“Night Shift Warriors: Reflective account on personal experiences and evidence based suggestions for recognising how to improve health during unsociable hours”
Vicky Weller BSc Hons RVN Vicky Weller NCert&ECC, WSAVA Pain Management
Vicky brings experience from a range of clinical settings and is committed to continual skill development. She is passionate about teaching and supporting the next generation of veterinary professionals. With a strong interest in out-of-hours and emergency stabilisation work, she thrives in fast-paced, demanding environments. Her professional perspective is further shaped by international volunteer experience in Asia including: Cambodia and Thailand.
Working emergency and urgent care out of hour’s shifts can be exhilarating, fast-paced and fun-filled for those thrill seekers. Whilst also being emotionally and physically draining being on your feet for anywhere between 10-13 hour shift stretches. The night shifts often provide great opportunities to utilise those extensive set of nursing skills developed and allow you to provide one to one attention and care for the patients housed overnight. Caring for yourself and identifying good practices that work for you to perform to the best of your abilities is key.
This reflective piece identifies what has worked from personal experiences to those evidence based findings for optimising health and caring for yourself on out of hours shifts.
Handy suggestions, tips and evidence based recommendations will be reviewed for how to care for your mind and body whilst undertaking night shift work will be reviewed.
Working long and unsociable hours comes with the trade to ensure our patients receive the care they require out of hours. Whilst, we as a nursing profession are fighting for our patients and strive for the best nursing care, are we watching out for ourselves?
Over the years, I have found a passion for working out of hours, attending to patients extensively, monitoring those critical cases and enjoying the excitement and uncertainty of what may come through the door. It can be thrilling attending to trauma cases and learning new skills and ways we can assist our patients in need. In contrast, it can also become exhausting, battling sleep deprivation, low staff levels and sometimes zero downtime in between nursing duties. For this reason, I believe it is important to reflect on how we prepare for shifts, consider strategies to optimise our health, and identify personal goals that support the care of both mind and body for overall wellbeing.
Night shift work can feel daunting at first and imposter syndrome can feel all too consuming however, working OOH can also develop skillset and confidence. It can allow you to explore varying caseloads, utilise all the nursing team OOH and provide new challenges [1].
Numerous studies have highlighted the risks associated with this type of work, and there are several internal measures that could be implemented in response, such as reviewing and improving work schedules and staffing levels, providing education on sleep and fatigue, and offering targeted support for colleagues undertaking long shifts [2]. It is important to monitor staff and possible long term effects of sleep loss that can cause physical and mental health conditions [3]. Understanding and monitoring veterinary professionals undertaking OOH work is important and whilst employers have a duty of care to maintain the health and safety of its workforce, acknowledging potential warning signs from your body is vital [3].
Working solely night shifts is advantageous for some individuals, facilitating work-life balance, while obtaining a financial reward [4, 5]. Figuring out whether this lifestyle is more beneficial for you is key and being fully informed of potential future detrimental health risks, provides individuals with steps to reduce this impact and make healthy choices.
Preparation
It is important to find out if a few nights before your block of shifts, helps you to transition into nights by gradually going to sleep a few hours later each night. This can help to adjust your sleep cycle, so it is not as challenging at the beginning of your stint of OOH shifts. Whilst, this may work for some individuals it may not be the case for everyone, this is why it is important to trial various adjustment techniques to determine if there is a more positive way to ease yourself into your night shift rotation.
Preparing your meals prior to your block of shifts can help immensely by ensuring you eat wholesome meals without the over indulging of snacking those sugary treats and enduring the highs and lows of a glucose come down. Being more mindful about choosing protein-based meals can help you feel fuller for longer and maintain your energy levels during busy periods.
During Night Slogs
I have personally found that by making small changes whilst I am working my night shifts contributes massively to how I feel during the week. It has been well reported and documented that working OOH shifts has various detrimental effects on the body both mental and physical. This is why is pays to be informed and well educated on the ways we can approach these shifts and self-care surrounding this kind of work-lifestyle.
Do one POSITIVE ACTION before your shift! This can be in the form of anything that brings you and your body joy.
MOVEMENT is key. Going for a short walk prior to your shift can help you to unwind and gather your thoughts before a long shift. Partaking in sports/ work out sessions or high-intensity interval training (HIIT) before night shifts has been shown to improve individuals physical work capacity and reduce potential health risks [6, 7]. The addition of any exercise intervention is reported to contribute to offsetting future cardiovascular/ cardio-metabolic risks associated with shift work.
Speaking to family and friends before work can have a beneficial impact on your emotional status, so you do not feel so isolated whilst working nights in comparison to others working during the day.
Staying HYDRATED. I know it is obvious but during nights just keeping on top of your fluid intake can have a major impact on how your body feels. Additionally, trying to eat healthy and avoiding excessive amounts of sugary foods during the night can help avoid those crash’s your body suffers due to glucose levels dropping. Meal preparation prior to your shifts can help to create nutritionally balanced meals with good amounts of a protein source to help you feel satiated. This will help to avoid the highs and lows associated with sugary food cravings.
