Want to Join Night Shift Nurses? These Are the Pros and Cons

Medicine doesn’t stop when the sun goes down. While other team members are off, night shift nurses are passing medications, performing assessments, charting, and responding to emergencies. And even though the night shift (sometimes called NOC shift or third shift) is commonly thought of as less busy than the day shift, some experts call it the most challenging.

So, what is NOC shift like? The nocturnal shift happens between late evening and early morning. These shifts may be different depending on the lengths of shifts your unit uses:

• 12-hour shifts: Night shift is typically 1900 (7:00pm) to 0700.
• 10-hour shifts: Night shifts may be 1400 (2:00pm) to 0000 (12:00am), or 2200 (10:00) to 0800.
• 8-hour shifts: Night shift is typically 2300 (11:00pm) to 0700.

Night nurses are essential in many acute care and post-acute care specialties. In most hospital units, nurses work three 12-hour shifts per week and have four days off. Whether you’re a registered nurse (RN) or licensed practical nurse (LPN), if you’re thinking about becoming a night shift nurse, you’re probably curious about the pros and cons.

Advantages for Night Shift Nurses

Check out the benefits of night shift nursing:

Ease of Entry

For new graduate nurses, night shift positions can offer a smoother entry into the nursing profession. Many facilities only hire new grads on nights to help them acclimate to the pacing of nursing. With fewer visitors, staff, and procedures going on, there’s more time to work on your skills and get your questions answered.

Quieter Environment

Night shifts provide a calmer atmosphere as they lack the hustle and bustle of daytime activities. You won’t see physical and occupational therapies, physician rounds, or as many surgeries and procedures at night. This quieter setting lets nurses focus more intently on patient care without the daytime distractions.

Potential Downtime

Night shifts sometimes have periods of lower activity, and you might have downtime. This can be an opportunity to catch up on charting, study for certification, do continuing education, or even study for another degree. This is unique compared to day shift, when downtime is much rarer.

Reduced Oversight and Visitors

With less management around, many nurses enjoy less oversight and unit politics at night. Regulatory bodies, like the Joint Commission, don’t tend to visit on nights. Additionally, there are fewer visitors around the hospital at night, which means fewer interruptions for nurses.

Shift Differential Pay

Because of the irregular hours, facilities offer higher pay for night shift nurses. This shift differential (sometimes called “shift diff”) may be a flat additional rate per hour, or expressed as a percentage of your flat hourly pay. For example, you might make $7 extra per hour on nights, or you might get 125% of your standard hourly rate on nights.

Disadvantages for Night Shift Nurses

As a night shift nurse, you might also face these drawbacks:

Disrupted Sleep Schedules

Even if you keep a relatively regular schedule when you’re off, your circadian rhythms may be irregular. Problems with your sleep can contribute to mental health issues and cognitive dysfunction. Working nights can increase your risk for cardiovascular problems, cancer, and even early aging. The effects of poor sleep may worsen nurse burnout, and some experts believe that the exodus of new graduate nurses may be partially attributed to night shift work.

Work-Life Imbalance

Inverting your sleep schedule can leave you feeling disconnected from the rest of the world. Night shift nurses can struggle with maintaining a balance between work and personal life, because even on your days off you’ll be recovering from your shift. If your friends or family work office jobs, there might not be much overlap in your time off with them, and it might be more difficult to meet new people. You might miss events or time with your family because of an irregular work schedule.

Difficulty Sleeping

Even after a long shift, it can be hard to get the recommended amount of sleep during the day. Sleeping can be especially challenging if you live with roommates, a significant other, or family. And many night nurses juggle family responsibilities as well as shift work: picking up kids from school, running errands, and keeping the house running between shifts. It can be hard or impossible to protect your sleep time when other daytime responsibilities come up.

Reduced Clinical Support

It’s not just the nursing staff that tends to be less experienced on night shift — the medical team, management, and other support staff may be newer as well. Your night shift physicians may be residents rather than experienced attendings, and you’ll need to pay close attention to their clinical decisions and orders.

