Digital Repository Masters Projects Spring 2025 Helping Night Shift Nurses Develop More Resiliency Sam Devine-Snow Weber State University Follow this and additional works at: https://dc.weber.edu/collection/ATDSON Devine-Snow, S. 2025. Helping Night Shift Nurses Develop More Resiliency Weber State University Masters Projects. https://dc.weber.edu/collection/ATDSON This Project is brought to you for free and open access by the Weber State University Archives Digital Repository. For more information, please contact scua@weber.edu. WSU REPOSITORY MSN/DNP Helping Night Shift Nurses Develop More Resiliency Project Title by Sam Devine-Snow Student’s Name A project submitted in partial fulfillment of the requirements for the degree of MASTERS OF NURSING Annie Taylor Dee School of Nursing Dumke College of Health Professions WEBER STATE UNIVERSITY 04/22/2025 Ogden, UT Date Sam Devine-Snow, BSN, RN, MSN Student 04/22/2025 Student Name, Credentials (electronic signature) Date Kasey Grubb, DNP, RN, CNE 04/22/2025 MSN Project Faculty Date (electronic signature) Anne Kendrick, DNP, RN, CNE (electronic signature) DNP, N, CNE MSN Program Director Note: The program director must submit this form and paper. 04/25/2025 Date 1 Helping Night Shift Nurses Develop More Resiliency Sam Devine-Snow, BSN, RN, MSN Student Annie Taylor Dee School of Nursing Weber State University MSN Project 2 Abstract Purposes/Aims: Nurses lack the knowledge to implement strategies to reduce the health effects of working night shifts. This project aims to educate new nurses about techniques and habits that promote health and encourage resiliency. Rationale/Background: Nursing schools and new nurse clinical orientation programs often neglect night shift preparation strategies. As a result, many nurses develop negative feelings about night shifts. While the adverse health effects are widely recognized, there is insufficient guidance for nurses, new and seasoned, to create effective night shift routines. Current research points to methods for leadership support, nutrition, caffeine consumption, exercise, and sleep hygiene. Methods: To enhance new nurse orientation, evidence-based educational materials were developed with feedback from stakeholders, including a PowerPoint presentation, pre- and postsurveys for attendees, and an infographic for quick reference of the presentation content. Preand post-survey data will evaluate the relevance and usefulness of the presentation and aid in developing further improvements for this project. The Iowa Model of Evidence-Based Practice to Promote Quality Care guided the project's development. Results: This project aims to empower new nurses to incorporate strategic habits that will benefit them while they are on shift caring for patients and on their days off. It also aims to build nurses' resiliency and increase job satisfaction. Conclusions: By educating nurses on how to prepare for and work the night shift effectively, new nurses can feel confident, resilient, rested, and mindful, and decrease impacts on health. This will enhance their resiliency, allowing them to provide the best care for patients. Keywords: night shift, nursing, resiliency, support 3 Helping Night Shift Nurses Develop More Resiliency With the current turnover rate in the United States for nurses being at 22.5%, nurse leaders must think of ways to improve nurse job satisfaction, leading to less turnover (Moyo & Grywalski, 2024). With this high turnover affecting the profession, finding issues that affect nurses and tackling them head-on is necessary. Night shift nurses need to be considered essential in their jobs. They often feel forgotten and less crucial than day shift nurses (Weaver et al., 2020). Powell (2012) reported that there is a perception that night shift nurses have it easier because their patients are asleep and that nurses who work the night shift are less intelligent than their dayshift counterparts. Beliefs like this harm the nursing profession and negatively affect self-esteem and morale. Nursing leadership is critical in shifting the narrative surrounding the night shift and can positively influence their staff when they take time to understand the flow of the night shift. Shift work, specifically night shifts, is associated with poor sleep, mental health issues, cancer, and other chronic illnesses (Silva & Costa, 2023). While it is easy to stumble upon the negative effects of a night shift, there are positives as well. Nurses who work the night shift feel a better connection to their co-workers and feel like they can depend on the other nurses they are working with because there are fewer staff and resources at night (Powell, 2012). Nurses are not taught how to work a night shift in nursing school or during orientation. Research shows that providing education on exercise, sleep, nutrition, and caffeine can benefit night shift nurses (van der Rhee et al., 2024). While much of the research on shift work focuses on its harmful effects, this project aims to highlight ways to build resilience among night shift nurses and how leadership teams can best support them. Statement of Problem 4 The night shift is a challenging aspect of healthcare that has seen little change despite advancements in nursing practice. Nurses often feel