Nursing & the Night Shift: What’s It Doing to Our Waistlines?

This guest post is by Lynn Robinson, an RN and a student at the Hunter–Bellevue School of Nursing. In 2012 Lynn took a course in narrative writing for nursing students at Hunter taught by CHMP senior fellows Joy Jacobson and Jim Stubenrauch.

It’s almost midnight, five hours into my 12-hour nursing shift, but the lobby’s still buzzing with excitement. I’m greeted by whiffs of strong coffee every time I pass the nurse’s station. The little old lady in the room by the nurse’s station is complaining that her temporary roommate won’t turn down the volume of the television, while the young, strapping lad in the room at the end of the hall is limping across the floor pleading for more pain medication. I feel the pressure building up behind my eyes. I take a minute to run to the bathroom to wash the sleep off of my face. Just a few hours more and the unsightly dark circles will begin to form around my eyes. Ah, burning the midnight oil on the night shift!

Nursing is a 24-hour-a-day business—the availability of round-the-clock health care is a hallmark of our modern society. Some nurses take on the lengthy 12-hour day shifts, while others opt to work late evenings and nights when most people are watching Modern Family or Once Upon A Time in Wonderland just before their bedtime. Working the night shift has been found to be associated with an increased risk of a number of health complications including sleep disorders, obesity, heart disease, hypertension, diabetes, reproduction irregularities, infections, as well as familial and social life disturbances. Lengthy shifts, in general, have been found to cause similar problems. Take a look here at this literature review from the National Institute of Occupational Safety and Health, which examines research reports that studied the links between long working hours and performance, employee health, and safety complications.

Nurses are no strangers to stressful shift-work schedules. The job postings for nursing jobs advertise the attractive differential in pay for taking a night-shift position. Sure the night shift pays more, but can you put a price on your health? Studies have linked obesity in nurses to job stress and long work hours. Check this study out here, which found that 55% of nurses are overweight or obese. Obesity in nurses is getting much-needed attention. Take a look at a press release about this study from the University of Maryland.

I’ve found the night shift to be particularly challenging. Sleep is a big factor in our health. Some nights I imagine leading a call-and-response chant with my coworkers.

What do we want? Sleep!
When do we want it? All the time! Basically.

Our bodies prefer to be active during the day and to rest at night. Being awake at night interrupts our circadian rhythm, or body clock. Our body clock sits inside our brains, running the show—it’s responsible for our sleep-wake cycles, temperature, metabolism, hormones, and reproductive system. Tick-tock!

With enough sleep, my body is a well-oiled machine. But when’s the last time I got eight hours of uninterrupted sleep? Maybe a year and 10 pounds ago, before I started working the night shift. Nobody really respects daytime sleepers. Your kids more than likely won’t. Neither will the heavy-duty truck horns, the UPS deliveryman, or the 15 errands on your to-do list.

Unhealthy habits are also to blame.

Quick question! What time’s lunch time when you’re on the night shift? Maybe 2 am. Some may argue 4 am. But, where’s the kitchen staff that serves all those healthy food options to the day-shift clan? They were already gone by the time my belly grumbled for “lunch.” Sure enough, there was also no time for home-cooked meals, so I opted for delivery. A chicken-and-steak burrito, served on a fresh 12-inch tortilla, with rice, beans, lettuce, ripe tomatoes, and cheese, minus any remnants of guacamole, became “the usual.” Potato chips or candy bars were also popular choices from the vending machines that lined the hallway outside the cafeteria. As you could imagine, finding time for much exercise also became more difficult.

It’s surprising to me that anyone is still willing to work the night shift. But I think there’s hope. Employers need to get involved in addressing these health issues. Making schedules that allow nurses to get enough rest needs to become a top priority. They can also put wellness programs in place to help encourage healthier lifestyles. I’m talking about offering on-site gyms, or discounts and reimbursement for off-site health club fees, or weight management programs. How about addressing that cafeteria? During the day, healthy selections of food and drinks are available for employees. Night-shift workers aren’t always this lucky. Putting healthier options in the vending machines may be a good start. No more candy bars, potato chips, and sweet drinks. Maybe nuts, low-fat pretzels, baked chips, diet sodas, and water might be better choices!

A lesson in irony? I lost sleep to finish this blog post. I’m not worried about that just yet, since America likes her nurses like nurses like their coffee—strong.