Nursing can be rewarding, but it can also be hard, draining work. Nurses who work overnights or long, 12-hour shifts often struggle to maintain their energy, and they risk real trouble if they start making drowsy mistakes or fall asleep on the job.

Nurses and hospitals have known about the dangers associated with long shifts and overnights for ages. They have been well-documented, and the fatigue that nurses suffer on these shifts can lead to lapses in memory and attention, poor problem-solving, poor judgment and the types of mistakes that may lead to a “letter of concern” from the PHMP.

Staying alert is a full-time job

You need to stay alert at work because your patients are counting on you, and you may lose your license and your job if you ever fall asleep. But staying awake and staying alert aren’t just for the workday. Your energy levels are the result of lifestyle choices you make every day, including:

• Prioritize your sleep schedule. Most people need 7—9 hours of sleep, and if you go without the amount of sleep you need, your sleep deficit will drag you down. Getting a good night’s sleep between long shifts leaves very little time for anything else, so you’ll likely need to think about your bedtime as you plan your days.
• Eat for energy. Nutritionists recommend diets that are low on sugar and high on protein and fiber. They often advocate “power snacks,” of high-protein foods like nuts or yogurt at intervals through the day. This helps keep your fuel supply nice and steady.
• Drink lots of water. Dehydration can lead to fatigue.
• Get your exercise. Regular exercise helps you stay fit and trains your body to burn food for energy efficiently. Exercise is also great for disrupting moments of fatigue. A brisk bout of exercise can give you a jolt. It boosts your oxygen intake and sends modest amounts of stress hormones through your body to make you feel more alert.
• Find ways to reduce your stress. This may mean reducing the number of chores and errands you assign yourself outside of work. You might take up meditation or a hobby. Stress takes up a lot of energy and leaves you feeling fatigued, so devising a tried-and-true method of releasing your stress is essential.
• Coffee. Coffee is good, but in moderation. Caffeine can lead to increased attentiveness, but the returns diminish when you drink too much or so late that it disrupts your sleep cycle.
• Drink alcohol sparingly. A few drinks after a long shift may help you fall to sleep faster and deeper, but they can reduce your REM sleep. REM sleep is believed to be highly restorative, and losing it can lead to drowsiness the next day.

So many of our lifestyle choices affect our energy levels that staying alert at work is truly a full-time job throughout the week, even on your days off.

What happens if you do make a mistake while you’re exhausted?

Even people who know better sometimes let themselves run low. Nurses with infants at home or night classes may simply not be able to find the time to take care of themselves. And it’s possible to make mistakes at work. If you ever receive a letter of concern or find that your license or job may be at stake, it’s critical that you know all your choices. Talking to an experienced attorney can help you avoid costly mistakes and set you back on the path to success.