The physical and social toll on nurses from working shifts is great. As nurses age, the disruption to the circadian rhythm caused by rotating shifts is less likely to be tolerated. Night shift invariably brings more responsibility and increased workload because few support staff and other health care professionals are available. Many times, the RN is it even though medical emergencies such as heart attacks, frequently occur at night time. Staffing levels are lower at night, yet many patients or elderly residents do not sleep through the night.
Nurses working at night also have to contend with safety and security issues.
For all these reasons, an increase in night shift premiums is an important recruitment and retention factor. In other industries, shift premiums in general are higher. Working weekends is one of many conditions viewed as a drawback to nursing as a career choice as it conflicts with the societal norm. The current 50 cent hourly premium falls far short as an incentive for keeping nurses in the health care system and attracting new people to the profession. Nurses have not received an increase in the weekend shift premium since it was first achieved in 1991.