Night duty. Personally, I hate, hate, hate, hate it.
But I have the greatest respect for those nurses who either do a lot of it. Or chose to make it their life.

A study to be published in the Journal of Advanced Nursing looks at the experiences of nurses working the night shift at three regional hospitals in Australia.

Data was collected via questionnaires, interviews and diary entries over a six month period in 2010 and was augmented by a series of semi structured interviews.
Of the 14 study participants, 10 were on permanent night duty and all were female.

The results of the study found a very strong cohesive team amongst the night shift. But it also fond evidence of the night shift crew operating somewhat as a silo (or separated unit) from the rest of the shifts. And there were several themes around this:

Staff felt that they had to deal with a poorer working environment that their daytime colleagues, particularly around distribution of workload and staffing.
They also felt that they were required to work with much less resources and “sub-optimal” leader ship support from department managers.
They expressed feelings that the night shift nurses appeared to be considered of lesser value or ‘lower status’ than other shifts.

There was also a sense of disconnectedness from the organization that might stem from the organization not trying to involve night nurses in hospital activities and processes or from the night-shift nurses actively choosing not to become involved. The disinterest in governance issues could be ambivalence or direction of energies to departmental concerns.

Other concerns included access to professional development and educational opportunities.

With respect to the personal impact of working the night shift, participants felt that it had a major impact on their lives. Health, sleep and fatigue were a common theme along with expressions of feeling socially isolated.
Although some participants felt the choice to work night shift afforded them a unique opportunity to have a more flexible lifestyle.

The study also produced a set of recommendations to drive a positive change around the issues raised.

  • Managers review current policy and develop new policy and practices as required.
  • Managers consider how to build on the teamwork, co-operation, and collegiality practised by night staff.
  • Managers consider strategies to improve communication and co-operation related to the night-shift role, responsibilities, and position
  • Managers explore professional development needs of night nurses and develop strategies comparable to non-night-shift nursing staff to meet these needs
  • Managers recognize that while night staff work with minimal supervision, they still need and desire leadership. Managers examine leadership options for night staff.
  • Managers overtly recognize the contribution of night-shift nurses.
  • Replication of this study in different geographical areas and facility settings.

The authors go on to conclude:

It is important that the key areas of interpersonal relationships, effective leadership, work environment, clinical competencies, and recognition of the critical role of night nurses be taken on board by managers to inform decisions that have an impact on night staff. This knowledge will assist ward staff, managers, and clinical educators to improve the work environment and potentially maintain a sustainable and effective workforce in regional hospitals. While management has a key role, non-night-shift co-workers must also rethink their approach towards their night-shift colleagues. Just as managers and non-night-shift nurses have a role in change, so do the night-shift nurses themselves, who must accept responsibility for implementing change through co-operation with management and peers.

Although this study had a relatively limited number of participants and was also limited to a small geographical area and particular type of rural healthcare setting, it provides some thought generating reading of any night shift worker.

If you are a regular night shift worker you might like to read the whole study and reflect on its relevance and similarity to your own experience.

Powell, Idona. “Can You See Me? Experiences of Nurses Working Night Shift in Australian Regional Hospitals: a Qualitative Case Study.” Journal of Advanced Nursing (2013).

4 Responses to “Night shift nurses. Strength in a silo?”

  1. Not sure if you have room here for a nurses aide but I work on a cardiac floor, I have training in basic ECG interpretation and provide patient care and I do this on night shift. The sense I always get from our opposite shift (two shifts running from 6:30-7:00) is that nights are quiet and relaxed, this has never been further from the truth. Even patients have this assumption that if they’ve been peacefully sleeping for majority of the night then everyone else must be too. I wouldn’t trade for days though, because I do feel a bond with my fellow co-workers, I feel a team atmosphere with my nurses and I just don’t know if things could be the same in the higher staff traffic of the day time.

  2. All of the rest of us (D/E folks) certainly value and appreciate Night staff, if for no other reason (among our more ruthless members) that they allow us to avoid taking on their dark burden: more than I would bear willingly, having been forced a few times over the years. Nursing management, by its essential nature, is a Day shift animal. Night folks gain and lose from this fact. They gain relative immunity from supervision, as managers tend to rather strongly avoid dealing with any issues at night. Otherwise they might have to work less convenient hours, and if anything about Nursing managment is clear, it is that manager convenience and comfort are King and Queen of their world. Also, confronting Night staff risks them leaving, which entails diffficult hiring and conflict with all those forced to work Nights in the meantime: refer above to convenience and comfort. As a result, there is no better place for certain folks to get away with mischief or neglect. On the other hand, Night staff have little or no independent influence on treatment team and managerial decision-making, as they lack the crucial ‘boots on the ground’ in criucial meetings to have much influence. It’s a mixed bag on the whole, to be certain. All that matters to me personally about Nights, frankly, is that others are willing to spare me their pain for whatever reason, and that our patients are not harmed in the process. Enough said, and perhaps more…

  3. I for one cannot do the 5am thing. I sleep horribly the night prior and just can’t seem to get awake for my shift. I love working the night shift, I think we have a little more autonomy on nights because there aren’t a bevy of Doc’s at our disposal and we have to handle things if they go down hill.

    I think one of the main reasons night shifters feel a little marginalized is because all of the “extra” things are done on day shift. Ice cream socials, holiday meals, even the mandatory education is all done on days because most of the staff that provides these lovely things all work in the waking hours. It would be lovely if everything in a hospital was 24 hours.

  4. I worked night shift in the ED for 4 1/2 years, and only took a day shift position because my significant other no longer found it convenient — even though it allowed us to have family dinner every night and I was able to spend more time with our child. I do find I sleep better, and I feel more healthy, but I miss, miss MISS my night shift people! We are a different breed. The nurses I work with now are nice enough, and (at times) we have a cohesive team, but I have never felt from them the kind of support I felt with my old crew…

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