The Best Schedule for Night Shift Nurses

Nearly half of the nurses in the United States work the night shift. For many, this means starting work at 7 pm and ending at 7 am, but it can also include other hours like starting at 11 pm and ending at 7 am and more. 

As anyone can guess, this is hard to do, mentally and physically. People who work night shifts are more likely to experience sleep deprivation because of circadian rhythm imbalances. 

The circadian rhythm is a natural flow our bodies follow during a 24-hour period. These rhythms follow natural lighting, which is where night shifters get into trouble. Trying to sleep during the sunlight hours and stay awake during the night sets off these imbalances, making it hard to sleep during the day and stay awake at night, leading to sleep deprivation. 

Sleep deprivation can lead to the following health concerns: 

• Impaired learning ability 

• Slowed reaction time 

• Decreased cognitive abilities 

• Impaired cognitive flexibility 

• Poor mood and feelings 

• Impaired communication skills 

• Suddenly falling asleep 

These are fancy ways to say that you’re more likely to make errors, like drug administration errors, needle stick injuries, and medical equipment and operation inaccuracies. 

Night shift nurses are 28% more likely to make these errors than day shift nurses. But errors aren’t the only problems that the night shift causes. Night shift nurses are more likely to experience health issues, including sleep disorders, diabetes, high cholesterol, high blood pressure, obesity, and cancer. 

Why would you even choose to work the night shift, then? There can be a lot of benefits, and we’ll always need someone to care for patients after hours.  

Here are some of the benefits: 

• Less competition with other workers 

• More time to learn and gain experience 

• Fewer disruptions from management 

• Generally, more employment opportunities 

• Fewer meetings, if any 

• Less traffic during commutes 

• More competitive pay 

With these perks, there are many reasons you may choose to be a night shift nurse. So how can you optimize it so that you’re taking care of yourself as well? 

Below we’ll discuss sleep strategies and how to adjust your schedule to feel your best.  

Better Sleep Strategies  

Many studies have been done on preventing sleepiness during night shifts and the evidence is mixed. 

Some options include the following: 

• Taking a nap before the scheduled night shift. This nap could be getting up at your usual time in the morning and then going back to sleep around 2 or 3 pm until you get ready for work. 

• If your organization allows, taking a 30-minute to 1-hour nap during the shift, similar to taking a lunch break, can improve alertness.

• Moderate caffeine intake during the shift, but stopping by around 2 am, can help improve wakefulness. High intake has the opposite effect. 

• Using light during your shift, so not turning off all the lights on the unit

• Avoiding sugary foods 

• Exercising or moving for 30 minutes 

Once you’ve prevented sleepiness during your shift, how can you better improve your sleep at home? 

Here are a few strategies to try:

• Create a bedtime routine 

  • It’s helpful to do the same things you would typically do on any night, especially if you’ve been doing them for a long time. Having a bedtime routine helps trigger your mind for sleep

• Control your light and noise intake 

  • Hang blackout curtains 

  • Try earplugs 

  • Listen to an ambient noise machine 

  • Use an eye mask 

• Consider taking low-dose melatonin over the counter if needed

• Take care of your body

  • Eat healthily. You may need to pack your lunch since most hospitals don’t have healthy cafeteria options at night

  • Exercise regularly

  • Drink plenty of water

  • Limit caffeine

• Take naps when needed

While these tips may help keep you from being sleepy and improve your sleep, your schedule will still have much to do with how you feel. 

Better Schedule Options 

Many units will allow “self-scheduling” in which you sign up for the days you want. This option is generally even more common for night shift nurses, giving you a massive advantage in that you get to (for the most part) pick when you work.

Studies have shown that the best way to maintain our circadian rhythms is not to work consecutive nights. However, this expectation is unrealistic for most people. 

Another recommendation is not to rotate frequently, which contradicts the first one. So, what will work for the real-life night shift nurse? 

Here are a few tips to make the most out of your schedule: 

• Work in groups of two shifts. Three shifts in a row have been shown to increase exhaustion. Working two shifts can also ensure continuity of care for you and your patients. 

• If working three shifts in a row isn’t too exhausting for you, do that. It helps you get more time off to recover between groups of shifts, but this doesn’t work for everyone.

• Group your shifts to give yourself long stretches off, like three to four days which gives you more time to recover.

• Stay on the night schedule, even on your days off. This schedule means you sleep during the day and stay up all night. You can play with this schedule so it works for you, but it has been shown to make switching easier. Sometimes this option is easier if you don’t group your shifts. For example, you work Monday, Wednesday, and Saturday nights. Then, you’ll have to stay on the night shift sleep schedule for your actual work schedule. 

• Stay on night shifts for longer periods. As new grads, most nurses work the “rotator” role. This schedule can be anything from two months of day shift, then two months of night shift, and repeat or switching within the same week. 

In the end, the best advice is to find what works for you and only you. Everyone is different. Experiment with your schedule, especially when you’re just starting out as a new night shift nurse. Try out all of the options listed above and see what works for you, your life, and your body. 

Working the night shift is challenging and can be hard on your body and mind. Finding a schedule that works best for you is vital in continuing to be successful in your career and other parts of your life. 

It’s also so important to take care of yourself! Practicing self care with things like meditation, exercise, yoga, practicing gratitude, and spending time outside can also help you feel and sleep better, no matter what time it is.