Nurse Night Shift Hours: What to Expect Working Overnights

• Explore a typical nurse’s workday on night shift hours. 
• Discover the pros and cons of being a night shift nurse.  
• Learn how to prepare for a successful shift as a night nurse. 

‘To be a night nurse, or not to be a night nurse’… that is the question.

Let’s face it. Night shift is hard. For some, it can be torture. It can be hard to stay awake and you might find yourself taking naps during your lunch break.

But with the right preparation, the night shift can be a rewarding experience and a great start to your career. 

Typical Workday on the Night Shift

On day shift, it might be easier to balance the workload throughout the day, as patients are mostly awake. However, on nights, nurses may have to bundle care in the beginning and end of their shifts to allow patients time to sleep in between.  

Night nurses may also have to bundle care with ancillary staff to avoid frequent interruptions during the night. Night shift duties can vary based on the department a nurse works in. However, the workflow is often similar. Here’s a walk-through of a typical 12-hour-shift on nights. 

Beginning of Shift (Hours 1-4) 

• Receive report from the day shift nurse.  
• Review orders, tests, labs, and vital signs.  
• Perform head-to-toe assessments. 
• Start medication passes as ordered.  
• Complete pending patient discharges. 
• Begin treatments (wound care, dressing changes, IV starts, etc.) as ordered.  
• Review charts and anticipate any needs the patients may have throughout the night (call the physician for orders as needed).

Middle of Shift (Hours 5-8) 

• Ensure that patients have received all night medications, including sleeping pills and pain medication. 
• Assist patients with toileting, showering, and any other bedtime activities as needed.  
• Encourage quiet time by dimming lights, keeping voices down, and anticipating when IV pumps and other equipment will alarm (or as per facility protocol).  
• Start documentation (if not started already). 

End of Shift (Hours 9-12) 

• Start drawing blood for lab (or anticipate that phlebotomists will come to do so). 
• Administer early morning medications. 
• Assist patients with morning activities (toileting, bathing, other activities, etc.).  
• Finish any documentation that was not completed. 
• Give report to the day shift nurse. 

Pros of Working Night Shift Hours

Less Distractions 

There are typically fewer procedures, surgeries, tests, phone calls, and visitors on the night shift. Night shift nurses interact less often with other care team members, ancillary staff, management, and patients’ families, leaving more time with patients.

Stronger Teamwork 

Due to the minimal staff support available during nights, working a night shift may require nurses to depend on each other much more than they would if working on days. 

Increased Pay Potential 

Due to work-life balance challenges the night shift can bring, night shift nurses are often paid a higher salary than those on days. Night shift nurses can make more than $8,000 more per year than day shift nurses.  

Cons of Working Night Shift Hours

Busy Nights 

Medications and vital signs are often scheduled around the clock, patients may need more frequent toileting assistance, and laboratory and diagnostic tests may be scheduled during the late night or early morning hours. In addition, patients are admitted to the hospital at all hours of the night.

Less Resources and Support

The night shift typically begins at a time when many departments are closed, most physicians have gone home, and visiting hours have ended. This causes many night nurses to learn to be resourceful and autonomous, often managing shifts with minimal supplies and support.

Disrupted Sleep

Night hours can disrupt sleep patterns, especially when working long shifts. A lack or disruption of sleep can lead to stress, frustration, health problems, social issues, and poor work performance.

How to Prepare for Work on the Night Shift

As a previous night shift nurse, I recommend the following tips to better prepare for the shift: 

1. Set a sleep schedule: Get enough sleep before each shift. Setting a sleep schedule every day may help to ensure adequate sleep before work and on off days. Taking naps may also be beneficial.
2. Pack a lunch: Facility cafeterias often close during night shift hours. Packing a lunch (including protein-rich snacks) ensures that nurses will stay energized throughout the shift. 
3. Set a reminder to drink water: It can be easy to forget to drink water when the shift gets busy. Setting phone alarms or using free hydration apps like My Water – Daily Water Tracker or WaterMinder may help remind you to stay hydrated.
4. Wear a Jacket: As minor as it sounds, it can get pretty cold on the unit at night during downtime. Thermostats are set at certain temperatures to comply with infection control measures. Bringing a jacket to work (or wearing a long-sleeved undershirt) may be beneficial. Nurses should ensure that clothing is dress-code appropriate.
5. Join a Support Group: Studies have shown that working the night shift affects mental well-being and can cause mood changes. Participating in support groups with other night shift nurses may be beneficial in maintaining good mental health. Simply venting to night shift coworkers can bring relief.
6. Know your limitations: Ultimately, if it turns out that the night shift is too challenging, nurses should speak to their managers about the issue. Oftentimes, managers will work with nurses to place them on day shift instead. Many nurses start off on nights and transition to days. 

The Bottom Line

After working nights for a while, you may eventually transfer to a day shift position. Nights can help you to become more confident in your knowledge and skills and help prepare you to interact more often with physicians, other care team members, and patients’ family members. The transition from nights to days can be smooth. While it may seem like it might be difficult adjusting to a new sleep schedule, many nurses do just fine. 

Night shift nurses are essential to the nursing profession. As with day shift, the night shift has its benefits and drawbacks. With the right preparation, nurses can have successful shifts on nights. 

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