Night shift is hard on nurses

It’s unhealthy, even unsafe

‘Night shift throws everything into chaos: irregular meal times, sugar cravings at 4am in the morning; coffee to stay awake at 4am which interferes with sleep when I get home. There are lots of lollies and chocolates available on night shift – we tend to nibble throughout the night shift rather than have a sit down meal. There is no healthy, wholesome food available for nurses working on the night shift, only the lollies and chips in the vending machines.

‘I regularly get sudden waves of nausea and vomiting at the end of a night shift.

‘I am concerned about nodding off when I am driving home after work. On one occasion when I had a 30-minute drive home I had a micro-sleep and drifted across the road until the lane divider woke me up. At least two other nurses have told me recently that they have also experienced micro-sleeps while driving home after night shift.’

Karen Featon, RN, ED, Campbelltown Hospital and Camden Hospital

Fatigue puts patient safety at risk

‘My experience as a Nurse Manager is that, with very few exceptions, nurses generally don’t like working night shifts but see it as a necessary evil of the job. It is generally difficult to get nurses to work night shift, especially to cover unplanned absences.

‘There have been staff who have requested periods off night shift when they have been experiencing problems in their family relationships and felt that only being rostered to work day or evening shifts would relieve some of the pressure on the relationship. I have always tried to accommodate these individual needs. However, it is not always possible because the roster needs to maintain a proper skill mix.

‘Staff have also discussed with me their concerns about their safety at work on night shift, particularly during consecutive shifts. They are worried about making mistakes because of fatigue and find the night shifts are more stressful than other shifts.

‘Night shifts can place extra stress on family relationships both because nurses on night shift are not available to participate in activities and because when they are available they tend to be overtired and irritable.’

Grant Isedale, Emergency Department Nurse Manager

I sleep OK but I have no energy

‘It is my experience as the NUM that sick leave among nurses is more frequent during or immediately after a period of night shifts. My observation is that during and after periods of night shifts nurses suffer higher rates of minor ailments such as colds.

‘I am lucky to be one of a small number of nurses who do not experience difficulties in sleeping when on night duty. Even though I was able to sleep for about seven hours I was still affected by working night shifts. When I woke up I had no energy or motivation for my usual physical activities such as walking, or for any social engagements.

‘I also experienced difficulties in maintaining awareness when driving home after night shift. I used to arrive home on several occasions and realise that I had no memory of the drive home.

‘I also suffered from minor infections such as cold sores more frequently when working night shift.’

Gail Hanger, Nurse Unit Manager,

High Dependency Unit, Bowral Hospital

It’s impossible to manage

‘I worked a rotating roster until 2002. In my experience there is a real survival mode when one is working night shift and a real mental anguish coping with night shift and then knowing you have to get up and do it all over again. It was a vicious cycle that I found impossible to manage properly, even after 20 years.

‘Nurses working in my unit complain of tiredness on a regular basis. They have difficulty sleeping during the day and there is a cumulative effect on their level of tiredness. Staff report mood swings due to tiredness. There is a tendency for staff to put on weight during the night shift due to irregular and changed eating patterns.

‘I need to be very fair, careful and at times apologetic when rostering staff on nights. I know how I felt about the night shift. If staff are feeling unwell or stressed due to night shift, after consulting with other staff, I attempt to give them a break from it for a couple of months. The only reason I am able to do this is because my staff are very supportive of each other.’

Dianne McCarthy, NUM, Aged Care Rehabilitation Unit, Prince of Wales Hospital

It’s too hard and people leave

‘The skill-mix on night shift is critical because of the lack of clinical support on that shift. Even though I currently have a full complement of midwives I still have difficulties obtaining midwives to cover unplanned absences and clusters of births during night shifts.

‘Staff are reluctant to fill in for a night shift vacancy as an ordinary additional shift so we need to pay overtime to attract them. Sometimes the shortage of relief staff means that permanent employees have to work extremely long hours. On a few occasions I have personally had to work a night shift after my regular day shift because of the unavailability of relief staff.

‘I have lost experienced midwives during my time as the Midwifery Unit Manager specifically because of the requirement to do night shift. One midwife found a Monday-Friday midwifery job, one left nursing altogether and another retired early on medical advice that she should not continue to work night shifts.’

Donna Garland, Midwifery Unit Manager, Bankstown Hospital