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Night shift nursing: Not your typical 9-5’s

January 24, 2020

Healthcare jobs are not usually your typical 9-5 experience. The healthcare business runs on a 24/7 schedule with shifts that run an average of 8-12 hours. Due to the natural fluctuation of our serotonin levels from day to night, this can cause a significant discrepancy in nurses working night shifts compared to their dayshift counterparts. And although night shifts may be less hectic and more quiet, without proper night-shift training, disturbing the circadian sleep rhythms is hazardous to both nurse and patient safety.

The coffee culprit

Several factors affect the performance of a night shift nurse, including methods used to stay alert for the shift. Caffeine is the most popular stimulant used by people who work long and late hours, and nurses are no exception. Caffeine triggers tiny glands on our kidneys and releases hormones to trigger the fight-or-flight reaction of our body, helping us feel more awake. For night shift nurses, it’s common to consume a good bit of caffeine to keep their body alert and moving through the late nights and early mornings. However, too much or long-term doses of caffeine does the opposite and actually stimulates fatigue.

Of course, the real culprit behind fatigue are the long and late hours nurses work. Research shows that this decreases both brain power (thinking, solving, remembering, etc.) and job performance throughout the shift.

“We know that during night shifts, no matter how well rested you and your colleagues are, everybody will experience some fatigue and may have to fight sleep,” Ann E. Rogers, PhD, RN says online. “You simply are not as alert as you should be. Even seasoned night shift workers can experience sleepiness while on the clock.”

Whether it’s your coffee culprit, or late night shifts, sometimes fatigue is practically inevitable when it comes to fighting the night shift blues and lower serotonin.

Night shift blues

Feeling tired after a night shift is completely normal, but the fatigue is usually accompanied by an emotional hangover, or the night shift blues. A study around night shift workers found that they have a significantly lower level of serotonin than their day shift comrades. It’s only natural that a nurse short on serotonin will struggle with their job and impact the patient experience at best and compromise safety at worst.

Because nurses spend a lot of time with patients, they greatly affect the patient experiences. Unfortunately, sometimes nurses become discouraged because their extra cup of coffee and positive attitude wears off sooner than they’d hope due to their lower serotonin levels. This the reason why it’s imperative for hospitals to provide the proper mentorship and leaders for night shift nurses.

Proper night shift training resources

Without proper training through the non-traditional shifts, fatigued night shift nurses put both themselves and their patients in danger. In order to establish a healthy work environment, it’s important for night shift nurses to start by strengthening their relationships between their coworkers and managers—after all, we’re all in this shift together.

In addition to their work with broad engagement initiatives, PRC’s Excellence Accelerator® coaches can hone in on night shift nurses. PRC provides a team of coaching experts to walk alongside night shift nurses and help them find their own path to sustainable improvement and beating fatigue.

In addition, the National Institute for Occupational Safety and Health (NOISH) also provides a free online course that aims to train nurses and their managers on long work hours and strategies to reduce risks.

“Healthcare is the fastest growing sector in the U.S. economy with nurses working shift-work schedules to provide services around the clock,” NIOSH Director John Howard, M.D. says online. “This course provides strategies for reducing risks on the job for both employers and their workers, and shows how innovative training can fill a need in ensuring workplace safety and health.”

NOISH also provides solutions for both nurses and managers to reduce sleep deprivation and fatigue by looking at sleep patterns, circadian rhythms, and other practices to improve mental health for the night shift nurses.

As rare as those typical 9-5’s are for nurses, it’s crucial to have the proper training to provide patients with an excellent patient experience and nurses with a great place to work. In the end, whether a nurse works day or night, 8-hour or 12-hour shifts, it’s important to be aware of your mind and let your body speak when it is tired. Just remember, a positive attitude and a cup of coffee can only go so far.

Further Reading:

Are 12-hour shifts safe?

How nurses and their work environment affect patient experiences of the quality of care: a qualitative study

Journal SLEEP: Rotating Shift Workers Have Lower Levels of Serotonin

Night Shift Nurses Need Management’s Support

Our Cup of Coffee: 6 Caffeine Facts for Nurses