All 11-7 nurses, what do YOU think?

[rnhannah]

Their findings don't surprise me at all. After I work 6-7 months on midnights my body gets all out of whack. I get terrible mood swings, I gain weight, I never feel quite right... It's proven that working midnights effects circadian rhythms and cortisol levels, I'm sure that's just the tip of the iceberg.

[strawberyheelz]

i couldn't agree more with TrishLPN. I feel like working 11-7 has done irreversible damage to my body. My sleeping patterns are a disaster. Sometimes when i get off work in the morning i won't go to sleep until 6 or 7 in the evening. i can't lay down early unless i'm just exhausted. but the funny thing is, is that i'm exhausted all the time. before i became a nurse i tried to work 11-7 as a data entry operator for a major bank. i kept that job less than 2 months because i am a natural early bird. i normally get up in the morning at about 4 or 5 and go to sleep at 9 or 10 at night. not anymore. my eating habits are absolutely insane. when should i eat. i'm hungry just before i go to sleep which isn't the time to eat. i'm diabetic and i've gone from being hypotensive to hypertensive. i'm always cranky because i miss my bed. i'm actually in the process of getting an mds certification so i can go to the day shift and not work the floor at the same time not to mention that i'm in school taking RN prerequisites for a bridge program. i've been a night nurse for almost 5 years and YES IT IS KILLING ME.

[cougarnurse]

Well, I had to bump this thread up some. Look what the heck got written up in Nursing Spectrum: Nurse.com - Cancer Risk on the Night Shift

In December 2007, the World Health Organization’s International Agency for Research on Cancer declared that shift work involving disruption of the body’s natural circadian rhythm is “probably carcinogenic to humans.”

This conclusion was based on published evidence that includes data collected from the Nurses’ Health Study and the Nurses’ Health Study II. A summary of the evidence was published in the December 2007 issue of The Lancet Oncology. According to the article, 15% to 20% of people working in Europe and the U.S. have jobs that involve night work, and this type of work is prevalent (above 30%) in industries that include healthcare, industrial manufacturing, and mining, to name a few.

“Among the many different patterns of shift work, those including night work are the most disruptive for the circadian clock,” according to the article, and this disruption may be carcinogenic to humans.

Despite this news, nurses and other personnel who staff the graveyard shift should not become alarmed, says Sue Hankinson, RN, ScD, principal investigator of the Nurses’ Health Study and associate professor of medicine at Harvard Medical School in Boston.

Other researchers concur.

“It’s too early to panic,” says Eva Schernhammer, MD, DrPH, coinvestigator for the NHS. “The risks that we see are modest compared to other risk factors for cancer, such as smoking.”

In October 2007, a WHO working group met to review the published literature on the topic of shift work, circadian rhythm, and the risk of cancer. To date, most studies in humans have focused on breast cancer in nurses and flight attendants and have found that long-term night workers have a higher risk of breast cancer risk than women who do not work at night.

“It’s largely because of the breast cancer evidence that the International Agency for Research on Cancer committee changed the classification of night work to a probable carcinogen,” says Hankinson.

Researchers also are examining the possible association of shift work to colorectal cancer and endometrial cancer risk.

“We came to the conclusion that while human data are still limited, animal data are fairly consistent and support a mechanistic link between light exposure at night and eventual risk for developing various forms of cancer,” says Schernhammer.

It is believed that artificial light exposure at night does its damage by initiating the suppression of melatonin, also known as the “hormone of darkness.” Melatonin is produced in the brain’s pineal gland during periods of darkness and is believed to inhibit cancer growth.

“Melatonin is produced in a very distinct circadian fashion,” says Schernhammer. “There is almost no production throughout the day in people who have regular circadian rhythms. Most production occurs at night when they are sleeping.”

Other mechanisms that are theorized to lead to a higher risk of cancer in night-shift workers include vitamin D deficiency because of a lack of sun exposure. Sleep deprivation also may negatively impact the immune system and the body’s ability to mitigate the production of cancer cells. Plus, disruption of the circadian rhythm may disregulate genes involved in tumor development.

Researchers have a long way to go to answer questions raised by current evidence. Although they suspect that the longer a person works the night shift the higher the risk for cancer, it is yet to be proved. Scientists also are questioning whether the timing of light exposure is more important than the duration.

“It is possible that there is a certain time in a woman’s life that she is more vulnerable to developing breast cancer from that sort of exposure,” says Schernhammer.

Based on biological principals and current data, researchers hypothesize that working rotating shifts may be more detrimental than maintaining a consistent night-shift schedule.

“We think people who work a stable night shift may be more able to adapt, and ultimately that would mean their melatonin levels are probably more normal than in someone who switches between day and night shifts,” says Schernhammer.