undervalued and invisible during night shifts (Weaver et al., 2020). If night shift nurses continue to feel unsupported at work, the turnover rate will keep climbing, making it harder to retain highly skilled nurses (Imes et al., 2023). Research suggests that working the night shift can have adverse effects on the body, similar to exposure to carcinogens, raising concerns about cancer, heart disease, reproductive health, and sleep disorders (Silva & Costa, 2023). Due to these effects, this project will focus on developing solutions to promote resilience within the nursing community. The intention of this MSN project plan is to create and implement a guide on how to educate the night shift nurses on techniques to reduce the harmful effects on nursing staff in a clinical healthcare setting. Significance of the Project Nurses do not receive education during new hire orientation (NHO), and student nurses do not learn how to successfully navigate working night shifts in nursing school (Powell, 2012). This project is crucial for the nursing field because many nurses work night shifts and require support during their shifts. Since nurses are not typically taught how to manage night shifts, developing an educational module for nursing staff could boost morale and resilience among nurses (Navruz-Varli & Mortas, 2024). Focusing on nutrition, physical exercise, sleep hygiene, and caffeine tailored to night shift workers will improve nurses' overall well-being (van der Rhee et al., 2024). Leaders can help facilitate a culture focusing on self-care activities that promote exercise, diet, and sleep hygiene (Navruz-Varli & Mortas, 2024). When the leadership team invests in their night shift nurse team, morale and retention can improve (Moyo & Grywalski, 2024). The next section will break down the literature that was used to create this project. Review of the Literature 5 The literature review explored current research on nurse resiliency, particularly focusing on the roles of diet and exercise, mental health, and sleep hygiene for night shift nurses. The specific PICOT question directing this project’s literature review was: In night shift nurses, does implementing an educational module during NHO designed to teach how to manage night shifts successfully - affect job satisfaction and resiliency within six months of implementation? Framework This project will utilize the Iowa Model of Evidence-Based Practice to Promote Quality Care (Melnyk & Fineout-Overholt, 2023). This model was chosen because it is a process model that provides guidance for nurses and other clinicians in making decisions about clinical and administrative practice that affects healthcare outcomes (Melnyk & Fineout-Overholt, 2023). The model begins by identifying a trigger that leads one to question current practice and find an opportunity to improve it (Melnyk & Fineout-Overholt, 2023). Then, a statement of purpose is made that will influence the direction for later steps in the EBP process, and a topic is identified that is considered a priority, for example, making a change to address patient safety or high-cost topics (Melnyk & Fineout-Overholt, 2023). A team is formed, the evidence is appraised and synthesized, and articles are chosen to create a sufficient number of resources (Melnyk & Fineout-Overholt, 2023). The last few steps are to design and implement a pilot test run, and once the initial implementation has been done, the post-pilot evaluation is completed, and it's decided if the change that was made is appropriate or if it needs to be adjusted or modified in any way (Melnyk & Fineout-Overholt, 2023). Sustaining the project and disseminating results on a larger scale are the end goals of the Iowa Model (Melnyk & Fineout-Overholt, 2023). The Iowa model is relevant to this MSN project because it focuses on building resilience among nurses by developing an educational module to teach them how to work night shifts. The 6 identified problem is that nurses are not trained in school or during orientation on how to work the night shift (Powell, 2012). Implementing this project will help reduce turnover, thereby addressing the high costs associated with onboarding and training new nurses. A team of nurse educators, nurse managers, and nurses will collaborate to create an educational module, which will then be distributed to staff during NHO. Feedback will be collected through pre- and postsurveys, and based on the survey data, adjustments will be made to the presentation to ensure it is most effective and beneficial for nurses working night shifts. Strengths and Limitations The Iowa Model has both strengths and limitations in its application for improving healthcare practices. One of the key strengths of the Iowa Model is its proven effectiveness in various academic and clinical settings (Gawlinski & Rutledge, 2008). The model incorporates several feedback loops, allowing for ongoing evaluation and modification based on collected data (Melnyk & Fineout-Overholt, 2023). Additionally, the Iowa Model combines quality improvement with research in a way that nurses find straightforward and easy to understand (Gawlinski & Rutledge, 2008). This approach is relevant to the MSN project, as feedback from the nurses participating in the educational module will