American Academy of Nursing Policy Recommendations to Reduce Health Risks of Night‑Shift Work

Summary

This American Academy of Nursing consensus paper synthesizes evidence that night-shift nursing is an occupational health hazard linked to higher risks of diabetes, cardiovascular disease, cancers, depression, cognitive impairment, and earlier mortality—and that these risks drive substantial costs via errors, burnout, turnover, and increased healthcare use. The paper stresses sex differences in shift tolerance and calls out health-equity gaps, then moves beyond individual fixes to system solutions: advocate legislation and regulation that create safe night-shift conditions; fund research to define safer shift designs and disease-prevention strategies; and engage insurers, organizations, and government to recognize and pay for prevention. Proposed initiatives include virtual nursing to redistribute workload, AI to cut medication errors and track burnout/well-being, circadian-savvy lighting (e.g., red-light alertness at night without suppressing melatonin), eliminating mandatory overtime, tracking errors by shift, and piloting alternative/staggered night schedules (shorter 4–6-hour blocks or revised 8-hour patterns) to protect sleep and cognition. Rather than prescribing fixed rules (e.g., a set limit on consecutive nights), the AAN issues three policy recommendations: (1) systemic changes that reduce circadian disruption and disease burden; (2) working conditions that respect nurses’ rights and improve safety/quality; and (3) advancing novel tech and scheduling models—backed by research funding and multi-stakeholder accountability.