Love night shift or hate it, even if you consider yourself a night owl and love penalty rates, working the night shift has some disadvantages, including potentially negatively impacting your physical and mental health.
In this article, we’ll cover four of the main night shift nursing health risks, plus ways to mitigate them.
Firstly let’s look at how significant the risk of working night shifts is.
Is Working the Night Shift Dangerous to your Health?
In a nutshell, potentially … yes. It is widely accepted that people who regularly work at night have poorer long-term health outcomes than the rest of the population. And it is backed up by fact – a team of international researchers who followed 75,000 female registered nurses in the United States for 22 years found that 11% of those who had worked night shifts for more than six years had a shortened lifespan. Risks of cardiovascular disease and lung cancer were also high.
It’s not just long-term effects on health that are the issue. Women who work graveyard shifts are also more likely to suffer from miscarriages and all night shift workers are more likely to be involved in accidents. It’s scary-sounding stuff, so let’s look at why working at night poses these sorts of health risks.
Why Does Night Shift Work Cause Health Problems?
The bottom line is that humans are not nocturnal. We are designed to sleep at night and be awake during the day, so staying up all night knocks us out of our circadian rhythm. Our circadian rhythm is basically our 24-hour body clock. It tells us when it’s time to go to sleep and wake up. It also regulates our appetite, hormones, heart rate, blood pressure, digestion, brain activity and body temperature. When we move around, eat, and sleep when our bodies are not supposed to, the clock gets confused and all our signals about what to do when get out of whack. Anyone who has pulled an all-nighter knows how that feels.
So now let’s look at the main health problems that night shift nurses experience.
Top 4 Night Shift Nursing Health Risks to Look Out For
There are many night shift nursing health risks that have been highlighted through research. It’s also a topic where researchers are constantly learning new information, such as the changes night shift work can make at a genetic level.
Here are the top four health risks to watch out for.
Chronic sleep deprivation
Noise, daylight and room temperature can make it difficult to sleep during the day, especially in warmer climates such as Australia. On average night shift workers get two or three hours less sleep than other workers, so are more likely to suffer from sleep deprivation. Health organisations may a point of reminding us about how a lack of sleep causes a whole range of health problems including an increased risk of epilepsy for people who are predisposed and a higher risk of motor vehicle accidents and work accidents.
Weight gain and obesity
Many things go wrong with our appetite and metabolism when we work at night. Nurses who don’t get enough sleep, often report that they eat more calories, experience more cravings for calorie-dense foods, have a lower resting metabolism rate and are less likely to exercise. In fact, researchers who followed approximately 60,000 non-obese nurses for 16 years found that nurses who slept five or less hours a night were 15% more likely to be obese at the end of the study than those who got at least seven hours of sleep.
Messing with your body’s circadian rhythm can cause insulin resistance and lead to diabetes or pre-diabetes because eating late at night doesn’t give your insulin receptors time to rest.
Sleep deprivation, the effects that night shift work can have on your relationships and the disturbance to your body clock can all lead to depression.
So while this all sounds very serious, and it is, the fact of ht matter is that if you’re a nurse who has limited choice other than to work regular night shifts, there are some things that you can do to mitigate these health risks.
How to Adapt to Night Shifts
It may take some experimentation to find out what works best for you, but these are some general tips to help nurses adapt to the night shift, and you should be single-minded about helping your body get the nutrients, rest and movement that it needs.
Night shift may not be for everyone, but others absolutely love it. Here are some comments from nurses who enjoy working night shifts.
“Ultimately if it’s something you want to work, you’ll make it work. Just because it’s different doesn’t mean it’s wrong. A million things in life aren’t ‘the usual’ but someone’s gotta do it. If you have a goal in mind go for it! If you don’t like it, you can always try something else.”
“I love working nights, but haven’t committed to doing it permanently yet, I usually do 3/4 weeks of nights each month, usually in lots of 3 nights in a row because it’s just what I’ve found works for me. I find it really rewarding exercising after a shift (it’s not for everyone) but I know it helps me with my sleep and my days off are usually packed full of plans so I really don’t feel like I’m missing out on much socially. The extra money from doing this the past year and a half has helped so much!!”
“I did only nights for years. It’s great financially, always plenty of shifts and I love night shift staff – we are a different breed.”
“I’ve taken on a night shift contract 3 nights a week. I’ve been in the position 4 months and have never been sicker. 2 x conjunctivitis, sinus infection and chest infections. I exercise daily, take supplements and eat well but just can’t shake the fatigue and germs.”