enable adjustments to the evidence-based content based on their input. On the other hand, a notable limitation of the Iowa Model is that its numerous steps can be cumbersome. When feedback suggests that changes are needed in clinical practice, the team must restart from the beginning and navigate through all the steps and feedback loops again (Melnyk & Fineout-Overholt, 2023). While this limitation does not necessarily undermine the use of the Iowa Model, it can take time to implement changes. Analysis of Literature 7 Nurses generally experience higher job satisfaction when working straight night or straight day shifts. In contrast, frequently switching between the two shifts can lead to significant dissatisfaction and exacerbate issues related to sleep, diet, and exercise (Silva & Costa, 2023). To improve retention and job satisfaction, leadership teams should create a supportive environment for night nurses (Imes et al., 2023). It is crucial to provide new nurses with sleep education during their orientation. Additionally, units could offer healthy food and caffeine options for night shift staff and promote a culture that encourages short naps during nighttime breaks (Imes et al., 2023). This literature review aims to explore the resiliency of night shift nurses and determine strategies that promote resiliency. The themes that continued to arise in the literature were mental and physical health, diet and exercise, and sleep hygiene. Search Strategies A literature review was conducted to identify current evidence using Weber State University’s Stewart Library OneSearch and Advanced Search, which is a multimedia software tool specifically searching for related articles. Google Scholar was also utilized. The review included only articles published between 2019 and 2024, with the exception of one article from 2012, as its information remained relevant. The keywords searched included nurse, nursing, night shift, health, well-being, resiliency, job satisfaction, diet, exercise, shift work, leadership, support, mental health, psychosocial factors, and patient care. Various Boolean combinations of these keywords were created to ensure a comprehensive search. Synthesis of the Literature A thorough literature review was conducted, resulting in the identification of three key themes for exploration. These themes are: 1) mental and physical health concerns for night shift 8 nurses; 2) diet and exercise recommendations for night shift nurses; and 3) sleep hygiene and scheduling for night shift nurses. Mental and Physical Health Concerns Working the night shift has been linked to various health issues, such as disturbances in the circadian rhythm, heart disease, some types of cancer, and digestive problems (Silva & Costa, 2023). Women may experience adverse effects on their menstrual cycles, including irregularities or missed periods, as well as an increased risk of breast cancer (Silva & Costa, 2023). Studies have shown that night shift nurses have a reduced ability to maintain sustained attention compared to their day shift counterparts, and even long-term night shift workers do not seem to develop a greater attention span (Imes et al., 2023; Powell, 2012). Night shifts can significantly impact nurses' mental health. Many nurses report feeling excluded from patient decision-making and may be perceived as less trustworthy than their day shift colleagues (Powell, 2012). As a result, working night shifts is among the most challenging experiences for nurses, many nurses reported feeling invisible and undervalued (Weaver et al., 2020). The reduced presence of staff and leadership during night shifts creates a disconnect between feeling part of the team and lacking leadership support and connection (Silva & Costa, 2023). Night nurses often believe they have limited access to education, procedures, and opportunities for growth that their day shift counterparts enjoy (Powell, 2012). Additionally, the challenges of working night shifts extend to family dynamics. The struggle to get adequate sleep after a night shift can lead to increased family conflict and negatively impact child development outcomes for those who have children (Silva & Costa, 2023). 9 Positive aspects of night shifts that foster resilience and connection include leadership making an effort to check in with the night shift team, either by staying late or coming in to meet face-to-face (Moyo & Grywalski, 2024). Nurses who feel supported by their leadership and have rapport with their managers are more likely to remain in their roles and encourage their peers to do the same (Moyo & Grywalski, 2024). Additionally, nurses who feel valued and receive recognition from their peers, leaders, patients, and families and guidance from their leadership team demonstrate increased productivity, engagement, and job satisfaction (Powell, 2012). Diet and Exercise The human body’s endogenous circadian rhythm increases alertness during the daytime and reduces wakefulness at night (van der Rhee et al., 2024). As a result, night-shift nurses often face disrupted sleep patterns. Eating outside of this natural cycle can lead to metabolic issues and various health problems (van der Rhee et al., 2024). Night shift workers are at a higher risk for obesity, type 2 diabetes, and