be a good option for feeling refreshed in a shorter amount of time when you’re working nights.

2. Eat a Balanced Diet & Hydrate

For Nurses: Many people crave sugary snacks and beverages when they’re sleepy, however it’s best to resist the temptation to reach for junk food when you’re on a late shift. A high carb intake can leave you feeling sluggish; balanced meals and snacks give you energy that will last through the entire night. Dehydration can also leave you feeling overly tired, so be sure to drink plenty of water during your shift.

For Nursing Students: Dietary choices have the power to increase your energy levels and positively affect your mood while on shift. While typically you might grab something on the go, keep in mind that the cafeteria might not be open overnight at the facility you’ve been assigned to. Come prepared with healthy snacks like fruit, vegetables, or nuts so you can skip the vending machine snacks.

3. Watch Caffeine Intake

For Nurses: Caffeinated beverages can help you wake up or give a much-needed boost of energy when you’re lagging during a shift. However, it’s a temporary fix, and too much caffeine could result in shakiness or anxiety. Not to mention, if you drink caffeine during the last few hours of your shift, you might have trouble sleeping once you get home. While a cup or two of coffee is fine, opt for water for the remainder of your shift.

For Nursing Students: For many students and night shift workers, caffeine is a go-to solution for surviving off-hours work. While there are short-term benefits to gaining a caffeine boost, ingesting excessive amounts can cause headaches, racing heart rate, and trouble sleeping once you’re done with your shift. Limiting caffeine to a couple of cups of coffee helps avoid the downsides of over-caffeination.

4. Stay Alert & Engaged at Work

For Nurses: During quieter times of the night and lulls in activity, staying awake can be more challenging. Engage your mind through conversation with coworkers in between your other duties, or consider taking care of paperwork to ease the workload for the day shift. If your facility allows nurses to nap during breaks, for some people a short rest can help you focus once you’re back on the floor.

For Nursing Students: If you’re attending classes during the day and clinical rotations at night, the extra work can leave you low on energy. While you might struggle to keep awake on night shifts, it’s essential to stay alert. Grogginess increases the chances of delayed thinking or making mistakes; being able to act with care is critical to both learning and meeting patients’ needs. Conversation, quick exercises, or taking a walk during downtime can keep your mind and body engaged while on shift.

5. Exercise

For Nurses: Sitting behind the nursing desk during the quiet hours of the night might make your eyelids feel heavy, but elevating your heart rate with simple exercises helps you stay more alert while you’re on shift. Try climbing a flight of stairs, briskly walking a couple of laps around your unit, or squeezing in a few sets of squats. If you have time for a break, getting outside and doing some stretches in the fresh air can remedy drowsiness.

For Nursing Students: Exercise may fall to the bottom of the priority list when factoring in studying, doing clinicals, working nights, and all of life’s other responsibilities. Studies show that the right kinds of exercise can increase your strength and stamina that are needed to do your job. Even just 30 mins a few times per week can have a huge benefit and help you build a habit that can help you for the entirety of your life and career.

Five Should-Dos for Night Shift Nurses

Sleep, diet, and exercise are three pillars of night shift survival. They’re absolute musts. But what else could you do to make those off-hour rotations even easier? What could you make part of your routine when you’re clocking in at 8pm and clocking out after sunrise? Check out these 5 should dos when on rotation late.

1. Bond with Your Coworkers

Fewer people staff overnight shifts, so the ones who are on duty have to be resourceful and rely on each other to make it through the night. Many nurses find that bonding with their coworkers fosters an amazing sense of team spirit that boosts morale and fights off the feelings of isolation that can happen with night shift work. Coworkers can look out for each other if they’re feeling sleepy, and seasoned veterans can offer newcomers their best tips for staying wide awake.

2. Wear Bright Scrubs

A creative way to combat drowsiness on the job is with your choice of attire. Colors can affect your mood; gray is considered calming, and orange is considered energetic. Choosing brightly colored scrubs with fun patterns engages and stimulates your brain, sending a subtle message that it’s time to be awake. As a bonus, your coworkers might also benefit from your colorful attire.

3. Create Your Own Unique Family Life or Routine

One household member joining the night shift can mean the whole family must make adjustments. Whether you have a partner, children, or roommates, helping others understand the changes in your routine can get everyone on board as you switch to working nights. Find a new time to connect with your family, such as during dinner before your shift or breakfast the morning after.