Another question is whether it is the night shift itself or other attributes of women who tend to work the night shift that increases the risk of breast cancer. NHS researchers have been able to account for higher family risk, but not some other variables.

“It’s very difficult to sort out other factors that play a role, such as body mass index and lack of exercise,” says Hankinson.

Researchers also are studying the possibility that some individuals are genetically better able to cope with nighttime exposure to light. It is hoped that someday subgroups that are more vulnerable to the risk will be identified so screening tools can be developed.

It is too early in the research process for experts to make recommendations to minimize the impact of shift work on the risk of cancer. There are, however, a range of possibilities that are not yet proved. One benign, common-sense option is to use black-out curtains when sleeping during the day.

“Melatonin secretion is very sensitive to the amount of light, so sleeping in a darkened room is a good idea,” says Hankinson.

Other possibilities include working a consistent shift and limiting the number of years worked on the night shift. The use of oral melatonin is not recommended because of a lack of current research about potential long-term side effects. Both Hankinson and Schernhammer agree that, at this juncture, it is most important to address the controllable factors that are proved to increase cancer risk.

“This is good reason to pay more attention to the things that are influential in cancer risk, such as maintaining a lean body weight, [engaging in] physical activity, eating well, quitting smoking, getting regular physical exams and mammograms, and minimizing alcohol consumption,” says Hankinson.

Because of the increasing consistency of the evidence, much of it from the NHS, more studies are expected to be funded soon by the National Institutes of Health.

“The nursing profession is clearly very affected by this type of research, but it is also actively contributing to it — so stay tuned,” says Hankinson.

[lilsunny]

Thanks Cougar, I read this and all of the replies. I have found that in my case working nights for a long period of time my cortisol levels were elevated along with other labs that were just out of wack. Cancer is a big concern along with depression and other risky behaviors. I honestly believe that there are those who enjoy the night and prefer those hours, and folks like you who like the 3 - 11, but for those of us who no matter what we do to adjust to working nights, it is not going to happen and it causes damage, weight gain, irregular menstrual cycles and other issues. Yet hospitals are a 24 hour 7 days a week operation. Managers should listen to their employees if they approach them and tell them that they are having issues working nights, cant sleep, just do not feel good what harm is it to let them have a break and work days for a spell. Dont know just a suggestion.

[cougarnurse]

I have worked 11-7's...both Home Health AND NH's, and understand where you're coming from, sunny. When I got back to my 'normal' routine, it took quite a while for me to get back on track. Then again, I tend to say, 'Define normal.'

[ruby43]

Well, now, we have all known for years how hard the night shift is. It is hard to get sleep when the rest of the world is running and going. Yes, it can wear you down and affect your immune system. It is definitely tiring. We night shift workers learn to accomodate. Whether it be taking supplements like vitamins and trying to eat healthier...which in itself can be hard since night time doesn't provide a place to get food; so we have to resort to bringing something or ordering out. Those of us who have been working the night shift for awhile have accepted being tired sometimes. We often choose this shift to accomodate the needs of our family when we are home during the day. It isn't easy by any means, but we adapt. One of the adjustments I made is working 12 hour shifts instead of 8; so I am not doing it so many nights in a row. I at least have time to recuperate. And I take naps rather than sleeping 7 or 8 hours in a row...never could do that. I sleep awhile, then get up and go back to bed for a while before I go to work. Unfortunately I have the bad habit of caffeine and nicotine...which will catch up with me eventually, but it is how I survive the night shift for the most part right now. Interesting article. It may be that the means by which we get through those graveyard shifts is more likely the cause of health issues rather than the time of day we work.

[Rethaeros]

I love working 7p to 7am. I know the drag feeling in the wee hours of the morning BUT I use Energy C! It gives you a lift with vitamins. Easting heavy sugar; all those lovely cakes, sweets and those terrible chips we eat can be changed to bringing fruits and veggies to share! Exercise. Your doing these things for you not the patient, though the patient gets a better alert nurse. No one else will take care of you but you-the best nurse for yourself is you!

[Rethaeros]

Hannah there is something I know about night shift workers which surprised me, that is, that they take anti-depressants! I was also amazed the number of doctors also take an anti-depressant. It does help the sleeplessness and mood swings in most.

[AmandaWIRN]

Hannah there is something I know about night shift workers which surprised me, that is, that they take anti-depressants! I was also amazed the number of doctors also take an anti-depressant. It does help the sleeplessness and mood swings in most.

I am a night-shift worker, and do not take anti-depressants or other medications. Nor do I use any type of energy supplements, etc. Occasionally I will have a cup of coffee, but that's it.

[cougarnurse]

Coke Classic was my 'poison of choice' on the overnight shift. Gawd, does it help! No antidepressents here, either.