12 Tips to Survive Night Shift Nursing: From Fatigue to Focus

Nursing is one of the most essential, demanding, and stressful jobs in the world. You spend long periods of time on your feet, constantly helping others, and are needed during night shifts. That does not even include working in a hectic hospital environment, all while staying calm and helping others. It is not surprising that such a demanding vocation is associated with several health issues. Nursing staff report higher levels of stress, injuries, and burnout than almost any other career. Thankfully, there are effective ways to minimize the risk of developing these issues, as well as make a nurse’s shifts more comfortable.

In this article, you will learn how to improve your comfort and focus levels, particularly during night shifts. Read on to get our 12 top tips, as well as answers to frequently asked questions about night shift nursing.

How to Survive Night Shift Nursing

Whether it is fighting the inevitable urge to sleep, dealing with complex scenarios where you must be focused and reactive, or just coming up against the aches and pains from being on your feet for long periods of time, there are many ways in which night shift nursing can be quite challenging. Here are our top tips for night shift nurses to help you stay healthy, focused, and effective.

1. Develop a Pre-Shift Routine

Having a pre-shift preparation routine  will ensure that you are prepared for your shift and will never miss your essential items. It can help reduce your pre-work jitters and may let you sleep more before your shift!

Start by making a list of what you need to pack for every shift, and keep it somewhere handy so you can tick everything off before you leave for work. Additionally, work backwards from when your shift starts to work out how much you can sleep and how much time you need to get ready.

To optimize awareness and focus, set time aside to take in natural light (if it is still daylight out before your shift starts). Scientific research found that exposure to sunlight is essential for optimizing your cognitive function. Even if it is not daylight anymore, take a brisk walk in fresh air to awaken your senses and get your blood flowing throughout your body. Follow that up with easy stretches. 

Some of our nurse customers have told us that they prefer to wear compression socks before their shift to give their lower leg muscles a gentle massage and to energize their calf muscles.

2. Boost Circulation with Compression Socks

Looking after the lower limbs is paramount for the wellbeing of nurses on their night shifts. Lower limb health issues are the one of the most common musculoskeletal issues that nurses experience. Unlike other roles where employees can sit down and rest at work, nurses are often on their feet for most of their shift. Nurses can even walk over 3 miles during a shift! This can lead to increased strain on their lower-limb circulatory systems, which research has found to cause muscle soreness and high levels of discomfort. Add the increased swelling directly linked to long hours of standing and it’s no surprise nurses experience high levels of lower limb discomfort at work. 

Wearing knee-high compression socks increases lower leg blood flow, which reduces the stress on lower leg muscles, blood vessels, and even bones. Studies suggest that knee-high socks with pressure levels between 11 and 21 mmHg are the best compression socks for nurses with no comorbidities or risk factors for increased edema. This compression level can both reduce and even eliminate lower limb swelling to allow nurses to comfortably move around throughout their entire shift.

If you struggle with leg discomfort as a night shift nurse, compression socks are the answer. Not only can you use them to prevent peripheral circulation issues, but you can look stylish while doing so! Our fun styles, materials, and different compression levels will meet your needs. 

Discover soothing, supportive compression socks for nurses.

 

 

3. Prepare Yourself Mentally for the Night Shift

The National Institute for Occupational Safety and Health (NIOSH) offers a training program to help nurses prepare for long work hours. This program can help you identify potential risks of night shifts and consider all the ways that this type of work can impact their wellbeing. It is important to be as informed as possible and to also discuss your lifestyle change with your family and close friends. Consider the changes you will need to make in your everyday routines and get the support of your loved ones upfront.

Next, adjusting your sleep patterns and ensuring you are well fueled and hydrated are the key pieces of the puzzle to survive night shift nursing.