“Permanent nights is such a divisive thing in nursing. If you can achieve a good work-life balance go for it. The only challenge is nights often mean you get left out professionally for updates/changes/education so factor this in on how it would work for you and your employer (you have a mutual responsibility). I would also consider how you can debrief, especially if it is a challenging shift. I would encourage healthy eating rather than 12 months of the bad eating that night duty shifts tend to attract (avoid the bags of chips, lollies, chocolates, and cake!). Mind you, we used to treat ourselves with a sneaky Maccas run from ICU/ED on occasion – frozen Coke is the best at 0300 🤣”
Stick to a routine
If night shifts prevent your body from following the natural rhythm of sleeping at night and being awake during the day, tell it what to expect and when by keeping a routine – just as you would do during daylight hours.
Savvy savers have long been talking up the benefits of meal prepping – from portion control to money savings to eliminating hidden calories, and it works just as well for when you’re doing a night shift. Night shift work is hard enough without having to worry about what’s for dinner each day. Cook a few large meals in advance, portion them and put them in the freezer or refrigerator to ensure you have healthy meals on hand.
Put exercise into your routine and make it non-negotiable, for example by arranging to meet a friend at the gym or making it a rule that you don’t have a shower until you’ve been for a run.
Learn what to avoid
For example, no coffee after 3 am so you don’t hijack your sleep when you get home. You might want to avoid dipping into that bag of lollies or chips that someone else brought in to work. And to prepare for sleep on your way home, you could minimise exposure to daylight, for example by wearing sunglasses on your way home from a shift.
We are mostly made up of water and getting enough is key to good health, maintaining a healthy weight and removing waste products from the body. If you don’t love plain water, add in fruit for extra flavour or include drinks without caffeine such as Rooibos tea.
Depending on the sleep schedule you adopt, naps in the afternoon before you start your shift can really help you top up your sleep.
Seek support when you need it
The reality is that sometimes, long term interruption to schedules due to intermittent night shifts can mean troubled sleep when you try to flip your routine back to days. If this is the case, it’s important to seek help early on. There are some great Apps out there – from sleep meditations to white noise that can help, and your pharmacist can or suggest over-the-counter products to help with sleeplessness, and your GP is always there to help if prescription medication is required for long term issues. Shift workers need closer monitoring because of their increased health risks, so schedule regular check-ups and see your doctor as soon as you can if you’re noticing any problems.
Next, we’ll look at what nurses can have on hand to help them sleep.
Night Shift Nurse Self Care Tips
Here is a list of things suggested by other night shift nurses to help you sleep during the day. You may wish to use it as a checklist before you start a rotation of nights.
Heat pack to help you feel snug and warm in winter
Do not disturb sign for your front door
Sleep meditation or white noise soundtrack (check out the App store, or you can also find many on YouTube)
Suggestions from nurses who do regular and permanent nights include:
”I love nights and I don’t do anything that different to day shifts. I do try and keep busy the first day so I can try and nap before work but I don’t always sleep. Then come home have breakfast shower and go to bed. Darkness and warm with calm music on if you live in a busy area to block some of the noise! I don’t wear a mask but try anything to find whatever helps!”
”I often go for a walk or swim after a night shift, sleep really well in a darkened room and yes, sometimes I wear an eye mask.”
”4 hrs sleep before first nite shift. Sleep at least 8hrs between nights. Discipline discipline. Enjoy the solitude.”
”White noise, even a fan is enough. Dark is good but blackout I find not necessary. Don’t turn the light on if you need to get up to go to the bathroom. Remember to mute your phone, including the buzz, and don’t check it if you wake up unless it’s time to get up.”
”Use earplugs as well as a mask. I also try to squeeze in a bit of exercise to help wind down. Dark room, mute your phone and ensure the room is warm/ cool to your liking. My GP gave me something to help me sleep which I take every 3rd or 4th day only. I do long stretches of nights and absolutely love them.”
Staying Healthy While Working Night Shifts
Hospitals are generally open 24/7 and some patients require around-the-clock care so the need for night shifts will never go away. As researchers continue to investigate ways to mitigate health risks, night shift workers can minimise the risks to their bodies by following the tips above and by always making their health a priority.
For nurses who want more control over the shifts they work, there are also options which don’t involve inflexible rosters, such as uPaged.