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Does Working at Night Work for Your Health?

The cafeteria is closed. There's only a skeleton staff on at the pharmacy. Three o'clock in the morning is fast approaching. While many in the medical community sleep, a brigade of night nurses continue to distribute medications, monitor vitals, and handle patient emergencies.

Night nurses sometimes feel they are the forgotten members of the hospital staff. They work just as hard as day nurses, but their work may not be acknowledged because their patients are often asleep. And it's not easy to stay alert all night. Being a night nurse may mean resorting to vending-machine junk food for meals and drinking way too much coffee or soda to stay awake. And after the shift is over, it's a juggling act to find sleep time that fits personal and family schedules.

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Mary Ann Cadavillo is an RN who worked night shifts for more than five years. She’s very familiar with the toll the night shift takes on personal nutrition. “The night shift is notorious for eating,” she says. “I used to nibble all night long to stay awake. I also used to drink seven to ten cups of coffee each night.”

Too much caffeine and overeating, coupled with job stress and sleep deprivation or broken sleep patterns, easily can create both short-term and long-term health problems.

The Effect of Light
According to a recent study, another factor that may add to long-term health risks for night-shift nurses is exposure to artificial light. A recent report by the Nurses’ Health Study indicates that night shift workers’ exposure to artificial light decreases their natural production of melatonin, an important hormone that helps the body suppress cancers, particularly colorectal and breast cancers. As a result, nurses who work nights for a long period of time may be at increased risk.

The study suggests this risk is especially high for nurses who switch back and forth between day shifts and night shifts, or those who work part-time nights, because they are constantly changing their sleep patterns (circadian rhythms). A summary of the report in the June 4, 2003, Journal of the National Cancer Institute states: “Melatonin would be less strongly suppressed among women working on permanent night shifts than among women who work on rotating night shifts.”

Common-Sense Care
If you’re a night-owl nurse who prefers to work while others sleep, certain strategies can help guard your health.

Eva Schernhammer, MD, a researcher at Brigham & Women’s Hospital in Boston, recommends steering clear of melatonin supplements as a preventative. Further study is needed, she says, to confirm the connection between melatonin production and cancer risks. A better strategy is simply to eat right and take care of yourself. The following tips will help decrease the health risks associated with night-shift work:

• Screen, screen, screen
  After age 50, all women should receive regular mammograms and screening colonoscopies. It’s doubly important to do so if you are a night-shift worker.
  

• Get plenty of sleep
  Numerous studies show that lack of sleep can negatively impact your health. Working at night doesn’t mean you should sleep less, but you may need to re-adjust your traditional sleep habits.

Give yourself some decompression time after work, just like daytime workers do. Without giving yourself time to unwind, you may find yourself too agitated to sleep well.

When you are ready for bed, don’t let the rest of the world intrude on a good day’s sleep. Unplug the phone (if you have school-age children, give them an emergency beeper or cell phone number) and darken your bedroom. Try a “white noise” machine to block daytime noises. And set firm boundaries with your family so they respect your sleep time.

If possible, stick to the same sleep schedule on your nights off so your circadian rhythm isn’t interrupted.

• Eat right
  What you eat is not only important for your overall health, it also can affect your ability to sleep well.

“Many night shift nurses stay awake eating junk food out of the vending machines, all of which are full of high-content sugars and a lot of fat,” observes Allen Siegel, RN, who has worked many night shifts over the years. “They’ve got all that stuff in their system and then they go home and try to sleep.”

If the hospital cafeteria is closed at night, bring healthy food with you and try to establish a consistent schedule of meals.

• Skip the caffeine
  Drinking coffee and sodas can increase blood pressure and enhance the effects of stress on your body. Find other ways to stay awake. If you can, take a quick walk (or even a sprint) outside. Or stick your head out a window to get some fresh air.
  
  
• Exercise
  Determine the best time to exercise, and when it won’t interfere with your sleep schedule. Cadavillo remembers when she would go biking or inline skating in the mornings after work. “But then I was so wired, I couldn’t sleep. I’d only get to sleep for a few hours [before I’d have to get up again to go] to work.” Choose a time that allows you at least 30 minutes of aerobic exercise each day.
  
  
• Make suggestions
  Many nurse administrators are so accustomed to working days, they forget what it’s like at night. Volunteer ideas on how you can make your workplace healthier and better.

Siegel recalls working in one unit that established a policy that required each night nurse to take a half-hour nap during the course of the shift. “[I] woke up so refreshed,” he says. “And it provided a safer environment for the patients.”

• Return to daylight
  If you suffer adverse effects from your night job, quit the night shift. When your health takes a hit, the shift differential is worthless.