4. Fuel Your Mind and Body with Good Nutrition

In the NIOSH guide for night shift nurses, you can find diet advice to help keep you awake and energized. Experts recommend that you eat on a normal day and night pattern as much as possible, avoiding meals between 12AM - 6AM. However, eating high-quality foods during your shift (such as vegetables, salads, fruits, or yogurts) can keep you energized as needed. So, it is okay to have snacks, but try to avoid sugar-rich products which could cause energy drops later during your shift.

Community is also important to lift your spirits and encourage mindful eating. Instead of munching on unhealthy snacks on the go, try to sit down with a colleague and eat nutrient-rich snacks when you take a break away from work.

5. Maximize Your Break Time to Recharge

The best way to optimize breaks when working night shifts is to take micro naps as needed. Power naps can boost your energy levels and improve your cognitive performance if you keep them to below 30 minutes. One study found that a 5 to 15-minute nap can even reduce sleepiness and help your brain function better for up to 3 hours!

If you cannot take naps, try to find time to move and stretch. This helps blood flow throughout the body and keeps you energized. If possible, step outside for 10-20 minutes so you can get exposure to fresh air. This is also a terrific way to wake up and refocus.

6. Move and Stretch Regularly

Nurses are at high risk of musculoskeletal injuries because of their work. Because nurses spend most of their shift time walking, bending, stretching, standing, and/or reaching a high number of cases of back pain are reported by nurses each year. According to the U.S. Bureau of Labor Statistics, musculoskeletal problems were reported at an incidence rate of 46 cases per 10,000 full-time nurses. This is much higher than all other jobs where these problems occurred at a rate of 29.4 cases per 10,000 workers. Most of these musculoskeletal disorders are related to the back, particularly the lower back.

To combat the risk of back pain at work, a short injury prevention routine during pre-shift preparation may help. Here is what we recommend:

1. Gentle Pelvic Tilts

• While eating your pre-shift meal, sit up tall in a chair with both feet planted.
• Place your hands on the bony sections of your pelvis (like hands on hips).
• Gently roll your pelvis forward to create a “sway back” posture.
• Gently roll your pelvis backward to create a “tucked” posture.

Do 10 repetitions. Do not push too hard, and breathe slowly with each movement. This exercise mobilizes the lower back and pelvis, which may help the joints that are most at risk during your shift.

2. Dynamic Calf Stretches on a Step

• Stand on the edge of a step holding onto a railing.
• Gently lower your heels down below the step so you feel a stretch in your calf.
• Slowly rise onto the ball of your foot so you are on your tiptoes.
• Gently lower back down so your heel is below the step.

Repeat this exercise for two sets of five. Move slowly, and do not push past where it feels comfortable. This exercise helps to stretch your calf muscles, largely the gastrocnemius, in a dynamic way to help prevent injury to your ankles and lower limbs during your shift. It also helps pump blood out of your lower limbs to improve your comfort.

3. Spinal Rotations

• Sit up tall on a chair with both feet planted.
• Holding onto the seat of the chair, gently pull your body around until your shoulders are rotated as far as feels comfortable.
• Don’t rotate your neck; keep it in line with your spine. Aim to keep the rotation limited to your middle back (thoracic spine).
• Breathe in, and release the twist halfway.
• Breathe out, and gently twist again.

Go gently with this exercise, and repeat five times on each side. This can also be done while standing, with the arms out at shoulder height. Again, do not push. You should feel a gentle stretch and no pain.

7. Consume Caffeine Strategically and Stay Hydrated

There is conflicting information on the use of caffeine and hydration levels in nurses and night shift workers. It’s important to stay hydrated regardless of what job you do, but there are also indications that continuing to sip water regularly can help you feel more focused and awake. Certainly, research  has shown that dehydration can lead to greater fatigue and worse cognitive function.

As for caffeine, some studies have looked at how much is being used by nurses at work and whether it can affect clinical performance. While further research is needed to understand whether high-energy drinks or coffee can affect the wellbeing and performance of night shift nurses, strategically consuming a small amount might be beneficial - especially if it forms part of your regular routine and you ensure that you have a good sleep when you’re off your shift. Do not allow long stints of sleeplessness to continue by excessively consuming caffeine. Even if your circadian rhythm is disrupted, consistency of caffeine consumption and regular sleep will help your body find a routine to feel well rested.

