The night shift. It is a mystery to all those 9-5 business types out there, but usually no stranger to nurses. Many of us have started off as new nurses on this shift because it's all that was available, yet others prefer to stay on this shift for years and years because it fits their lifestyle. It might be better for child care, or maybe they just aren't morning people. If you have been a nurse for any period of time, most likely you have done nights for at least some of your career. Let's face it, it definitely has it's perks - usually free parking, more money, less noise and less doctors around to interrupt your flow - it can be very appealing to many for good reason!
But what about the downfalls? Especially when you're trying hard to take good care of yourself and be healthy and well? You often hear of people saying they gained a ton of weight working nights, or their sleep was all messed up, or they just felt rundown all the time with no energy to spare for exercise. Sometimes you get so messed up you can't even remember what day it is! These can all certainly be stumbling blocks for someone trying to stay healthy and well.
Let's be honest, our bodies are designed to be active during the day, and need rest and repair at night. Our blood sugar and hormones are regulated differently at night than they are in the daytime. Our body thinks we are supposed to be shutting down during those hours and it makes adjustments accordingly. Our muscles are not supposed to require energy during these hours, so they can become less receptive to insulin. Our digestive system would like some rest at night and does not want to be working. All of these things can potentially lead to glucose intolerance, weight gain and possibly issues with our digestive system. It can get ugly! Not to mention, sleep is vital for good health. If you're working nights and not getting any good quality sleep, you will get into trouble.
So I am proposing some strategies to help those of you who do work nights to stay as healthy as you possibly can. Avoiding health issues that can sneak up on you is vital to surviving well on the night shift. Let's look at what we can do:
1) Try to stay as closely as possible to a normal day/night pattern of food intake. Minimize eating between 12-6 am as much as possible. This gives your body and vital organs that normal night time hours of rest that they need. The liver is very busy rebuilding the body during the night. Studies show that the liver is most active between the hours of 1-3 am. It gets to work healing and cleansing the body of toxins that have accumulated during the day. If we eat large meals during this time, we can disrupt this important and healthy process the liver is trying to accomplish. So I would propose that if you work 12 hour nights (7p-7a), try to be done eating before midnight if you can take your break before then. If you start at 11pm, maybe try to eat right before you go in so you can leave the overnight hours without eating. Then, if you have time, maybe eat something right before leaving work in the morning, or maybe eat as soon as you get home before going to bed. Please avoid the temptation to snack all night long!
2) Meal prep and choose whole foods! This is key. You absolutely must have a plan for your food intake. Prepping your food at home and making sure you are bringing fresh whole foods to work with you is a life saver. Don't leave it to chance. Don't be victim of eating whatever is in the cafeteria, whatever is sitting at the nurses' station, or whatever someone decided to order out for the unit. Plan your food, and stick to the plan!
3) Exercise - get it in. This is non-negotiable. Yes, I know you might feel like crap and have no energy - even more reason to exercise. You need to rely on the energy you will get from exercise to get through your night shifts (and keep you healthy!). I used to find it helpful to exercise in the late afternoon before heading into work. That workout would give me the boost of energy I needed to get through the night. Even if it's just a brisk walk! Do something to get you going. I know it is tough if working back to back 12 hour shifts. If exercise is not possible to fit in on those days, just make sure you are not backing down on your days off. It is a MUST. And if you have any down time at night, take a brisk walk or do some stairs to help keep you awake and get in a little exercise!
4) Sleep patterns - find what works best for YOU! This is such a grey area. There is no perfect one way for everyone to get the right sleep on this shift. Some do best with staying on somewhat of a night schedule even when they are off (maybe staying up until 3am on a night off to mimic work), and some prefer going to bed as usual on a night off, then maybe napping before work the next night. The most important thing here is that you are GETTING sleep. How and when is really a personal preference. Just make sure you are getting some quality sleep! Personally, I found that napping before work screwed me up more than helped, but that's just me. I know many nurses who counted on those naps and they had to have them. Do what you need to do!
5) Use caffeine strategically. This means don't drink coffee around the clock! I know I relied on caffeine pretty heavily on nights, but I always tried to keep it to the beginning of my shift. Drink water during your shift to stay alert and hydrated. Try to avoid drinking too much caffeine at the end of your shift when you're trying to get ready for a day of sleep (unless you are one of those people who can drink a pot of coffee and go right to sleep - that's certainly not me!).
6) Make your daytime sleep as good as possible. You want your daytime sleep to be good sleep, not just feel like a little cat nap. Rule #1, turn off the ringer on your phone! Please don't forget that ever so important rule (and turn volume down or off on your answering machine!). I hear about nurses getting mad that someone called them during the day when they are sleeping. Well why is your ringer on??? You should have no idea someone tried to call you. ;-) Noise machines are also helpful for some people to drown out the daytime noises outside. If necessary, get room darkening shades and curtains to block out as much light as possible. Dark is GOOD! And be careful with regular melatonin use. I know it is popular for many, but just be aware that you can eventually train your body to no longer produce it on it's own if you are constantly taking it in a pill form.
7) Get your vitamin D levels checked. This is something most people don't think to do. Working nights or not, many of us are deficient in vitamin D. Night shift workers especially, are not getting exposure to natural sunlight as much as the rest of us. Your body must have enough vitamin D to absorb calcium and promote bone proper bone health. A lack of vitamin D can lead to misshapen and fragile bones in adults. Vitamin D deficiency can also lead to mood swings and irritability. We don't need any more of that since we're already over tired and cranky from being awake all night anyway! Supplementation is certainly okay if you're not able to get enough vitamin D from sunlight, but good food sources to be aware of are things like fatty, cold water fish (salmon, sardines, tuna, herring), milk, cheese and eggs.
8) Last but not least - GET HOME SAFE! This might sound obvious, but it's a serious concern for night shift workers. Falling asleep at the wheel is no joke and should not be taken lightly. Make plans accordingly if you know you have issues with this problem. Carpool, use public transportation, get a taxi or an Uber! Saving your life, and potentially the lives of others, is way more important here. And if you find yourself falling asleep at the wheel, please pull over. Take a nap to shake it off, or call a friend to come get you.
Bottom line, if working nights fits your lifestyle without compromising your health very much and you are able to get plenty of quality sleep, then good for you. However, if you are someone who just cannot get sleep or find yourself really feeling awful despite trying all of the above suggestions, you may want to consider a different shift. Nights are not for everyone. I know at times you need to do what you have to do, but just make sure your own health is not taking a serious hit in the meantime. Pay attention to what your body is telling you, and be kind to yourself!
Terri Wentzell is a registered nurse with more than 20 years of experience. She is also a certified personal trainer, wellness coach, fitness nutrition coach, and sport yoga instructor.