cardiovascular disease; however, these issues can be mitigated through diet and exercise (Davis et al., 2023). Consuming meals in alignment with the circadian rhythm can enhance mood stability and cognitive function. Unfortunately, this alignment is not always feasible for night-shift workers who sleep during the day (Wasiewicz-Ciach et al., 2024). Several studies recommend meal scheduling methods to promote optimal weight control (Davis et al., 2023; van der Rhee et al., 2024). Meal timing is an effective strategy for promoting glucose stability and maintaining—or even losing—weight (Davis et al., 2023). One approach is intermittent fasting, where individuals fast during their two-night shifts and eat following a regular sleep-wake cycle for the remaining five days. This method has been shown to aid weight loss for shift workers (Davis et al., 2023). Another effective way to reduce fatigue and promote glucose homeostasis is to distribute calorie intake throughout the day. A recommended approach 10 is to consume 40% of calories at an early dinner (between 18:00 and 20:00), 20% of calories around midnight, 25% at the end of a shift but before sleeping, and 15% as an afternoon snack (van der Rhee et al., 2024). To align with the body's insulin fluctuations, it is advisable to eat carbohydrates more in the morning and fats in the evening (van der Rhee et al., 2024). Consuming fatty foods and those high in sodium has been associated with low-quality diets, which are common among night shift workers (Navrus-Varli & Mortas, 2024). The research indicated that healthcare organizations can support night shift workers by providing foods that are high in protein and low in sodium and sugar for purchase or for free during shifts (Imes et al., 2023). Energy drinks, which often contain around 200 mg of caffeine, can also have high sugar content; should be drank in moderation (Imes et al., 2023). Leadership teams can make coffee and tea, especially green tea, available for night shift workers; however, caffeine should be avoided during the last third of the shift to prevent interference with sleep after work (Imes et al., 2023). Research found that physical exercise can be utilized to yield positive benefits for night shift nurses. If nurses feel tired and fatigued during their shifts, taking a brisk 15- to 20-minute walk can help boost energy and reduce sleepiness (Imes et al., 2023). Engaging in regular physical fitness can positively influence circadian rhythms, with aerobic exercise before a night shift aiding in quicker adaptation (Wasiewicz-Ciach et al., 2024). However, intense exercise after a shift and before sleeping should be avoided, as it may negatively affect one’s ability to fall asleep (Wasiewicz-Ciach et al., 2024). Sleep Hygiene and Circadian Rhythms Several negative impacts on circadian rhythm disturbances were identified in the literature. Circadian rhythm disturbances frequently affect night shift workers because their 11 sleep-wake cycles need to adjust. This disruption can lead to various sleep problems, as well as an increased risk of physical illnesses and diseases (Silva & Costa, 2023). Furthermore, altering the sleep-wake cycle can significantly raise the likelihood of drowsy driving after shifts and increase errors in patient care (Weaver et al., 2020). In hospitals, patient care is required 24/7, which forces nurses to work hours that conflict with their natural circadian rhythms (Imes et al., 2023). Chang and Chang (2019) report that there is a direct correlation between job satisfaction and sleep hygiene. Nurses who prioritize quality sleep before and after their night shifts have reported higher job satisfaction and a greater likelihood of staying at their jobs (Chang & Chang, 2019). Shift work can result in sleep-related cognitive impairments, negatively affecting perception, learning, and attention and increasing the risk of occupational injuries (Imes et al., 2023). While some individuals can manage night shifts without issue, about 20% of shift workers experience shift work disorder (SWD), which means their bodies struggle to adapt to a night shift schedule (Imes et al., 2023). Ejebu et al. (2021) report that having a set schedule of night shifts is more strongly associated with health risks. However, if a nurse alternates between night and day shifts, they are more likely to experience increased fatigue, higher rates of errors, and a greater likelihood of engaging in substance abuse. Recommendations were found to support the issue of fatigue in night shift nurses. To help reduce fatigue during night shifts, it is advisable to limit the number of consecutive shifts and take rest or nap breaks during the shift (Wasiewicz-Ciach et al., 2024). A randomized controlled trial demonstrated that 90-minute nap times can decrease fatigue and reaction times, while nap breaks are associated with a lower risk of insomnia and fatigue and help maintain performance levels (Wasiewicz-Ciach et al., 2024). Another effective strategy for reducing fatigue and sleepiness during night shifts is 12 managing lighting in the hospital. Research shows that using blue-enriched white light can help lower sleepiness in night-shift healthcare workers (Wasiewicz-Ciach et al., 2024). This type of light, which has a