January 03, 2019

On the night shift


What we can learn from our teams that continue to care for residents through the night.

With lighter mornings and darker evenings, what better time to acknowledge our night time teams who play a crucial role in running our care homes after the sun goes down.

Illnesses, separation from a loved one, hunger or thirst, incontinence, noise or light levels or getting in a comfortable position can often disturb sleep patterns (see the results of a unique research study where one of our homes trialled night-time posture products to improve residents’ quality of life here).

So providing good quality care for residents at night is just as important as in the day since an enjoyable evening and good night’s sleep can improve residents’ overall wellbeing and social interaction. It’s also another opportunity for colleagues to get to know residents, explore their wants and needs and support at a time that can be very distressing for some.

Gail Whittaker, Night Nurse in one of our North West homes commented: “Our shift runs from 8pm to 8am – there is no set plan for bedtimes so residents have the flexibility to decide when they like to go to bed, such as straight after tea or after winding down in the lounge. Helping residents get ready for bed is shared between day and night teams.

To ensure a seamless transition of care between the day and night team, we use a digital handover sheet which is updated each time a resident’s needs change and spend some time at the end of a shift to pass information to the team taking over.

Nurses and carers that work nights enjoy the close relationships they form with residents and one another in a quieter atmosphere that has fewer interruptions. We provide a familiar face at night which can be a distressing time for residents when anxieties and worries surface and seem magnified in the early hours of the morning. We help residents feel comfortable by getting to know their preferences such as what they like to drink, the type of bedclothes they like to wear and the level of lighting they prefer. Night’s fly by as there is no strict routine and care is based on individual needs.

As night teams, we can participate in resident reviews to giving a true 24 hour care picture, reflected in care plans that are truly centred around the individual.”

Many colleagues choose to work night shifts because it fits in with other parts of their life but it can take 6-9 months to adjust to being on nights, and it’s important to get adequate sleep to stay healthy and alert.

Here, My Home Life - a UK initiative aimed at promoting quality of life for people in care homes – have put together some top tips for night-time care: 


1. Quality of sleep and rest is hugely important for residents. Supporting residents to sleep can have a positive impact upon their well-being during the day.

2. Individualised night care plans: Use night time care plans to assess and communicate the needs of each resident. Include regular updates on pain and continence.

3. Keyworkers: Allocating colleagues to work with individual residents (night key worker system) can increase support for residents at night,

4. Noise and light: Although sometimes unavoidable, constant assessment on how noise and light may be affecting residents sleep is recommended.

5. Emotional support: Night colleagues play a crucial role in offering support to residents who struggle to sleep at nights and need someone to talk to for reassurance. 

6. Relatives support: Find a system to allow night colleagues and relatives to keep in touch.

7. Feeling valued: Night colleagues can geel overlooked in terms of support and training. Managers need to make time for night colleagues to support them at work and identify their training needs.

8. Team-building: The divide between day colleagues and night colleagues can make team building difficualt. Take time to communicate across these colleagues groups. Having colleagues work across day and night shifts can be helpful in minimising the divide. 

9. Appropriate Training: night colleagues sometimes feel overlooked when it comes to training, partly because it takes place during the day.

10. Keeping healthy: Providing night time care on a regular basis can make night colleagues more vulnerable to health problems. Have clear information available on how night colleagues can keep healthy when working nights. 

Four Seasons Health Care has over 260 care homes across the UK with 17,000 colleagues providing care and support for 16,000 residents

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