On the other hand, your attending physicians might be home and on call, and it’s sometimes hard to decide if a problem is worth waking them up for. This might lead to less clinical support when an emergency happens.

Less Interdisciplinary Communication

With fewer staff and family around, decisions around a patient’s care plan are usually put off until morning rounds. You might feel like you don’t have as much influence over a patient’s outcomes because you’re just carrying out the decisions of the day-shift team. While it’s nice to have fewer procedures going on, you might feel like you’re missing out on clinical experiences and interdisciplinary communication.

Fewer Nursing Staff

In general, night shifts are staffed with fewer nursing professionals than day shifts. You might have less support from CNAs and fewer colleagues to turn to when you have questions. Your patient ratios may also be higher, and that can be stressful when something goes wrong, especially if you’re less experienced.

Safety Concerns for Patients and Staff

With not as much staff around, patients are more at risk for falls and adverse events. Hospital-induced delirium, sometimes called “sundowning,” is when a patient becomes acutely confused at night. Up to half of patients over 65 may experience this, and it leads to safety problems for patients and staff, who may have to restrain them. Additionally, less security and supervision at night can put nurses at higher risk for assault.

Experience Discrepancy

Some competitive graduate programs, such as CRNA school, prefer candidates with day shift experience. Many management positions also want their candidates to have some experience on the day shift. This can make it challenging for night shift nurses to advance their careers in certain specialties.

How to Survive Night Shift: 10 Tips

Are you going into a night shift job, and you’re not sure how to prepare? Here are some essential tips for night shift nurses:

1. Learn about the risks to mitigate them: Courses like the CDC’s Occupational Health and Safety course for nurses can help you understand how to work long hours more safely.
2. Plan for sleep: Let friends and relatives know you won’t be available before or after your shifts, and don’t plan events when you should be sleeping. Put your phone on Do Not Disturb, or set it to only allow emergency calls and texts.
3. Adjust your sleeping environment: Once you get home from a shift, it’s easier to go to bed if you have a comfortable environment for daytime sleep. Blackout curtains and shades, a noisemaker, eyeshades, and earplugs can help you get to sleep and stay asleep.
4. Schedule shifts together: To avoid having to flip your sleep schedule several times per week, schedule your shifts close together. This will let your body adjust its rhythms, and give you more of a routine from day to day.
5. Prepare your sleep schedule: Stay up late when you’re working the next night, and take a nap before your night shift to help prepare your body to stay up. If you’re coming off of a row of night shifts, don’t sleep for the full day to switch your body back to a regular schedule.
6. Limit caffeine intake: It can be tempting to turn to coffee or soft drinks when you get sleepy around 0300, but caffeine can make it harder to fall asleep once your shift ends. Limit caffeine to the beginning of your shift.
7. Bond with coworkers: Downtime on night shift can make it easier to build relationships with other nursing staff on your unit. Having the support of your coworkers makes the job easier.
8. Healthy eating: The CDC recommends eating high-quality foods — like vegetables and nuts — and avoiding processed high-sugar foods.
9. Exercise: Maintaining a regular exercise routine may make it easier to sleep and stay well while working night shift. Try taking a walk before your shift or going to the gym on your days off.
10. Advocate for yourself: Although many nurses start their career on night shift, it’s okay if you don’t want to stay there. If you feel that working nights is interfering with your life or your mental health, let your unit manager know you need a change.

Night Shift Nurse Salary

The average annual salary for RNs is $94,480 and the average annual salary for LPNs is $60,790. Remember that one of the benefits of working nights is the higher pay compared to day shift, so it’s reasonable to expect a night shift nurse salary to be higher. Your years of experience, certifications, and location will play a role in your actual salary.

Find Night Shift Nursing Opportunities

Curious about joining night shift nurses? There are many openings across second and third shift. Get personalized nursing jobs sent to your inbox so you can find the role for you.