From Nurse Keith’s Digital Doorway

As a career coach for nurses, I receive a lot of questions and complaints about nursing careers, and one of the most contentious and confusing issues for many nurses is whether to work days or nights. Perhaps you, dear Reader, have experienced such confusion yourself.

Days vs. nights is an old nursing puzzle that so many nurses face: Do I work nights and get the differential while ruining my social life, or do I work days and run my tail off when the residents, surgeons, NPs, and doctors are on hand all day to send me running with new orders and admissions?

When I was decided to go to nursing school, my wife was very supportive but she issued one warning: I could never work nights, and I promised her I never would. So, 22 years later, I’ve fulfilled my promise to the letter.

In the end, days vs. nights is the nursing conundrum that never gets old.

Working Days

In terms of hospital employment, many nurses regularly work day shift. Day shift is when a lot happens: physicians, surgeons, PAs, and nurse practitioners make their rounds; tests are ordered; meds are changed; charts are reviewed; admissions can come in fast and furious. If you work in a teaching facility, residents and interns are also part of the mix.

Depending on the milieu or facility, day shift can be rather intense. There are generally more meds and procedures during the day, and patients may be poked and prodded more than they are at night when their main job is to try to get some rest (which can sometimes feel impossible in a hospital setting).

During day shift, meals are distributed to patient rooms three times a day and there are simply more personnel running around from task to task. Many nurses say that the potential for all hell to break loose is often more likely on days.

Pros of Day Shift

There are many benefits to working days — here are a few that are worthy of highlighting:

Sleep: Humans are generally wired to sleep at night. Period. Working days allows you to honor your normal circadian rhythms and sleep like everyone one. Your partner or spouse may also very much appreciate you being around to keep the bed warm, especially in winter.

Learning: Some anecdotal evidence from nurses shows that many feel that they have more opportunities to learn during day shift. With surgeons, physicians, nurse practitioners, and clinical nurse specialists roaming the halls and available, consults and rounds and off the cuff conversations can really help a nurse to gain and sharpen clinical knowledge. Other staff are also on hand during the day, including but not limited to respiratory therapists, case managers, and other valuable colleagues.

Teamwork: Since more people are around during day shift, you have more opportunities to interface with others and develop your teamwork skills. Working days also allows you to interface with patients’ families and do some important patient and family education.

You’re in on the action: Don’t get me wrong, night shift can be full of surprises and learning for sure. However, the faster pace of day shift may feel more exciting to some nurses who like seeing the hours fly by.

Connecting with patients and families: During day shift, you have more opportunity to connect with patients and their families. That relationship-building can be important, and only the day nurse has the chance to truly do that work. When you work days, you’re also around to see the changes in your patient. You also have the chance to send him or her to procedures and then assess them when they return to the floor. If you work days, you also have more chances to say goodbye to patients when they’re discharged.

Food: Cafeterias in acute care facilities are always open during the day. Having access to a warm meal (if you can manage to get a break) is a real boon, especially for those nurses who aren’t so good about bringing food from home.

Going out after work: Some nurses who work nights may go out for breakfast with colleagues after working all night, but reason leads me to believe that nurses who work days may be more likely to go out with colleagues for happy hour or a treat after day shift.

Cons of Day Shift

Day shift may be a panacea for some, but for others there are far too many detracting factors to make day shift a good choice for them.

Missed opportunities with your kids: If you work 7am to 7pm, you need to leave the house before the kids are barely awake and you miss the opportunity to be present for preparing for their school day. You also don’t get off of work until well after they get home, so you miss out on after school time as well. If you work 7am to 3pm, that shift will allow you more chances to be around for the kids after school.

Getting stuff done: Back in the days before electronic banking and online shopping, people who worked days would often have a hard time getting normal stuff done. If you work Monday-Friday during the day, making medical appointments can be very difficult, and some businesses and services are simply only available in the daytime during the week.

The relative chaos of days: Some nurses loathe days because it’s just too chaotic. In the previous section, we mentioned having other colleagues around as a plus, but it can also be a huge minus, especially for introverts who prefer more solitude and autonomy. Working days, there’s also more chances of being bossed around by a physician or other provider.

Patients’ families: Whereas having the chance to do patient and family teaching during day shift can be exciting and satisfying, families and visitors can often make your shift much more difficult. Some nurses love interacting with families, but some can’t stand it and prefer nights when no families or visitors are allowed (except for very special circumstances).

