If you work shifts, you know it’s not always easy to find time to eat. Your stomach may be growling, but you can’t sit down to eat if a patient codes, a coworker calls off sick, and you get five new admissions. Or maybe you work alternating shifts and have no routine meal schedule. Or you’re working back-to-back 12-hour shifts and barely have time to spend with your family, grab some sleep, and commute back to work.

Many shift workers have varying workdays and shift lengths and, in many cases, alternating day and night shifts, too. Their schedules may disrupt their personal lives and circadian rhythms (sleep and waking patterns), leading to chronic fatigue, cluster headaches, GI distress, and other problems. “It’s hard to eat three meals a day when you work the night shift because your sleep schedule is all messed up,” states Cassy, a nurse who works nights on the med/surg unit of a community hospital. “Sometimes I’m just too tired to eat.”

A recent study supported by the federal Agency for Healthcare Research and Quality showed that nurses routinely miss meals to care for patients. Many nurses who have limited mealtimes or work night shifts admit to snacking on less nutritious high-calorie items, such as candy bars or chips, because they’re easily accessible through vending machines.

Tips for healthy eating

But many options for healthy meals take less than 30 seconds to prepare, so lacking the time to eat isn’t a good excuse for skipping meals. What’s more, healthy eating aids weight management and can improve work performance. Although eating well takes some effort, you can do it if you prepare adequately and stay committed. Here are some strategies that promote healthy eating for shift nurses.

Don’t skip meals

When you skip a meal, your body goes into a fasting mode and uses less efficient energy sources. As your blood glucose level drops, your concentration suffers and you feel fatigued and irritable. Glucose, the brain’s main fuel, is compromised within 4 to 6 hours of a missed meal. The deficiency forces the body to use less efficient energy sources, starting with protein. To preserve remaining protein stores, the body resorts to using fats in the form of ketone bodies. When ketosis sets in, fatigue, low blood pressure, and nausea may occur. As a result, your decision-making skills may slow down and you may become physically unsteady.

Skipping meals also may lead to cravings and sudden blood glucose spikes, which in turn may trigger increased triglyceride production. The triglycerides are stored as body fat, increasing the possibility of weight gain.

Don’t binge on a single big meal

Eating just one large meal a day may contribute to calorie loading, which can overwhelm your body with calories it doesn’t need and can’t handle. It’s best to divide your nutrient load over the course of the day instead of consuming it all at once.

Limit your caffeine intake

While caffeine may increase alertness, consuming it in large quantities or within 4 hours of bedtime can cause insomnia, exacerbate GI symptoms, and act as a cardiac stimulant. (See Caffeine content of popular beverages by clicking on the pdf icon above.)

Stay well hydrated

Adequate hydration is essential to proper bowel function, circulation, and body temperature regulation. Water also carries nutrients throughout the body and removes waste. Dehydration, on the other hand, can stress the heart, increase core body temperature, and contribute to fatigue.

Try to drink at least 8 cups of decaffeinated beverages daily. Bring a large water bottle to work each day and keep it filled throughout your shift.

Take your own meals and snacks to work

Buy a good insulated cooler and keep it stocked with healthy food options. (For suggestions, see Web Exclusives at www.AmericanNurseToday.com.)

Relax when eating

Many nurses cite stress as a reason for missing meals. Stress hormones can curb hunger, making it easy to miss meals—or making it hard to even think about eating. So before you take your first bite, try to relax and take a few deep breaths. This helps give your body more time to properly digest food.

Plan ahead

If your facility has a cafeteria or restaurant facilities and you tend to buy your meals there instead of bringing food from home, read the menu in advance and decide what you’ll have before you purchase food. This may decrease impulse buying.

Prepare for the unexpected

Keep in mind that no two shifts are alike. During some shifts, you won’t be able to sit down for a break. When this occurs, try to find at least a few minutes to eat a high-fiber protein bar (one with at least 5 g of fiber and 7 g of protein to increase satiety) or to consume a meal-replacement drink.

Limit vending-machine snacks

Keep a steady supply of healthy snacks on hand. If the vending machine is your only option at any given time, choose a more nutritious snack (a granola bar, wheat chips, or peanut butter and crackers, for instance) instead of candy.

Schedule routine mealtimes

Stick to your meal schedule as much as possible. Inconsistent or sporadic meals may contribute to fatigue and weight gain. While mealtimes may vary with the shift, avoid going longer than 6 hours between meals.

Eat one or two healthy snacks instead of one large meal

If you work afternoons, try to eat your largest meal in the middle of the day. If you work nights, eat lightly throughout your shift and then have a small to moderate-sized breakfast. Eating a large or greasy meal can make digestion difficult at bedtime. (See Sample mini-meals by clicking on the pdf icon above.)

Don’t let shift work jeopardize your well-being. Making a few changes in your eating habits can have a huge impact on your energy level, job performance, and overall health.

Selected references

Engler L. The importance of all meals. NSCA’s Performance Training Journal. 4(6):10-11. www.healthygatherings.com/items/addonfiles/179_04064.pdf. Accessed June 15, 2009.

Mayo Clinic Staff. How much caffeine is in your daily habit? www.mayoclinic.com/health/caffeine/AN01211. Accessed June 15, 2009.

Tribole E. Eating on the Run. 3rd ed. Champaign, IL: Human Kinetics Publishers; 2004.

U.S. Department of Health and Human Services. Agency for Healthcare Research and Quality. Skipping meals or breaks may contribute to nurse burnout and jeopardize nurses’ health. www.ahrq.gov/research/mar05/0305RA4.htm. Accessed June 15, 2009.

Kathleen Meyer is Assistant Manager (Dietary) at Fairfield Medical Center in Lancaster, Ohio.