short wavelength, effectively suppresses melatonin secretion, thereby enhancing nurses' alertness and performance (Wu et al., 2022). Additionally, taking melatonin supplements 30 to 60 minutes before sleeping after a shift can help address disruptions to circadian rhythms and may protect against carcinogenic effects (Wasiewicz-Ciach et al., 2024). Hospitals can also create an environment that incorporates appropriate blue-enriched light in areas where nurses work and chart, which can help boost energy and alertness (Wu et al., 2022). Summary of Literature Review Findings and Application to the Project The literature review conducted for this MSN project identified several key themes and techniques for building resiliency in night shift nurses. Night shift nurses are a necessary and integral part of the healthcare team and system. Unfortunately, night shifts are often understaffed and lack the resources available to day shift staff (Imes et al., 2023). Leadership teams can enhance the health and well-being of their night shift staff by prioritizing face-to-face check-ins and communication, providing educational opportunities that align with their schedules, and recognizing their hard work (Powell, 2012). In addition, promoting physical health by offering healthy food and caffeine options at little or no cost can benefit night shift workers (Imes et al., 2023). Helping to improve the physical environment for night shift nurses can be enhanced by leadership incorporating appropriate blue-enriched light at the nursing station to promote alertness (Wu et al., 2022). This information from the literature review will be used to create an educational module aimed at teaching nurses and nurse leaders how to support night shift workers better. This knowledge is not included in nursing school curricula or during orientation. The goal of 13 this education is to promote resiliency and provide support for night shift nurses. Project Plan and Implementation Nurses and nursing students are not explicitly trained in managing the night shift (Powell, 2012). Consequently, there is a high turnover rate and burnout associated with scheduling, and nurses specifically report that working the night shift and frequently changing schedules can drive them to leave their positions (Moyo & Grywalski, 2024). The Leadership Team can aid in retention by engaging with the night shift staff to provide support and connection (Powell, 2012). One way to foster this support is to implement an educational presentation during NHO for all nursing staff. This section further discusses the plan and implementation process, which includes the interdisciplinary team, project deliverables, and timeline. Plan and Implementation Process A PowerPoint presentation will be utilized to review the research collected for this project and to break down the information into relevant topics highlighted in the literature. This presentation will be given during NHO for the onboarding nurses. It will start by discussing definitions and preconceived notions embedded in the night shift culture. Health hazards will be explained, along with measures to counteract them. Slides will be dedicated to covering diet, exercise, and sleep hygiene before and after shifts, as well as the mental health resources available to night shift nurses. The presentation will emphasize the information in the PowerPoint and then allow time for questions, concerns, and discussion from the audience Pre- and post-surveys will be developed to collect data to help refine the presentation, ensuring it remains relevant and valuable to the nursing staff. The pre-survey will be conducted before the presentation begins, while the post-survey will be administered to the nurses six months after the presentation concludes. The goals of the presentation are for nurses attending 14 this educational session to feel more equipped to manage the night shift and learn how to care for themselves during that time. In both the pre- and post-survey, some questions will use a Likert scale, as well as a section for essay-style responses to collect subjective data. The pre-survey will inquire about nurses' experiences with night shifts, asking whether they have worked them before or if this will be their first experience. The post-survey will focus on their experiences with night shifts and whether the educational presentation helped them feel better prepared and more resilient while working the night shift. Interdisciplinary Team The healthcare professionals contributing to this project include Nurse Managers, Nurse Educators, Nurse Directors, Project Coordinator, and Nurses. All these individuals involved will create a culture demonstrating to the night shift nurses that they are appreciated and viewed as vital interdisciplinary team members. Project Coordinator. The Project Coordinator will create the presentation for the nurses during NHO. This team member will be a vital part of the group, as they will first meet with stakeholders (nurse director, nurse manager, and educators) to get approval and buy-in for this project. After approval, they will present information related to this project and analyze the preand post-survey data, which will aid in revising and editing the project to ensure it remains relevant to