Survival Tips for Nurses New to Working on the Night Shift

• Working on the night shift as a nurse comes with a shift in mentality, not to mention your day-to-day routine.  
• If you’re new to nursing, or new to the night shift, prioritizing sleep and your safety are vital.  
• Preparing your body for the adjustment to new waking hours — and considering caffeine or caffeine alternatives — can set you up for success. 

There are several reasons to become a night shift nurse. For some new graduates, this may be the only shift available on their unit of hire. Sometimes, new graduates are asked to rotate shifts to get a feel for both day and night workflow. Some are seeking the higher pay that comes with shift differential.

Whatever the reason, being new to working on the night shift can come with challenges. Here are some helpful tips to ease your way into your new adventure as a nightshift nurse:  

Sleep

Before you start your first week of night shift life, you’ll need to accept that the sleep schedule you’re accustomed to will be forever changed. I should not say forever; however, it will be at least until you decide to retire or work during the day again. Preparation for this shift can potentially lessen the effects of this abrupt change on your body and your lifestyle in general. 

What Time Should I Go To Bed?

I was under the impression that I didn’t sleep well when I first became a night shift nurse because I was anxious that I would oversleep. I eventually found out that it was because I was trying to get little things done around my apartment before actually settling down to go to sleep. 

According to the National Institute for Occupational Safety and Health (NIOSH) , “if your circadian rhythms have not adjusted to sleeping during the daytime, there is only a small window of time before your natural circadian alerting mechanism will kick in and try to keep you awake.” 

This means it is recommended that nurses go directly to bed upon arrival at their homes. Whereas dayshift nurses can be a bit more flexible with bedtime, an intentional, consistent routine is vital for success as a night shift nurse. On average, night shift nurses already get less sleep than day shift nurses. For that reason, it is a good idea to make sure to sleep as long as you can.  

NIOSH states that nurses generally feel more rested the more sleep they get before 2 p.m. Some nurses find it easier to maintain a consistent sleep schedule if their shifts are clustered together as three shifts in a row.  

How Am I Supposed to Sleep During the Day?

Remember that your body is already accustomed to a certain type of environment while sleeping. The key is to simulate that environment.  

Blackout curtains are a great investment to keep the sunlight out and create a perception of nighttime. To be quite honest, for some people, once asleep after a night shift, the only thing that could wake them is a loud alarm clock. However, if you are a light sleeper, consider a white noise machine and/or earplugs. Just make sure your alarm is loud enough to hear past the earplugs. 

What Do I Do On My Days Off?

Many people think that jetlag is exclusively related to sleep schedule disruption due to being in different time zones. However, adjusting from working on the night shift to sleeping at night during the week can cause what NIOSH calls a “perpetual state of jet lag.”  

Again, the key is to stay consistent with your sleep pattern even on your days off. It is recommended to try to stay up as late as possible in the evening on the day before you go back to your first overnight shift of the week. If you have been off for a stretch of days, if possible, take at least a 30-minute nap before returning to work.  

How Do I Stay Awake At Work?

My entire night shift career was spent in the medical intensive care unit (ICU). The only exception was the few times I was floated to the neuro ICU and a cardiac progressive care unit. 

My shifts were usually pretty eventful, but every once in a while, I would have a quiet night. Of course, we were forbidden to say the “Q” word because then the shift became not so quiet.  

One unit scheduled non-lunch breaks so nurses could go into a designated room for a few minutes to recline in a chair and catch a power nap to charge up for the rest of the shift. Of course, we know that will not happen everywhere. We already discussed creating a consistent sleep schedule. However, in all honesty, life events sometimes do not allow for consistency.  

In the event that your quality of sleep is disrupted, let’s chat about some other ways to stay awake at work. 

One of the first things that comes to mind when we think of staying awake is caffeine. While caffeine can be effective in maintaining alertness, be mindful of how you consume it. As my grandmother used to say: “Everything in moderation.”  

Studies show that consuming caffeine in moderation can improve alertness, vigilance, and psychomotor performance. Night shift nurses should limit caffeine consumption to one or two cups of coffee 30-60 minutes before the start of the shift. This is equal to 100-200mg. It is also recommended to avoid consuming caffeine four to six hours before laying down to sleep. Keep in mind that there are other sources of caffeine.  

Masala chai tea is a great coffee alternative. A cup of chai made from powder contains about 25-55 mg of caffeine, and 30-35 mg if made from concentrate. This is significantly lower than the approximate120 mg of caffeine in an average cup of coffee. The other benefit of chai is that the caffeine in chai interacts with tannin in the tea which calms the nervous system. Consumers experience more alertness, mental clarity, and a “calm, focused state” without the hyperactive effects one would experience with coffee. 

Another way to stay awake at work is to minimize the amount of time you’re sitting still. By no means, does this mean that you shouldn’t take breaks. This just means to engage in activities that will get the blood flowing.  

Research shows a correlation between walking and increased heart rate, as well as the release of endorphins. For this reason, “consistent light-intensity physical activity throughout the night shift could promote sufficient psycho-physiological arousal to result in cognitive, alertness, and mood improvements while on shift.”   

This can be a few short walks around the unit during your shift. If your night is particularly slow, you can walk around the unit to check if any of your coworkers need help with anything. If you go to the cafeteria for a food break, instead of taking the elevator, opt for the stairs.  

Nutrition While Working on the Night Shift

Working on the night shift and maintaining nutritious food consumption can be a challenge. Depending on where you work, the cafeteria may not be open at certain times. In some organizations, even if the cafeteria is open, the food choices may be more limited than daytime options. If you didn’t pack a meal, the temptation to join the crowd and order takeout is certainly a reality. Here is where discipline plays a role in not only maintaining energy during your shift, but also maintaining a healthy lifestyle in general. 

Snacking during nightshift can help, but ensure you’re choosing healthy, energy-boosting snacks. This includes fruits, vegetables, and protein-packed foods. Consider nuts, eggs, yogurt, tuna, fish, and poultry.  

Heavy meals that include higher sugar and fat content tend to cause sleepiness. If the ever-so-popular pizza party hits your unit, be mindful not to eat until you are stuffed. Also, be sure to hydrate! There are plenty of motivational water bottles in-store and online that can help you to keep track of your water intake. Something I used to do was take one of those styrofoam cups and write the numbers one through eight on it. As I finished a cup, I would cross out a number. The goal was to consume eight of those cups. 

Safety

Your safety and the safety of others should be the highest priority. To be successful and safe as a nightshift nurse, you must be self-aware. Listen to your body. Lack of alertness can lead to dangerous situations like medication errors, slower responsiveness to patient emergencies, and even vehicular collisions.  

If you notice that you are extra sleepy at work, communicate with your charge nurse about needing a quick break. Delegate some tasks to your patient care assistant or the float nurse, if available. If you are feeling extra sleepy after your shift is over, do not attempt to drive home.  

I will never forget driving home, blinking, and not remembering when I drove through a tunnel. Call a friend or family member to give you a ride home. Take a quick nap in the break room. If it is safe to do so, take a quick nap in your car. I do not recommend this if you are street parking. This is safest in a covered parking garage with security. 

The Bottom Line

Working on the night shift is a huge adjustment. However, once you find a good routine and healthy habits, it can become as normal as working during the day. Much of what has been discussed are general tips that can be customized to fit your life. Once you find what works for you, stick with it. I wish you all the best on your night shift journey. 

Read More