Day-time Sleeping
As you may be aware, our bodies are programmed for sleeping based on light and the circadian rhythm. Summarised briefly, we have a biological clock that approximately spans a 24 hour period that peaks and troughs with various hormones. This includes hormones such as melatonin which help to regulate our circadian rhythms where our bodies would be in tune with the environment for light and dark cycles (light = awake, dark = sleep) [8]. Therefore, sleeping in the day is generally a lot more difficult and so steps should be taken to try and maximise sleep quality and duration.
Research has also suggested that sleep deprivation can have a negative effect on the body and may result on reducing the ability to perform psychomotor tasks [9]. Efforts can be taken to try and reduce the effects of sleep deprivation and counteract sleep disturbances. It has been reported that fellow nurses in the NHS have adopted adaptive strategies including; engaging in regular exercise, optimising the sleep environment and balancing sleep with other activities [10].
Take steps to create the best sleep environment:
- Utilising sleep masks and ear plugs
- Installing thick black out blinds
- Creating a cool environment to sleep in
- Playing white noise if this aids individuals sleep routine
Post Night Shift Transition
Completing night shifts can be equally as difficult when trying to ease back into a day routine and transitioning your sleeping pattern back to normal. A few studies have reported positive outcomes for the use of aromatherapy in supporting improvements in alertness, reduced sleepiness and improved sleep quality following night shifts [10]. This still needs more investigations however, it appears to be an easy, non-invasive tool to help support and complement approaches by veterinary staff in alleviating some adverse effects associated with working night shifts. Another aspect to consider is the addition of regular massages or the introduction of acupuncture to help improve autonomic nervous system regulation [10]. Current investigations suggest its potential to help correct autonomic imbalance associated with circadian disruption with individuals on shift work.
Although this review hopes to provide suggestions and tools to aid carrying out night shifts with supported evidence, the topic still requires more extensive research to validate the improvements and support ways individuals can improve their health from negative effects of shift or out of hours work. It can be deduced from other research in human medical professions that scheduling longer recovery periods following nights can contribute to reducing physiological strain of irregular shift patterns.
Overall, individuals should tailor a suitable regime to aid sleep quality and duration for scheduled night shifts. Discussing with management where support interventions can be integrated internally at work can contribute to ensuring patient and employee safety. Whilst it is important to determine what aspects are successful in improving sleep deprivation, monitoring health and taking action and conscious efforts will improve nurse’s emotional and physical status.
References:
1. Pye, J., (2022). Taking the plunge into out-of-hours emergency nursing. VetRecordcareers. Accessed online: 01/09/2025 [Accessed at: https://www.vetrecordjobs.com/article/out-of-hours-emergency-nursing-]
2. Steffey MA, Scharf VF, Risselada M, Buote NJ, Griffon D, Winter AL, Zamprogno H. A narrative review of occupational scheduling that impacts fatigue and recovery relevant to veterinarian well-being. Can Vet J. 2023 Jul;64(7):674-683. PMID: 37397701; PMCID: PMC10286151.
3. Burns, E., Gray, C., Vivian, S., (2024). The impact of ‘sleeping night shifts’ on veterinary clinical staff’s cognitive performance and fine motor skills. Veterinary Nursing Journal. Pp 30-39 (1)
4. Saul, A.M., (2019). Ethical dilemmas surrounding 24-hour nursing provision for patients in veterinary practice. The Veterinary Nurse. Vol 10(3) pp 124-127
5. West, S., Mapedzahama, V., Ahern, M., Rudge, T., Rethinking shiftwork mid-life nurses making it work! Nurs Inq., (2012) 19(2):177-87. Doi: 10.1111/j.1440-1800.2011.0055.x
6. Exercise training prior to night shift work improves physical work capacity and arterial stiffness. Schäfer C, Mayr B, Müller EE, et al. Eur J Prev Cardiol. 2020;27:891–893. doi: 10.1177/2047487319848196.
7. Shakhloul M, Amer A, Zekry M, Elgewely M, Saleeb A, Ghobrial S, Shehata MZA, Abouelkhir I, Kamal MO, Manqaryos B, Abdulfattah M, Syed A, Shakhloul D, Kamel M. Effective Interventions for Reducing the Negative Effects of Night Shifts on Doctors’ and Nurses’ Health and Well-Being: A Systematic Review. Cureus. 2025 May 3;17(5):e83385. doi: 10.7759/cureus.83385. PMID: 40458350; PMCID: PMC12127892.
8. Beeston, D., (2021). Into the night,,,. Vet Times. Accessed online: 01/09/2025 [Accessed at: https://www.vettimes.com/news/vets/small-animal-vets/into-the-night]
9. Ballantyne, H., (2022) Stay calm and carry on a VN ‘s perspective on night duty by Helen Ballantyne. Veterinary Nursing Journal Vol 27 pp 237-238
10. Lim, H., Kim, S.H. Navigating night shifts: a qualitative study of exploring sleep experiences and coping strategies among nurses. BMC Nurs 24, 385 (2025). https://doi.org/10.1186/s12912-025-03001-3