The past few nights at my apartment have been quiet. Julia, my roommate aka best friend, is also a nurse. She works on an inpatient, medical-surgical floor at a large local hospital. She is scheduled to work the night shift this week, which is why my past few evenings have been quieter.
Julia and I were talking about our nursing jobs, decompressing about the stresses of being a nurse. During our conversation, we had a “the grass is greener on the other side” moment. I was dreaming about the niceties of working only three shifts per week; she was dreaming about having an 8am-5pm schedule, Monday-Friday. We went back and forth, pointing out the good things about one another’s schedule.
The Graveyard Shift
That conversation got me thinking more about the night shift. I’ve heard a lot about Julia’s experience on nights, but a lot of the nurses that I work with now also have history working nights. Most new graduate nurses get shunted to the night shift, while more experienced nurses have seniority with scheduling and can work fewer nights. From my conversations with my friends and coworkers who work/have worked nights in the hospital, almost everyone agrees on the brutal effects of a 12-hour graveyard shift on all aspects of life. One nurse I spoke with lasted less than a year working nights, and she stated that she would rather work in a gas station making minimum wage than work the night shift again. On the other hand, one of my current coworkers worked nights for 17 years, somehow mastering the circadian shift for over a decade.
I was so interested in the various effects of the night shift on the lives of nurses that I looked up research articles on the subject.
(Yes, my college training has paid off – I was in search of some evidence-based research to inform my opinion on night shift nursing!)
I came across many articles, but the one that stood out was from 2015, entitled Nurses working the night shift: Impact on home, family, and social life, by Susan Ann Vitale, Jessica Varrone-Ganesh, and Melisa Vu. I chose to explore this article because it analyzed the interviews of 21-night shift nurses for themes in order to determine the holistic impact of working through the bedtime hours.
Results of Research
I was astounded at the negative effects highlighted in the article. The physical toll of working the night shift included weight gain, stomach distress, and chronic fatigue. Psychologically, the study showed that night nurses are often obsessed with sleep and more stressed in general than day-shift nurses. Socially, night nurses were more likely to feel isolated with their irregular schedule. Many of the nurses felt that it was hard to maintain relationships with friends and family because the time spent with loved ones was always during the day when the nurses would typically be sleeping. Physically, psychologically, and socially, the night shift affects nurses in a way that increases burnout and wears at the soul of the person.
One of the scariest findings of the study was the increase in driving incidents and accidents for nurses coming off the night shift. After working 12 hours through the night, nurses were completely exhausted on the drive home. My coworker reiterated the truth in this, telling me that she barely remembers her drives home from the hospital post-graveyard shift. Julia also agreed with this. To counteract the exhaustion, the article found that nurses would try various methods to stay awake, such as talking on the phone with friends, napping in the car before driving home, drinking coffee, or eating food. It’s scary to think that we’ve run the caregivers of the night into such a state that they cannot even travel home safely.
The article concluded with some potential solutions to the current situation. The only problem? The solutions are not very practical, no matter how you frame them. One table presents possible coping strategies for nurses entering the night shift: exercise often, follow a healthy diet, stay balanced, be social, etc. There is an argument for why each of these won’t work. When you are tired all the time, you don’t have the energy to function normally, let alone go out and exercise. Salads at 2:00 am aren’t exactly the most appetizing (cookie dough, please). It’s difficult to remain in touch with people who both live opposite schedules and don’t understand the difficulties of working through the night. See? The coping strategies are nice in theory but near impossible to execute. The second table in the conclusion presents suggestions for institutional change to help nurses working the night shift, yet these also can easily be ripped to shreds. One idea is to allow nurses to take naps during breaks, but when have nurses ever been guaranteed a break? I don’t even get a break, and I work in an outpatient office. Another idea was to have gym access close for nurses before or after a shift, but again – if you are too tired, working out is at the bottom of the priority list.
The night shift is just a hard gig, and it seems like there is a desperate need to figure out a sustainable solution for patient care during the nighttime hours.
If you work the night shift, I’d love to hear what you do to cope mentally and physically. Drop some comments below.