 

 

8. Build a Supportive Network at Work

Your colleagues are not only going through the same difficulties as you, but they are also the best sounding board and support group. Working together helps reduce the risk of making errors during a night shift, so create a buddy system to check each other’s work throughout the night.

You can also benefit from your work network for better eating (taking meals together and reducing tension during the shift) and stress reduction. Finally, think about carpooling at the end of a shift - you can then take turns driving home, helping you spend less time behind the wheel when you are tired.

9. Be Proactive About Managing Stress

There is no question that night-shift nursing can be extremely stressful. Not only are patients’ demands weighing on you constantly, but you also must fight the natural urge to go to sleep when preparing  to deal with emergencies and complex cases. This is why stress management is so important for improving your performance during night shift nursing.

Introducing just 10 minutes of concentrated breathing and meditation into your daily routine could effectively minimize stress and burnout in health professionals. One study recruited health professionals, including 12 nurses, to examine the effects of a 12-week meditation and mindfulness course. The results? A significant improvement in measures of burnout and emotional wellness. The 12 control participants observed no change in their burnout or emotional wellness scores.

If you are new to meditation, you can start by using an app to guide you. Daily sessions will help you step away from your busy day, slow down, and refocus your mind to help you experience less perceived stress at work. Additionally, spending some time in the fresh air, even for just a brisk walk, can make a dramatic difference in clearing your head and reducing stress.

10. Utilize Light Therapy to Stay Alert

Manipulating light exposure can help your circadian rhythm adjust to night shifts and maintain your concentration, while also allowing you to have a better sleep when you go home. The National Sleep Foundation recommends a dark bedroom with blackout shades for a good night’s sleep. So, when you return from night shift, ensure you have eliminated any source of light that may distract you from your sleep. 

Similarly, using lighting as you wake up and during your shift can be remarkably effective in “tricking” your body into thinking that it’s daytime. If you sleep before your shift, use a gradual light alarm clock that mimics natural sunrise to wake you up. Then, maximize your exposure to natural light (assuming it is still light out as you prepare for your shift). Also, night shift workers need to get as much vitamin D as possible. Sun exposure causes your skin cells to convert cholesterol to vitamin D. So, if you cannot get enough sun exposure, speak to your doctor about supplementing as needed.

11. Stay Organized to Enhance Efficiency

Staying active and organized will help you stay awake, too. Night shifters can benefit from creating a routine, where they know very well where everything is and can reach essential items quickly when needed.

Then, spend your downtime being creative or keeping your brain active. Do crossword puzzles, read, or do things that keep your mind active. Avoid spending time on social media or scrolling on your phone, as this will tire your eyes and can make you sleepy. Speaking to coworkers is also a good idea.

Staying organized outside of work is also important. Prepare meals in advance by batch cooking, if you want to reduce the time spent preparing them after your shift. Additionally, plan your social calendar well in advance so you can have some healthy, fun interactions with your loved ones to look forward to (and you will not have to try to coordinate this when you’re groggy after a night shift!).

12. Plan for Post-Shift Recovery and Quality Sleep

How you recover after your night shift as a nurse is key to your overall wellbeing and work performance. Following your shift, stress reduction practice can help you transition from your work mindset to your home mindset. If you sleep after your shift, be sure to have a comfortable bed, supportive pillow, and soft sheets to help you get cozy and fall asleep faster.

If your legs are sore after your shift, compression socks can help you recover quicker and give your legs the gentle massage that they deserve. Additionally, look into a wind-down routine (just like a pre-shift routine). Do gentle stretching and yoga to help you get ready for sleep, soothe your limbs in a warm bath, and go to bed in a cool, dark room to optimize your sleep.

 

 

How Can I Maintain Work/Life Balance While Night Shift Nursing?