4. Get Home Safe

Once you make it through each night, you may be exhausted and ready to get some rest. But you’ll still need to make it home safely, and driving while you’re exhausted can be dangerous. If you don’t feel like you can safely drive yourself home after a shift, opt for public transportation, use a ride sharing service, or ask someone to pick you up. Carpooling with a coworker can be helpful because you can converse during the ride home to make sure you both stay alert.

5. Stay on Top of Your Health

Night shift workers are at greater risk for adverse health conditions like cancer, heart disease, and stroke. Maintaining good nutrition, regular sleep routines, and positive mental health practices can ensure that you are at a lower risk for these conditions. And while you’ll be active on shift and may incorporate small exercises into your nights, a regular exercise schedule can increase your energy and keep you in top shape.

Extra Credit: Night Shift Tips for Nursing Students

Even if your goal once you are out of school is to work the day shift, as a nursing student you may be assigned to the night shift for clinical rotations. While you might be used to pulling all-night study sessions to prepare for an exam, working throughout the night can be more demanding than you’re accustomed to. Fortunately, there are some things you can do to complete after-hours clinicals while minimizing negative effects. Check out our tips for surviving clinical night shifts while in nursing school.

Allow Yourself Time to Adjust

For a while, being tired will be normal — getting used to the night shift takes time and experience. During your first few night shifts, you won’t feel as alert in the middle of the night as you normally would during the daytime. Adjusting to the night shift comes through maintaining a disciplined schedule and a lot of practice. After all, you’ve been staying awake during the day and sleeping at night throughout your entire life, so it’s completely normal if you need some time to adapt.

Use Your Downtime Wisely

Night shifts are typically quieter than day shifts, so there might be time for studying or working on class assignments, which can save time in your off hours. One of the benefits of working nights is that shifts are often much calmer than those during daytime hours. Once patients’ routines are accomplished for the evening, they’ll usually rest for longer periods of time, leaving you with fewer tasks to accomplish. During the quiet parts of the evening, take advantage of the slower pace to study and work on class assignments so you don’t have to choose between coursework and rest during the day.

Take Breaks

Working while in school is hard, so you need to take some downtime when possible. Adding clinicals to your plate on top of your other studies increases your workload and adds to your stress levels. Juggling your personal life, studies, and work at the same time can be difficult, and you might feel as if you don’t have extra time to spare. However, taking breaks is an important part of caring for your own health and well-being. Allowing yourself a few moments to unwind and do something you find enjoyable or relaxing will leave you feeling refreshed and restored.

Why Work the Night Shift? A Sanity Check

The night shift comes with unique challenges, but it also comes with numerous benefits. For every nurse that dreads sleeping while the sun is up, there is one who loves the seemingly “backwards schedule”. With that in mind, a space on the night shift might be right for you if…

You like a slower pace…

Compared to day shifts, which are often bustling with doctors’ rounds and a large staff roster, night shifts are relatively quiet and have fewer people on the floor. Since many patients are resting, the primary task of night shift nurses often is to keep patients comfortable and stable.

You like fewer meetings…

Since most management staff and many doctors work during the day, night shift nurses are required to attend far fewer work-related meetings. If you’re a nurse who finds joy in caring for patients but would rather avoid excessive meetings and oversight from upper management, the night shift might be an amazing fit.

You like fewer patient visitors…

Daytime hours in healthcare facilities are also visiting hours, meaning friends and family are frequently with patients while nurses are performing essential tasks. Nurses who prefer to perform patient care without having to make conversation or answer visitors’ questions are well-suited for working nights, when they’ll only have to interact with patients.

You like fewer changes…

Even though patients need care throughout the entire night, they’re less likely to have scheduled medical procedures or be assigned changes to patient care plans. Rather than having to juggle your nursing tasks around these changes, you’ll be able to carry out your tasks on a more dependable schedule.

You like earning more…

Often, choosing night shift nursing comes with financial incentives. According to ZipRecruiter, the average night shift nurse makes over $36 per hour, while their daytime counterparts make $25 per hour. Working nights could help you achieve financial goals faster, whether that’s paying off debt, buying a house, or building savings.

You like an easier commute…

Since you’ll be commuting to work just as most people are arriving at home and beginning their evening routines, you can count on less traffic and a smoother commute to work. When it’s time to head home in the morning, you may also experience lighter traffic as everyone else commutes in the opposite direction.

You like your days free for appointments

Working when many other people are sleeping leaves you more free time during the day to accomplish things most people have to do on nights or weekends. As a night shift nurse you’ll have every morning and afternoon off, so you can beat the crowds when running errands, grocery shopping, or scheduling appointments.

