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Handling Stress
Successful Shuteye
Advice for the nurse on nights.

Nights: You either loathe them or love them. But as a new nurse you usually don’t get to choose your ideal shift. Nights are often all that’s available. And either you adjust, or you don’t.

Melissa Granger, an oncology nurse at Elmhurst Memorial Hospital in Elmhurst, Illinois, was “on the brink of depression” because she couldn’t handle nights when she first graduated.

But Christy James, a labor and delivery nurse at Evanston Hospital in Evanston, Illinois, and mother of two, found that nights fit her lifestyle. In fact, she says, “I like the atmosphere better.”

Whether you dig or curse nights, how do you survive?

Staying Awake
According to the National Sleep Foundation, during the night, your body feels like it should be sleeping. Boost your energy by exercising throughout your shift. Climb some stairs or take a walk.

Eating three healthy meals also helps keep your energy up. You’ll hit your lowest period around 4 am, so plan accordingly.

Granger felt best when she ate dinner at 3 am and a snack at 4 am.  While many night nurses resort to caffeine, remember it takes half an hour to react in your system.  And if you consume it five hours before you plan to sleep, it can hinder your rest.

Napping is also an excellent way to stay alert, even if you only have 20 minutes. You may feel groggy afterwards, but this usually passes within 15 minutes. Afterwards you should be energized and in a better mood.

Managing Your Personal Life
Sleeping in the day while everyone else is up isn’t easy to adjust to. But there are ways to make this opposite life work for you.

For example, most nurses work four nights a week, at most, so daytime events are still possible.  Granted, you often miss out on social activities. This is why communication with your friends and family is important. With their help, you can schedule activities that fit your schedule.

Ease marital tension by scheduling specific, routine times to spend together. With a little teamwork, this is possible, though not necessarily easy. Granger, a newlywed when she worked the nightshift, says, “You’re sleeping and eating at different times. It’s hard to connect.”  However, James found that prioritizing a specific meal—breakfast—with her husband helped her relationship.

It’s always important to remember that a lack of sleep can make you impatient, irritable, anxious, and depressed. Getting the needed 7-9 hours of sleep will help you stay positively engaged in the relationships that matter most.

The Sleep You Need
We all have an internal, natural cycle that regulates our body functions and revolves around daylight—our circadian clock. “Some people have real trouble sleeping during the day, even though they’ve been up all night,” says James. Granger was definitely one of those people. “My body never got used to it,” she recalls.

If this is the case, the National Sleep Foundation recommends setting a schedule and sticking to it, even on days off. Before you go to bed, take a warm bath or lower the room temperature. Avoid stressful activities that activate your brain, such as reading a suspenseful novel.

Then, fool your body. Darken your room and even wear sunglasses when returning from work to avoid the morning sunlight. Create some white noise to hush daytime clatter. You can also eat a light snack before bed so you won’t be too hungry or too full to sleep.

Most of all, make sure your family and friends know your situation so they don’t wake you up. And go ahead and unplug that phone  . . .  just in case they forget.

For more information on surviving the night shift, go to The National Sleep Foundation.

Melissa Granger, RN, BSN, received her BSN from Indiana Wesleyan University in 2005, worked in Med-Surg at Christ Medical Center, Oak Lawn, IL, and currently is working on the Oncology floor at Elmhurst Memorial Hospital, Elmhurst, IL. Christy James is a labor and delivery nurse at Evanston Hospital in Evanston, IL. An RN for eight years, she began working days on a med/surg floor and after one year moved to nights on the labor and delivery floor.

Read more Handling Stress articles

7 Responses to “Successful Shuteye”

  1. marita ofori Says:


    I am a new nurse on a medsurg floor I was wondering if any body can give me a format on how to
    organize my shift and save time effectively. I would appreciate if it would be in sequence. or if there is a book I can buy.


  2. Kathy Quan RN BSN Says:

    I have been asked this question I lot lately and have written a new article about it at The Nursing Site on Here’s the link: (
    This is a subject that troubles a lot of new nurses. Be patient and give yourself about a year before you feel really comfortable.

    After report, look over your assignment and pick out all of the tasks that you know you have to get done such as dressing changes, decub care, tubes or drains to take care of, Foley catheters to insert, change or remove, I&O to record, and any patient teaching.