The most crucial element of work/life balance for night shift nurses is their support network. Get your friends and family on board with your new day/night patterns. They will help you adjust better and reduce the pressure on you to attend events or behave in a certain way when you have the time to spend with them.

Next, prioritize self-care. Keeping yourself healthy will help you feel better each day while keeping your patients safe and healthy. This means creating a consistent sleep schedule, optimizing your wind-down after shifts to give yourself the best chance of recovery, and listening to your body. Try to group shifts together, too - it will give you more time off afterwards, to enjoy relaxing and spending time with family and friends.

Is It Better to Sleep Before or After a Night Shift?

There are different ways to look at this, but our circadian rhythms naturally want us to go to sleep at night. You may need to “trick” your body into wanting to sleep either before or after your night shift, but it is critical that you get the recommended 7-9 hours of sleep each day.

For some, it is ideal to treat your shift as “daytime,” coming home to “dinner” and then going to bed afterwards. However, if you feel tired before the shift, it is also good to take a nap a few hours before you head to work.

How Can I Adjust My Sleep Environment for Daytime Sleeping?

The trick is to convince your body that it is nighttime, so you can get the best possible sleep during the day. It all starts the moment your shift ends: wear sunglasses or blue light blocking glasses on your way home (if you are not driving!) so you can encourage the production of melatonin and prepare the body for sleep. Then, have a wind-down routine (gentle stretching, yoga, meditation, a bath, putting your feet up in compression socks) to signal to your body that you are ready for bed.

For your bedroom, get blackout curtains to prevent any natural sunlight from disturbing your sleep. Ensure you keep the room cool. If you have an alarm clock, ensure you can dim the light on it, so it does not disturb your sleep. Block out noises with ear plugs or use white noise from a fan or white noise machine to help you drown out the daytime noises from outside.

References

Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and Factors Associated With Nurse Burnout in the US. JAMA network open, 4(2), e2036469. Read it here.

Stolt, M., Miikkola, M., Suhonen, R., & Leino-Kilpi, H. (2018). Nurses' Perceptions of Their Foot Health: Implications for Occupational Health Care. Workplace health & safety, 66(3), 136–143. Read it here.

Kent, S. T., McClure, L. A., Crosson, W. L., Arnett, D. K., Wadley, V. G., & Sathiakumar, N. (2009). Effect of sunlight exposure on cognitive function among depressed and non-depressed participants: a REGARDS cross-sectional study. Environmental health : a global access science source, 8, 34. Read it here.

Waters, T. R., & Dick, R. B. (2015). Evidence of health risks associated with prolonged standing at work and intervention effectiveness. Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses, 40(3), 148–165. Read it here.

Antle, D. M., Cormier, L., Findlay, M., Miller, L. L., & Côté, J. N. (2018). Lower limb blood flow and mean arterial pressure during standing and seated work: Implications for workplace posture recommendations. Preventive medicine reports, 10, 117–122. Read it here.

Partsch, H., Winiger, J., & Lun, B. (2004). Compression stockings reduce occupational leg swelling. Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al.], 30(5), 737–743. Read it here.

National Institute for Occupational Safety and Health. (2020). NIOSH Training for Nurses on Shift Work and Long Work Hours. Cdc.org (Center for Disease Control and Prevention). Read it here.

Lovato, N., & Lack, L. (2010). The effects of napping on cognitive functioning. Progress in brain research, 185, 155–166. Read it here.

Zhang, N., Du, S. M., Zhang, J. F., & Ma, G. S. (2019). Effects of Dehydration and Rehydration on Cognitive Performance and Mood among Male College Students in Cangzhou, China: A Self-Controlled Trial. International journal of environmental research and public health, 16(11), 1891. Read it here.

Phillips, K. E., Kang, Y., Kang, S. J., Girotto, C., & Fitzpatrick, J. J. (2021). Caffeine and high energy drink use and knowledge by nurses in three countries. Applied nursing research : ANR, 58, 151414. Read it here.