For many nurses new to the field, working the night shift is seen as “paying their dues.” Often, when day-shift positions open up, they move on. But for countless nurses across the country, the night shift isn’t a punishment. In fact, it’s exactly where they want to be.
Catching Those Zzzz’s
For the past 19 years, Megan Brunson, MSN, RN, CCRN-CSC, CNL, has been working on the night shift. As the night shift supervisor and interim manager of the Cardiovascular ICU at Medical City Dallas Hospital in Texas and a director of the American Association of Critical-Care Nurses national board of directors, Brunson knows the best way to survive working the night shift—get enough sleep. (See her tips for sleep, etc. in the sidebar.)
“Night shift nurses all have different approaches to getting enough sleep. I choose to go to sleep immediately after my shift, sleeping from 8:30 a.m. to about 3 p.m.,” says Brunson. “Whenever I need to sleep, I get into my pajamas, go to bed, and make it a solid sleeping event.”
Eileen Sollars, RN, ADN, a staff nurse ICU at HonorHealth in Scottsdale, Arizona agrees. Getting the proper sleep also means letting family and friends know when they can call. “When I first started on night shift, my mother would call me around 1-2 p.m. just to chat—waking me up right in the middle of my sleep cycle. Trying to explain it to her was like beating a dead horse. She just didn’t get it,” recalls Sollars. “So I decided to call her to chat when I was at work. Took only three 2 a.m. calls for her to figure it out. To the day she died, she never called before 5 p.m. unless she knew it was my day off.”
“I tell my children they should not say, ‘My mom sleeps all day,’” jokes Brunson, “since that can be construed as meaning something else.”
Counteracting the Toll
Working the night shift can take a toll on nurses. “It increases cortisol levels and messes with sleep patterns, moods, weight management, eating routines, etc. At first, you have to really work on eating and drinking right,” says Sarina McNeel, RN, BSN, lead staff RN in the Neurosciences ICU at Nebraska Medicine in Omaha, Nebraska. “I have learned that eating a full meal before I go to work and getting the majority of my water between when I get up until 10 p.m. helps me stay hydrated, helps me not snack as much at work, and reduces interruptions in my sleep the next day for bathroom use.”
It’s important, though, to do what works for you. For example, while eating a full meal before her shift works for McNeel, Brunson says that doing so makes her nauseated. Instead, she eats light just before—fruit, veggies, tuna, and/or cheese and crackers. She packs a meal for work, which she’s usually ready to eat around midnight. “I have to admit I am a gold rewards member of Starbucks and Dunkin’ Donuts,” says Brunson. But, if she drinks coffee after 4 a.m., Brunson finds it a challenge to sleep, either because of the caffeine or the need to go to the bathroom.
McNeel finds that exercise helps her, and as an avid runner, she makes sure to get some kind of exercise every day. It also helps her stay awake. “If I start getting drowsy at work, many times, I will take a trip down to the basement and run the stairs,” says McNeel. She works on the 11th floor. Exercise isn’t the only thing that helps her. “I do drink an obscene amount of coffee.”
“Research says working nights will take a toll on your body. But I don’t feel it yet,” says Brunson. “I work with a nurse who is 73-years-old, and who has always worked the night shift. She never complains. I honestly think there are nurses who can do it easily, and nurses who can’t.”
Effect on Family
Working the night shift can be stressful for families. The best way to prevent problems is to be a master planner, says Brunson. “If you schedule a doctor or dentist visit, you have to think how it may impact your sleep. For every school function or family gathering, you weigh the pros and cons,” explains Brunson. She adds that nurses can always do something different, like have an early meal with their families or meet friends or family for breakfast after their shifts. Brunson has even come up with a way to help her 12-year-old daughter choose her outfits for school. “She texts me with outfit choices, and I text back with opinions,” says Brunson.
“I try to keep my life on a steady keep,” says Sollars. “I plan my special events around my schedule and so does my husband.”
Biggest Challenges and Greatest Rewards
“At night, we have minimal staff, no students (except nursing students), no rounds, and much less family. The trick on nights is getting our work done with minimal resources,” says McNeel.
“It is especially critical for night shift nurses to be able to make your case for a patient when talking to a physician,” says Brunson. “You learn which physicians call back immediately and those you need to page several times before they return your call.”
What Brunson loves most about working the night shift is the camaraderie that the nurses have with each other and that she gets to see her family every day. And there’s so much more.
“It truly is a treasure to work a full shift without the distractions of so many other medical needs such as physical therapy, procedures, rounds, incoming calls, and meal service,” says Brunson. “When you look around the ICU at night, it’s primarily nurses and our patients. I value this as it is the element that drove me to nursing in the first place. It is quiet comfort. Of course, we have our emergencies, and the patients are just as sick, but generally, it is a special time to care for patients at night, with just the nurses and patients.”