    Make a list of time specific tasks and then plug these other tasks in to your list. Do the ones you don’t like to do, or the patient is difficult, or for whatever reason you’d like to put off as long as possible…FIRST. Once they’re done, you’ll feel the load lighten because they won’t be weighing you down, and you won’t be dragging your heals.

    Plot out a specific time to do each task and how much time you think it will take to do each task and cross it off as you get it done. Refer to your list every hour and make sure you’re on time.

    Work in passing meds and other routine duties you have to do. Schedule breaks and meals and don’t skip them! Schedule time to chart at least 3-4 times during your shift and make sure you do it.

    There are a couple of booklets available from that you might find helpful as well.

    Good luck!
    ~Kathy Quan RN BSN

  3. daizyrhonda Says:

    I have just left my medicine position because of my job being constant day shift. I was in a relief line and of course the needs were for days on my unit – much of the senior nursing staff preferred to work nights because it was less hectic. So I learned a lot of things on medicine that helped me get through the shift.

    1. Leave the call bells to your other team members first thing in the morning, as well as setting people up for meals/toileting (if this is possible, of course). Flip through your medications to see if you have anything that needs to be taken with the breakfast, as well as any IV meds. Flag up/down if you need to/can.

    2. Start with your diabetics for meds on all passes – you’ll most likely have metformins or insulin to do before the meals arrive.

    3. Make sure your patients that have physio or appointments are up and dressed. Do vitals while you’re doing your rounds with meds.

    4. Go for coffee. Finish your am meds after that, check all of your IV’s and check orders before sitting down to chart.

    5. Chart, then do more meds. Check IV’s/Foley’s again. Help with am care before lunch meds if you’re needed.

    6. Afternoons are good for getting caught up on the charting, checking orders, phoning for orders, and restarting IV’s/procedures/foley stuff. I find that my mornings just don’t afford me time to be doing procedures unless they are going to take less than a few minutes.

    – Keep a good set of jot notes on all of your patients. We have “cheat” sheets with their history and their status – like diet order, IV/fluid/rate, and any procedures or I and O’s needed to be done. We also have a “dirt” sheet for our vitals on a board attached to our vital machine. It helps to have that… but you need the cheat sheets going so you can answer questions anyway.

    – Delegate if you can. I had troubles delegating when I first started on the unit because I thought the RN had to do all of the procedures.

    – Ask for help when you’re drowning. There has to be at least one sympathetic person who can come and do stuff for you while you get caught up.

    I’m going to psychiatry. The busy pace of the day shift and the lack of staff left me with a back injury that will most likely be with me the rest of my life. The whole lack of organization and chaotic environment of medicine contributed a lot to my injury, and have also contributed to my complete demise in the area.

  4. Misty Says:

    I hear that about getting tired at 4 am.

  5. Cindy Says:

    I have worked nothing but night shift since graduating 3 years ago and I love it. There is less stress as you dont need to deal with the Doctors at night unless there is an emergency or an admission. You dont have to deal with angry or crazy pt family members at night. We do stay busy 80% of the time with charting and passing meds and hanging IVs. You have more time at night to deal with pt’s needs. No the patients do not always sleep at night so there is always plenty to do. If the census happens to be low then you may get bored, but this is very rare. I always keep a good book or magazine in my bag in case the night is slow. I wouldnt give up night shift for anything. I sleep very well during the day as I dont need dark or complete quiet to sleep. In fact I usually sleep with the TV on as background noise.

  6. liz Says:

    There was a story on Whats good for you, here in Australia a few months ago asking if shift work is bad for your health…Well the answers rather obvious- DUHHH of course it is! Apparently shift workers, esp those who do mostly nights, live 10yrs less.

    When i started out as an AIN, I did night shift, not knowing id be sitting there doing nothing. I started nodding off on numerous times, it was so boring. Then I did one night shift where I was just helping out, and when it was quiet i was drifting off. Then of course the cold air in the morning gets you awake lol.

    Ive done nights with a nursing home and they let you have about 90mins sleep which is really good coz it just really awakens you.

    I wont mind doing some night duties from time to time, as long as i get the penalty rates, and there is stuff to do. If theres nothing to do, even with a good book, I will fall asleep..and caffeine just makes me pee so thats not ideal lol.

  7. Kathy Quan RN BSN Says:

    I need to UPDATE my response above. is closing the Nursing site effective Nov. 30. I am in the process of moving my content to a new site ( as quickly as possible. This article hasn’t been moved yet, but I will try to get it posted as soon as possible.

    Kathy Quan RN BSN

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