Working Nights

Some nurses simply love night shift and would never trade it for days. Night shift has a certain mystique, and night nurses share that particular world with gasoline and convenience store attendants, law enforcement, first responders, firefighters, factory workers, hotel staff, and a host of other professionals and non-professionals who toil away while the rest of us are asleep.

Pros of Night Shift

The things that drive some people crazy about day shift may be the reasons why certain nurses love night shift.

Autonomy and relative quiet: During night shift, patients’ families and visitors are generally not around, nor are most physicians and providers. Thus, things are pretty quiet and nurses can focus more on patient care with fewer distractions.

Earning potential: Night shift salary and differentials can be significantly higher than days, and the extra earnings can really add up. Some nurses have a hard time giving up nights for this reason alone.

Errands: Getting off of work in the early morning means that the night nurse can (ever so sleepily) do a few important errands on the way home. Having to be at work at 3pm also means that the nurse has more opportunities to fit in medical and other appointments, although lost sleep may result if those appointments take longer than expected.

Fewer traffic woes and better parking: Commuting during off hours can make the drive to and from work must more pleasant and faster. Those nurses who work day shift have to deal with countless other commuters who are on the road at the same time. Meanwhile, parking can be much easier at night.

Time with the kids: Night shift nurses can sometimes make it home in time to get the kids off to school. Sleeping during the day and waking up mid-afternoon can also allow for the night nurse to receive the kids when they come home from school. This can be a big plus for busy families, including being available for parent-teacher conferences and other important events and meetings.

Time to think: The quieter environment and slower pace of night shift can allow for more time to think, plan, and sort out one’ life.

Cons of Night Shift

Marital/relationship issues: Not being around during many nights of the week can sometimes lead to relationship problems. Spouses and partners gain much from sleeping in the same bed, including but not limited to sexual intimacy. Working nights can cause some marital discord if energy isn’t put into making up for lost time to remain connected as a couple.

Your social life: Working nights, especially Fridays and Saturdays, can cause you to miss out on a lot in terms of your social life. If you head to work at 6:30pm on the weekends, you’re going to be slogging away on the unit while your friends are out to dinner or partying without you. Some night nurses feel their social life suffers enormously.

Fatigue and other health issues: There’s no escaping that working nights has many deleterious physiological and psycho-emotional effects due to significantly impacted biorhythms. Proper nutrition, self-care, and high-quality dietary supplements can help, but the negative side effects of nights are real. Working night shift has been shown to increase the risk of cardiovascular disease, diabetes, obesity, mood disorders, gastrointestinal issues, and more. The National Sleep Foundation even has a name for it: Shift Work Disorder. One of the main problems with night shift is a lack of exposure to the sun. Sleeping all day in a blacked out room certainly increases your risk. Having to sleep so much to make up for your fatigue can cause you to lose a great deal of time at home when you just need to rest and can’t do anything else.

Time goes by so slowly: For many night nurses, the hours go by incredibly slowly since the pace of work is generally much less intense. Night shift can seem endless, especially when you’re already tired.

Less connection with patients: Working nights means patients are often asleep most of the night and you have fewer opportunities to connect, talk, educate, and form a nurse-patient bond.

Making the Choice

Choosing between days and nights is never set in stone (unless you’re married to someone like my wife and you promise to never ever work nights!) If you’re new to nursing, you might want to try both and see what you like better. Luckily, you can always change your mind, but remember that making the change from nights to days (or vice versa) can be challenging for a while.

Some night shift nurses become very dependent on the extra money, a factor that can make it hard to return to days. Day shift nurses also value their regular sleep schedule and time with family and friends, so moving to nights can seem improbable, if not impossible. For those who like nightlife and partying, you’re definitely going to miss out on some fun when you’re doing the nighttime nursing thing.

In the final analysis, we need nurses working both days and nights, and there are luckily always people who prefer one over the other. Both days and nights have their ups and downs, and every nurse has to find the workstyle that fits with their chosen lifestyle. And as your life changes over the years, the shifts that seemed totally unworkable to you in the past may begin to seem more attractive as you and your life evolve.

You’re not married to your work-related choices forever. Make the best choice for now, and be open to a new way of working in the future.

Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind NurseKeith.com and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is co-host of RNFMRadio.com, a wildly popular nursing podcast; he also hosts The Nurse Keith Show, his own podcast focused on career advice and inspiration for nurses.

A widely published nurse writer, Keith is the author of “Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century,” and has contributed chapters to a number of books related to the nursing profession. Keith has written for Nurse.com, Nurse.org, MultiViews News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University, the ANA blog, Working Nurse Magazine, and other online publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, online nurse personality, podcaster, holistic career coach, writer, and well-known successful nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.