Resources for Night Shift Nurses

From research that helps you understand the science of better sleep to online forums where you can learn from other night shift nurses, we’ve gathered ten top-notch resources to help you get the information and support you need for success.

Drowsy Driving: Asleep at the Wheel

The Centers for Disease Control and Prevention’s guide to drowsy driving can help you understand the risks night shift nurses face when commuting home after their shift, as well as strategies to avoid the dangers of driving while drowsy.

Facebook: Night Shift Nurses

The Night Shift Nurse group on Facebook is a place for off-hours nurses to connect, chat about the challenges of life on the night shift, and find support.

How to Eat to Optimize Performance on the Night Shift

This article helps people understand how the night shift affects their bodies and how proper nutrition can help you achieve your best performance while working nights.

How to Get in Shape on the Night Shift

Whether your goal is to improve your fitness level or find ways to fit healthy choices into your life while working nights, this blog is full of practical exercise and nutrition tips.

Napping: Dos and Don’ts for Healthy Adults

This Mayo Clinic article outlines the pros, cons, and best practices of using naps to relax and reduce fatigue as you work nights.

The Nurse Nook on YouTube

Here you’ll find videos on effective night shift tips and routines, all from a working night shift nurse.

Reddit: Nursing

Reddit’s nursing board is a place for all nurses to gather and discuss the ins and outs of working in the field, including conversations about night shift work.

Shift Work and Family: A Practical Guide for Busy Parents

This guide offers easy-to-use tips on balancing shift work with family life by maximizing time with your family while making sure everyone’s individual needs are met.

Shift Work Sleep Disorder

This resource from the Cleveland Clinic can help you better understand shift work sleep disorder and how to cope with this condition.

Sleepeducation.org

This site, run by the American Academy of Sleep Medicine, is a comprehensive resource on healthy sleep habits, including a bedtime calculator and information on sleep disorders.

Interview With a Former Night Nurse

Barbara Olive worked for 20 years as an LPN in nursing homes and home health; 15 of those years were spent on the night shift. Barbara is now happily retired.

Q. What did a typical shift look like as a night shift nurse?

A. I’d go in a little early to check in with nurses from the previous shift and get prepared for my shift before doing my rounds and seeing if any patients needed attention. After that, things would get pretty quiet. You might have a resident or two with needs—a resident might get out of bed and need assistance getting back to their room. Around 4 am at my facility, lab techs would come in and begin drawing blood for patients’ lab work. At 5 am, we’d begin preparing for morning medications. At the end of shift, we wrote reports and prepared to pass everything off to the next shift. After you get off work, you might talk to coworkers for a bit to decompress before going home, closing the blackout curtains, and going to sleep. I’d wake up around 5 pm to pack snacks and drinks, spend time with my husband, and get ready for my next shift.

Q. What are some of the benefits of working the night shift?

A. I hate to get up early, so I loved not having to get up early to go to work. The night shift isn’t as busy and you don’t have as many people coming in the door, so you don’t have to stop and talk to family members. It was also nice that we didn’t have to deal with directors looking over our shoulders for the entire shift. For the most part, things are pretty quiet. You may have an emergency or urgent matter, but that was pretty unusual. We also got paid more, which was nice.

Q. What are some daytime habits you created to help you prepare for each shift?

A. I liked to go in early and check all the reports from the previous shift because it helped me get coordinated for my own shift. As far as sleeping, I realized that I couldn’t sleep with daylight coming into the room, so I got blackout curtains to help me sleep better. Before I worked nights, I had no problem sleeping during the day, with the windows open and light and neighborhood noises coming in. But after being a nurse, I can’t do that—I can’t take a nap at all during the day or even during a full moon without blackout curtains!

Q. How did you stay awake and alert when you were working nights?

A. There’s always something to do on the night shift. Sometimes I would feel tired, but my patients were always at the front of my mind. You can’t let anything happen to someone on your shift. I know some people like to nap or snack, but I tried to stay busy. If I felt sleepy, I would get up and walk around or go talk to nurses in another wing.

Q. What are some of the differences between the day and the night shifts as a nurse?

A. The number of people who were present. Working in nursing homes, sometimes you’d have patients with Alzheimer’s who would get more confused at nighttime. I didn’t work with the most serious patients, but it was a little more likely that people on my wing would pass away during the night shift instead of during the day.

Q. What was the biggest adjustment for you when you started out on the night shift?

A. For me, it was probably the sleep. I was still able to see my husband before I went to work or shift, but sleeping during the day was the hardest part. I know some nurses who like to sleep at any time of day, so it’s easier for them to sleep during the day and work at night.