Nightshift caring is one of those nursing duties few people really want to admit to.
The environment is serene, the illumination gentle, your body is pleading for some rest and yet, as a healthcare professional on a lonely duty at night, you are the one who ensures medications are properly administered, answers the call bells, and makes decisions for patients that their life depends on.
You are not alone if you feel really tired. It is nothing but a regular biological function to be drowsy after going against your natural body rhythm, which is a normal reaction. In a hospital however, the tiredness has to be managed for three reasons.
(1) for your patients
(2) for your fellow workmates
(3) for your own sake
This manual includes tips that night nursing, midwifery and other health personnel can get away on their late shifts safely and remain alert all the time.
Why Fatigue Matters So Much in Nursing
Dopamine levels go down and other stress chemicals come up. This makes the brain slower, less focused, more prone to errors and less emotionally stable during fatigue.
If a tired nurse is also a motorist, the tired nurse may drive tired. A study showed fatigued driving was 2 times more likely in the group of nurses who worked more than 12.5 hours and that nurses who work for a maximum of 13 hours or more increase their susceptibility to fatigue. The same survey found night-shift nurses in the studies reported being sleepy and therefore having to fight their sleep the entire way home in about 30% of those post-work periods.
You are not making a mistake by having a tired brain at some point. A well-functioning environment would provide good habits and good support. Below are a few things that you can do.
Before Your Shift
Take a short nap. Research on night shift workers shows that a planned nap before the shift can help. Many guides suggest around 20 to 30 minutes, though some studies use longer naps. If you nap longer, allow time to wake up properly before handover, since sleep inertia can leave you groggy for a while.
Eat a proper meal. Have a balanced meal before you leave, with protein and wholegrains. See our guide on what to eat on night shift for meal ideas.
Plan your caffeine. Have it early in your shift rather than all through the night, and try to stop around four to six hours before you plan to sleep.
Get some bright light. Bright light before and during the first part of your shift helps your brain feel more awake.
During Your Shift
Take your breaks. This sounds obvious, but it’s one of the biggest problems. One Australian hospital unit survey found that 45% of nurses never took all their breaks on night shift, compared with 6% on day shift. Skipped breaks add up. Protect your meal break and use it properly.
Nap on your break if your workplace supports it. Napping on night shift has been studied in several trials, and a review of studies by an Australian hospital unit found it reduced fatigue in five of six studies. Some hospitals have introduced night duty nap planners and designated nap spaces. If yours has a policy, use it. If it doesn’t, you could suggest one to your manager. Keep naps short, around 20 to 30 minutes, and set an alarm.
Keep moving. Short walks, stretching or helping with a task on your feet can fight drowsiness better than sitting down.
Use bright light. Work in a well-lit area for as much of the shift as safe and practical, especially in the early part of the night.
Stay hydrated and snack smart. Keep water nearby, and choose protein-rich snacks over sugary ones. A big, heavy meal at 3am usually makes sleepiness worse.
Time the hard tasks. Where you can, plan complex or high-risk tasks for when you’re most alert, and use double-checks for medications and calculations when you’re tired. Most people hit a low point in the early hours of the morning, often between about 3am and 5am.
Use your colleagues. Talk to each other, check in, and look out for signs of fatigue in each other. A friendly chat can keep you alert, and a buddy can spot mistakes you might miss.
Driving Home: The Biggest Risk
For many night nurses, the most dangerous part of the shift is the drive home. In one Australian hospital unit’s survey, 97% of nurses said they thought they were unsafe driving home after night shift. That’s not unusual, and it’s why this deserves a plan.
If you’re very tired:
- Have a short nap before driving. Some workplaces have a rest room, and a 20 to 30 minute nap in a safe place can make a real difference. One study found that nurses who napped or took a break straight after a night shift had less fatigue before heading home.
- Ask a colleague, friend or family member for a lift, or use public transport or a rideshare.
- Don’t rely on coffee alone. It can help for a short time, but it won’t fix serious sleepiness.
While driving:
- Wear sunglasses to reduce morning glare and help avoid sending your brain a “wake up” signal.
- Open a window, play something that keeps you engaged, and take breaks.
- If your eyes start closing, your head nods or you can’t remember the last few kilometres, pull over somewhere safe and rest. Don’t push on.
Hospitals can help too, for example by offering rest spaces or transport options. If yours doesn’t, raise it as a safety issue.
Your Roster Matters
Some roster patterns are harder on the body than others. Australian nursing guidance offers a few useful pointers:
- Avoid long runs of nights. The ANMF’s night shift policy recommends against working more than three night shifts in a row.
- Forward rotation is easier. Moving from day to evening to night is generally easier than going the other way. This also fits with what we covered in our guide on rotating rosters.
- Leave time between shifts. Short turnarounds don’t leave enough time for sleep and recovery.
- Plan your preferences early. If you can request your roster in advance, plan your nights and recovery days carefully.
If your roster regularly leaves you exhausted, raise it with your manager or union representative. Fatigue is a work health and safety issue, and employers have a duty to manage it.
Sleep Well After Your Shift
Good recovery sleep is half the battle.
- Aim for a total of 7 to 9 hours of sleep in every 24 hours. It can be split across a main sleep and one or two naps.
- Wear sunglasses on the way home, and turn down screen brightness.
- Keep your bedroom dark, cool and quiet, and use blackout curtains, an eye mask or white noise.
- Try to keep a similar sleep schedule for each type of shift.
- Wind down with a light snack and a short routine.
Our guide on how to sleep after a night shift has a full step-by-step routine.
Recognising Fatigue in Yourself and Others
Learn the warning signs so you can act early:
- Heavy eyelids, yawning, or struggling to stay awake
- Slower thinking or difficulty concentrating
- Making small mistakes or forgetting simple things
- Irritability or low mood
- Microsleeps, where you briefly “blank out” for a few seconds
- Feeling too tired to drive home
If you notice these in yourself, take a break, drink water, move around, and tell a colleague or your nurse in charge. Speaking up is professional, not weak.
Looking After Your Wellbeing
Fatigue and stress often go hand in hand. Nurses and midwives can access free, confidential support through Nurse & Midwife Support (nmsupport.org.au), and many workplaces offer an Employee Assistance Program. If you’re feeling burnt out, overwhelmed or low, reach out. It’s what these services are for.
When It’s More Than Night Shift
Ongoing tiredness isn’t always just roster-related. See your GP if:
- You sleep a decent amount but still feel exhausted
- You snore loudly, wake gasping, or have morning headaches
- You’re falling asleep during the day or nearly nodded off at the wheel
- You feel persistently low, anxious or unwell
Conditions such as sleep apnoea and shift work sleep disorder are common and treatable, and your GP can help work out what’s going on. Our guides “Always Tired?” and “Sleep Apnoea in Women: Why It’s Often Missed” explain more.
The Bottom Line
You will always find it tough to go with a night shift and fatigue, which is one of the most common factors, doesn’t have to be something you accept. Take your breaks and if there is a possibility of having very short naps take them and make time to prepare your lunch and dinner and also, your coffee or tea if it suits you. Protect your drive back home, don’t forget your sleep. Let others know that your roster is too heavy and that you feel too tired so they take measures to prevent accidents. You can’t help others if you’re running out of energy and your physical and mental health is part of your overall responsibility when giving care to other people.
This article is general information only and isn’t medical advice. Follow your workplace’s fatigue management policies, and speak with your GP if you have ongoing concerns about your health or sleep.