- Most nurses work night shifts during their career, which can increase their chances of encountering an unsafe situation.
- Risks rise with less staff in the hospital, nurses working hours opposite of their circadian rhythm, and a higher patient-to-staff ratio.
- Using these safety tips for night shift nurses can empower you to pay attention to personal safety, prepare for an emergency, and protect your health.
Working the night shift presents unique challenges, including staying safe. Whether arriving at work after dark, walking empty hospital halls during the night, or driving home exhausted, it's important to stay safe.
Most nurses work night shifts at some point during their careers. A higher patient-to-nurse ratio, smaller support staff, and battling your circadian rhythm are just a few of the challenges facing night nurses. Our contributors are familiar with the safety issues night shift nurses face and offer tips to help keep you safe.
Find out how you can stay safe working as a night shift nurse.
What Do Night Shift Nurses Do?
During a typical night shift, you'll receive a report from the day shift and begin planning the night based on which patients are going to surgery, getting treatment, need greater attention during the evening, or must undergo special preparation for testing in the morning.
Night shift nurses meet their patients and do a head-to-toe assessment before their patients go to sleep. For the next several hours, they complete the doctor's orders that weren't finished during the day shift, answer call lights, give as-needed medications, and schedule intravenous drips.
Most nurses share that between 2:00 a.m. and 4:00 a.m. they can get extremely sleepy; some even experience nausea from being tired. This is also a time when there is little to do during the night shift. Starting at 5:00 a.m., patients wake up, lab techs arrive to draw morning labs, and night nurses administer morning medication.
Night Shift Nursing vs. Day Shift Nursing
The largest noticeable difference is the drop in activity. During daylight hours, the hallways bustle with activities from physicians, social workers, support staff, therapists, and dieticians. The area becomes more peaceful during the night shift and may appear less stressful.
Yet, night shift nurses have a lot to deal with. While they may not serve meals or give baths, they have added responsibility since administrators or physicians may not be available immediately. Night nurses are responsible for monitoring changes in patients' conditions, administering medications, and providing support and assistance to patients and their families.
One of the biggest perks to working the night shift is the slower pace for nurses who thrive on independence. Night shift nurses often receive a premium in addition to their base rate. They also rely on each other more, so there's often more teamwork. Rarely are patients discharged at night.
13 Safety Tips for Night Shift Nurses
These simple night shift nurse tips can empower you to pay attention to personal safety, prepare for an emergency, and protect your health.
Park in well-lit areas
Muggers are looking for people who are more vulnerable than others. Parking in a well-lit area means you'll see the people around you and you'll be seen.
Take advantage of your smartphone location
The location option on your phone can help locate you in an emergency. Be sure to always share your location with a trusted friend or family member.
Don't leave packages in your car
Whether it's presents, groceries, or shopping, packages in your car tempt burglars to break a window and grab what you have. Nothing is more frustrating than going to your car at 7:30 a.m. to find you need repairs to your car and a police report.
Don't sleep in your car
Personal finance and health blogger Prisca Benson advises nurses to take a quick cat nap before driving home if they're sleepy. This can keep you and other drivers safe.
But don't sleep in your car. Sleeping in the car places you in a vulnerable position and increases the risk you may be robbed or attacked.
Don't go jogging at night
It's best to stay on your sleep schedule of being up all night and sleeping during the day on your off days. But, that makes it challenging to exercise. Don't be tempted to jog outside at night by yourself. Consider getting some exercise equipment for your home. You may find good second-hand equipment through an online marketplace or neighborhood forum.
Watch out for your colleagues
Nancy Mitchell has over 37 years of experience as a director of care. She advises nurses to watch out for their colleagues. "Nurses on the night shift will often venture into isolated halls in between wards and examination rooms, especially on slow evenings. Should any incident occur, you want to be sure that there are people looking out for you," she says.
Position yourself between the door and your patient
During the night shift, patients are more likely to become confused, disoriented, or combative. Benson advises nurses to position themselves between the door and the patient so they have a way out if the situation becomes dangerous.
Have a good sleep routine
Sleep is foundational to good health, but sleeping during the day can be challenging. Establish a healthy sleep routine as a night shift nurse that tells your body it's time to rest and make the routine consistent. Consider using a sleep mask and room darkening blinds to shut out the light and signal the release of melatonin to help you sleep.
Pull over if you're sleepy
Sometimes, you'll be on your way home and a wave of sleepiness may overcome you. Accidents often happen within miles of your home. You might think you'll be able to make it, but it's much safer to pull over and get your blood moving. Even better, ask a friend to pick you up and drive you home.
Stay alert on shift
Fatigue impacts cognitive performance, such as increasing your reaction time, decreasing vigilance and skill effectiveness, impairing memory, and lowering concentration. These issues negatively impact patient safety. Stay alert by staying active — listen to a podcast, do word puzzles, walk the facility, restock the nurses' station, or do a mini-exercise routine to boost your oxygen levels.
Stop drinking coffee/caffeinated drinks after 2 a.m.
It's ok to drink caffeinated drinks early in the shift, but as the night progresses, steer clear of caffeine. You'll be thankful in the morning when it's time to sleep and wind down as a nurse. A poor day's sleep will make the next shift even more difficult.
Hydration plays an important role in being alert throughout the night. Even becoming slightly dehydrated can lower your concentration level, increase your reaction time, and impact your short-term memory. Drink enough so the color of your urine is a light straw color.
Know your body
Staying safe isn't always about avoiding muggers. Sometimes it means staying healthy and watching your numbers. Night shift nurses may have a higher risk of health problems related to a lack of sleep and living outside their normal circadian rhythms.
Pay attention to the signals that warn you it's necessary to make changes to help manage your stress as a nurse. These include your blood pressure, fatigue, immune response, and an increasing number of accidents or injuries.
Ensuring Safe Patient Care
Night shift nurses are responsible for ensuring the safety of their patients. Yet, working during the night shift and sleeping during the day can place the nurse at an increased risk of fatigue and burnout. It's important for nurses to recognize the signs and symptoms of fatigue and burnout they may be facing.
Nurses may experience emotional exhaustion, feeling drained, detached, or apathetic toward their patients, job, or family. This is a difficult and challenging symptom and a hallmark sign of nurse burnout. Nurses experiencing burnout also might feel a lower sense of personal accomplishment at their work and a loss of interest in activities outside of work.
In addition, they might experience physical symptoms, including headaches, fatigue, and insomnia. Nurses who are fatigued or burned out complain of difficulty concentrating, lack of motivation, and low self-esteem. This can lead to increased absenteeism and a higher turnover rate for the hospital.
It is important to note that these symptoms can also be caused by other factors. So nurses experiencing burnout should see their healthcare professional to rule out underlying medical conditions. If you suspect that you're experiencing fatigue or burnout, it's important to deal with nurse burnout by seeking support. Take the steps needed to manage stress and maintain a healthy work-life balance.
Meet Our Contributors
Prisca Benson, PCCN
Prisca Benson graduated from Rutgers College of Nursing in 2011. She is a PCCN-certified nurse who has worked in various nursing areas in both hospitals and home care in New York and New Jersey. She earned her master's in nurse education at Chamberlain University in 2021. She currently practices as a nurse navigator for the neuroscience department at The Valley Hospital. Her passion for educating people led her to start a blog (ourgreenlifenj.com) during the pandemic to increase the accessibility of reliable information.
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