the nursing staff. The Project Coordinator must understand the information found in peer-reviewed articles that provide essential knowledge for nurses to learn and apply in their practice. This team member will be the go-to person for fostering resiliency and positive changes in the nursing profession within this hospital organization. Nurse Managers and Nurse Directors. Nurse Managers and Directors are crucial stakeholders in ensuring the retention of the nursing workforce and job satisfaction among their 15 staff. With their involvement, managers and Directors can engage with the night shift staff and shift the culture to demonstrate that nurses are supported and valued members of the nursing community. Moyo and Grywalski (2024) report that the leadership team plays a significant role in fostering community and connection with nurses and can significantly influence retention and resilience in their units. Nurse Educator. The Nurse Educator is a key stakeholder because they are members of the team that coordinates the NHO and have been trained to create presentations suitable for adult learners. The Nurse Educator is also on the unit, usually knows each member of their nursing peers, and can help build the connections that are important for the staff’s resiliency and culture. Nurses. The nurses who attended NHO and received this training are vital to the project's success. Without the nurses' willingness to engage with this information, the team wouldn’t know if this educational presentation positively impacts nursing retention and resiliency. The nurses' responses to pre- and post-surveys will generate data that helps refine the presentation to ensure the most relevant, helpful, and engaging information is provided to the nursing staff. Description and Development of Project Deliverables The MSN project consists of three key deliverables: (1) A pre-and post-survey to assess participants' thoughts and experiences, (2) a PowerPoint presentation that reviews recent literature and studies on effective preparation for and recovery from working night shifts, and (3) an infographic that will be provided as a handout to all course participants, offering tips and tricks for managing the challenges before, during, and after a night shift. The following three sections will explain the deliverables in more details and the importance of educating nurses on how to best work night shift. 16 Pre- and Post-Surveys The surveys will be used to monitor feelings and thoughts related to working the night shift, as well as food choices, caffeine intake, and exercise habits. The pre-survey and postsurvey consist of the same questions; however, the post-survey includes one additional question that allows nurses to provide free-text feedback on how the course could be improved (see Appendix A & Appendix B). The survey is created using Google Forms, which simplifies data sorting and tallying. PowerPoint Presentation about Nurse Resiliency The PowerPoint presentation outlines the research and evidence included in this MSN project paper. The information is presented in an engaging and concise manner to maintain the participants' attention and interest. The slides cover topics such as food, caffeine, sleep, exercise, and mental health (see Appendix C). Infographic of Tips and Tricks for Before, During, and After Night Shift The last deliverable created is an infographic that summarizes the information from the PowerPoint presentation. This infographic condenses the key points onto a single sheet of paper, which participants can take home with them. It is designed to serve as a quick reference guide for nurses, helping them remember what they learned and providing them with a useful tool to carry in their bags as they begin working night shifts consistently. (See Appendix D). Timeline The proposed implementation timeline is as follows: The project coordinator will start by meeting with the above stakeholders to secure their support for the project. Coordinating schedules will take a couple of weeks, allowing each stakeholder to voice their opinions on the project. The following month will focus on gathering evidence and reviewing research to design 17 a project that best serves adult learners. After creating the PowerPoint presentation, another meeting with stakeholders will be necessary to review it together and gather their feedback. At this point, we will be two months into the project. Once the PowerPoint and other infographics are approved, this educational module/presentation will be scheduled for the NHO class. Six months after NHO, a follow-up survey will be sent to the participants' email to collect data on the benefits of the class. The project coordinator will analyze the survey responses, and the class will be adjusted as necessary to best suit the nurses. Please refer to Appendix E for a visual timeline. Although this project paper outlines the explicit details to be included in the educational presentation for nurses during NHO, the timeline is vital since it requires approval from various stakeholders. When the stakeholders support this project, the project coordinator can collaborate with others to ensure that the presentation is valuable for the nurses receiving the information. Project Evaluation Evaluation and revision are essential components of project development and implementation. Creating positive change within the nursing profession is crucial for the growth of nurses and the retention of staff. Identifying areas for improvement is the first step toward developing an evidence-based project (Melnyk & Fineout-Overholt, 2023). Two measures will be utilized in this MSN project to collect nurses' experiences and use the data to improve the educational module. The first measure is the pre-survey (see Appendix A) for nurses, which will be administered before the PowerPoint presentation. This survey asks nurses to respond to questions about their attitudes toward night shifts, their preparedness to work night shifts, and their habits related to food, caffeine, and exercise. A post-survey (see Appendix B) will be conducted six 18 months after the presentation for the nurses who attended. This survey will ask the same questions as the pre-survey, but it will also include an additional essay-style question requesting feedback on how the presentation could be improved. The results of the pre-survey will be compared with the post-survey findings. This comparison is expected to provide insights into the effectiveness of the PowerPoint presentation and whether the education helps build resilience among nurses, making them feel better equipped to manage working night shifts than they did before the education. The feedback from the post-survey will be used to make continuous improvements to the PowerPoint presentation, ensuring that the educational content remains relevant, engaging, and beneficial to the nursing profession. After the initial group completes this educational module and the data is collected, it will help improve the presentation for future nurses and stakeholders; the project coordinator will continue to edit and refine the project. The information collected from the surveys will be presented to the unit director, manager, and nurse educator. Involving nurses in the modification of this project would be beneficial, as they have firsthand experience with the most valuable information that can assist them in their workflow. Ethical Considerations This section will explore the ethical considerations related to this MSN project. Since the project focuses on building resilience in nurses, it primarily addresses the ethical principle of beneficence. By creating an educational module that emphasizes evidence-based practices for optimizing night shift workflows, we are indirectly supporting patient well-being. As defined by Melnyk and Fineout-Overholt (2023), beneficence is the ethical principle centered on the importance of doing good for patients. The implementation of this project aims to enhance nurses' knowledge about how to 19 prepare for, perform during, and recover from night shifts effectively. When nurses are equipped with best practice information, their patients ultimately receive better care. This project is participation-based, and nurses will have the option to decide whether they want to participate in the data collection process. This will be explained at the beginning of the educational presentation, along with the reasons for collecting the data and how it aims to benefit the nursing profession. Since no names will be linked to the collected data, there is a low risk of HIPAA violations or any risk to the nurses themselves. Discussion Nurses are aware of the negative health consequences associated with working the night shift, including an increased risk of cancer, insomnia, weight gain, mental health disruptions, and stress (Imes et al., 2023; Silva & Costa, 2023; Weaver et al., 2020). Given this understanding of the risks, it is crucial for hospital organizations and leadership teams to support nurses by providing education on how to mitigate these negative health effects. This MSN project will be implemented at the children’s hospital during New Hire Orientation. Pre- and post-surveys will be administered to collect data on the outcomes of this education and to assess whether it helps prepare nurses for working night shifts. The following sections will discuss evidence-based solutions for dissemination, significance, implications, recommendations, and conclusions. Evidence-based Solutions for Dissemination After completing this project plan and its implementation, the results will be disseminated in various ways. The survey results will be utilized to update and enhance the presentation on diet, caffeine, mental health, and sleep hygiene. The findings from the pre- and post-surveys will be reported at a nurse leadership level during their monthly meetings. If the results demonstrate an improvement in nurse resilience and indicate that the educational module 20 has better-equipped nurses to care for themselves after working the night shift; this information could be shared at the executive hospital level. The project coordinator will oversee the interpretation of the data to report findings at all levels. Since the project will begin at the children’s hospital, there is potential for it to be included in the New Hire Orientation at the enterprise level, which could positively impact the nursing profession. Additionally, the project findings will be presented during the final week of the MSN program in a poster presentation to fellow students and faculty. If the project shows promise with positive changes for the nursing profession, there may be an opportunity for a journal publication submission in the future. Significance to Advance Nursing Practice The nursing profession is currently facing significant challenges related to retention and job satisfaction. A survey reveals that 47% of healthcare workers are planning to leave their jobs by 2025 (Moyo & Grywalski, 2024). Given the ongoing issues with nurse retention, it is crucial to identify solutions that focus on enhancing nurse resilience and job satisfaction. A considerable number of peer-reviewed articles highlight the health risks associated with nurses working night shifts, including deteriorating overall health, increased cancer risk, sleep disturbances, and substance abuse problems. This project aims to identify strategies that can help mitigate the negative effects of working night shifts. Research shows that when nurses receive training on how to prepare for night shifts— focusing on food timing, caffeine consumption, sleep schedules, and appropriate exercise—they are more likely to report higher job satisfaction (Tucker, 2020). By creating an educational module for nurses during New Hire Orientation, the goal is to improve retention and resilience within the nursing profession. 21 Implications The strengths of this project lie in its focus on the needs of nurses, aiming to improve their quality of life both at work and outside of it. During nursing school, nurses are often unprepared for the impact that night shifts can have on their physical and mental health. Therefore, offering this educational presentation during New Hire Orientation will be beneficial, as it provides information to help them cope with the challenges of working night shifts. However, there are some limitations. Initially, the data collected will be qualitative, but the aim is to gather quantitative data over time to showcase the positive impact this education has on the nursing profession. It may be difficult to correlate retention rates directly with the implementation of this educational module, but tracking this information could prove to be helpful. The hope is that by educating nurses on how to best support their mental and physical health while working night shifts, they will develop greater resilience, resulting in increased job satisfaction and higher retention rates. Recommendations Recommendations provided by the content expert focused on the financial aspects of the project. The feedback indicated that, at the corporate level, there is a preference for a detailed breakdown of the project costs and the benefits of the information that will be shared. Additionally, it would be helpful to include a budget section that compares our project with those of other benchmarking hospitals, explicitly examining whether they offer education on shift work and reviewing the data they have collected. Conclusions Nurses who work the night shift often face negative health consequences related to shift work (Landis et al., 2021). This project aims to promote resilience and provide strategies to 22 address these health issues. By teaching nurses how to prepare for night shifts—specifically focusing on the foods and snacks to consume during their shifts, the caffeine they drink, and how to improve their sleep after the shift - we can enhance productivity and reduce fatigue (Tucker, 2020). This initiative is critical to the nursing field, especially given the current risks of burnout and turnover. When night shift nurses feel supported by their leadership and organization, they are more likely to remain in their positions and maintain positive attitudes about their work (Powell, 2012). Through the implementation of this educational presentation, the goal is for nurses to continue thriving in their roles and to provide excellent patient care. 23 References Chang, W., & Chang, Y. (2019). Relationship between job satisfaction and sleep quality of female shift-working nurses: using shift type as a moderator variable. Industrial Health, 57(6), 732–740. https://doi.org/10.2486/indhealth.2018-0258 Davis C., Bonham, M.P., Kleve, S., Dorrian, J., & Huggins, C. E. (2023). Evaluation of the “shifting weight using intermittent fasting in night-shift workers” weight loss interventions: A mixed-methods protocol. Frontiers in Public Health, 11, 1228628122868 http://doi.org/10.3389/fpubh.2023.1228626 Ejebu, O. Z., Dall'Ora, C., & Griffiths, P. (2021). 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Z., Kutyla, K., & Mokot, W. J. (2024). Mitigating the adverse effects of night shifts: A review of strategies for enhancing health outcomes in shift workers. Quality in Sport, 19, 54237.https://doi.org/10.12775/QS.2024.19.54237 Wu, C. J., Huang, T. Y., Ou, S. F., Shiea, J. T., & Lee, B. O. (2022). Effects of lighting interventions to improve sleepiness in night-shift workers: A systematic review and metaanalysis. Healthcare (Basel, Switzerland), 10(8), 1390. https://doi.org/10.3390/healthcare10081390 26 Appendix A Pre-Survey 27 28 29 Appendix B Post-Survey 30 31 32 Appendix C PowerPoint Slides 33 34 35 36 37 Appendix D Infographic for Nurses 38 Back side 39 Appendix E Visual Timeline 40