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Nurses, Side Jobs, & The Risks To Consider When Working 12-Hour Days

There's a growing trend in this country: More and more nurses are joining the "gig economy." But how many hours can someone work in a day before it becomes unsafe?

Woman drinking tea and working remotely on laptop
Image via Unsplash.com/Dai KE

When I was in nursing school, my family assured me that choosing a career in nursing was smart because I’d always have a secure job. I might spend my days and nights covered in other people’s bodily fluids but, in their eyes, at least I would never starve.

Many people assume that nursing is guaranteed to be a “good” job that pays well and offers benefits that far outweigh the hard work it can entail. So it may come as a surprise that increasingly more nurses are adding side jobs to their already packed schedules. In fact, a 2019 study published in the Advanced Journal of Nursing found that about 13 percent of registered nurses currently have some kind of side gig — no small feat when you consider that the data also revealed that almost half of all the surveyed nurses work overtime, too.

So, what gives? Why are nurses willingly taking on all this extra work when they’re already pushed to their limits in their day jobs?

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Why Are More Nurses Taking On Side Jobs?

Well, it turns out that there are a number of factors that are contributing to this growing trend. As a 2018 LinkedIn article points out, some nurses are taking on side gigs as a way to offset the increasingly high cost of living, particularly in metropolitan areas. Others use it as a way to supplement their incomes or to help them pay off their student loan debt -- but, more often than not, it’s both. And even more nurses are turning to side gigs as a way to find the kind of job satisfaction they’re missing in their full-time roles.

Let’s dig a little deeper into three of the most common reasons for why more and more nurses are choosing to join the “gig economy.”

Motive #1: To Supplement Their Incomes

One major factor contributing to this trend appears to be finances - and specifically as it relates to the amount of student debt nurses are getting strapped with post-graduation. Although the end result of a nursing program is the same — an RN license — there’s a wide disparity in the amount of loans that a nursing student could rack up. While some nurses may get through school with minimal debt, others may graduate with as much as $150,000 in student loans. And although the national annual salary of RNs is at $71,730 per year, according to the Bureau of Labor and Statistics, it’s easy to see how it might take nurses significant amounts of time to pay down those loans.

Motive #2: To Get More Job Satisfaction

For some nurses, another factor that comes into play is their desire to have more control over their work than they get from bedside nursing.

“I think more nurses want to take charge of their destinies,” says Elizabeth Binsfield, BA, RN, from the Richmond, Virginia, area, and a part-time nursing case manager who has an actively growing side business as a freelance healthcare content writer.

After initially working in administrative positions early on, Binsfield says that she entered the nursing field to have “worthwhile work” that would also provide her with personal enrichment.

Despite having now spent 21 years in the nursing field, Binsfield says she’s becoming increasingly aware of the challenges nurses face, especially at the bedside.

“Nursing is becoming increasingly challenging, from the top down -- with administration, Press Ganey, insurance companies’ expectations -- and the bottom up as patients are more informed and more demanding (sometimes unrealistically so),” she says. “Stepping away from the bedside to forge your own trail without these stressors — in an already stressful field — is intoxicatingly appealing.”

Motive #3: To Have More Control Over Their Personal Lives

A 2019 study on nurses in the U.S. also showed that having children seems to be a big factor in nurses stepping away from actively working in the nursing field, whether that’s through side jobs or leaving employment completely. And, of course, we can’t discount passion and interest. Some nurses may simply take on a side job to explore their creative side or a new interest. Other reasons nurses cited for leaving the profession included violence in the workplace and burnout.

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What Types of Jobs Are They Taking?

One of the most popular types of side jobs that nurses gravitate toward is multi-level marketing (MLM). (Think: Companies like Stella & Dot or doTERRA Natural Oils.) Wander onto any hospital unit in the U.S. and you’re bound to find at least one nurse selling some sort of skincare, weight loss, organizational, fashion, or beauty product through an MLM company. But why? In response to a 2018 Reddit thread that questioned this particular trend, many nurses and APNs jumped at the chance to cite long shift hours, lack of flexibility for family time and duties, overwhelming patient loads, and school loans as factors for those who are seeking more balanced positions like those offered by MLMs.

But MLMs are just the tip of the iceberg. In fact, the types of side jobs nurses are taking are as diverse as the nursing field itself. Here’s a sampling of the types of side gigs that real-life nurses are taking on. (Source: an undisclosed Facebook nursing group)

Popular Side Jobs for Nurses

  • Writing and content creation
  • Graphic design
  • Driving for ride-share companies (e.g., Uber)
  • Small business owners/entrepreneurship
  • Resume-writing
  • Multi-level marketing (e.g., Rodan + Fields, Scentsy, Mary Kay)
  • Health coaching
  • Finance coaching
  • Real estate
  • Baking
  • Party/event planning
  • Education: Online consulting, tutoring, teaching at an academic level, etc.
  • Telehealth
  • Kombucha brewing
  • IT/computer work
  • Woodworking/craft selling on Etsy
  • Social media marketing
  • Chocolatier
  • Travel agent
  • Aesthetic services/cosmetics

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Working 12+ Hours? Here Are the Risks To Consider

According to the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA), nursing is, by definition, pretty much a hazard to an individual’s health because it classifies as an “extended or unusual” shift. Under the OSHA definition, an extended or unusual shift is one that “incorporates more continuous hours, requires more consecutive days of work, or requires work during the evening.” (Yep, that’s nursing!) This is especially true for new nurses who may be working swing shifts, going from day to night, filling in, or working on-call.

Working extended or unusual shifts, along with working 12 or more hours in general, does carry some health risks (as well as career risks!) that can include:

  • Fatigue
  • Stress
  • Reduced ability to concentrate
  • Decreased memory
  • Lowered motivation
  • Increased susceptibility to illness
  • Increased risk of depression
  • Serious health conditions like:
    • Headaches
    • Digestive problems
    • Hypertension
    • Cardiovascular disease
    • Musculoskeletal disorders
    • Chronic infections
    • Diabetes

Unfortunately, nurses aren’t the only ones who suffer from the detrimental effects of extended shifts and the associated burnout that comes with them. A 2016 Press Ganey report found that when nurses worked more than 13 hours, it didn’t just decrease their overall satisfaction with their jobs - it also significantly decreased the level of satisfaction patients felt about the care they received. In fact, many studies conducted over the past few years have demonstrated a direct relationship between 12+-hour shifts and the number of on-the-job mistakes (e.g., medication-related errors) nurses make.

While all of the risks highlighted above are nothing to overlook, at the end of the day, nurses like Binsfield ultimately value the flexibility and ownership that side jobs can offer, whether it’s driving an Uber on their off days or selling products. Unlike a nursing shift, a side job is something a nurse is ultimately in control of, as opposed to the other way around.

“I am the sole person to whom I am responsible for how and when things are done,” Binsfield says.

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Tips for Protecting Yourself During Your Shift

Tip #1: Be self-aware.

Because your patients and your career are your top priority, you need to make sure that you’re on the lookout for signs of burnout. If your concentration is wavering on a shift, take a mental break. Then, look to reassess your extracurricular commitments. Checking in with yourself is never a bad thing.

Tip #2: Take small breaks.

Try to incorporate small breaks in your shifts. Even a short five-minute breather to stretch your legs or grab a quick cup of coffee can help.

Tip #3: Talk to your supervisor.

If you’re struggling mentally and physically during your shift, it may be worthwhile to talk to your supervisor. There may be options for you to explore different shifts, such as a once-a-week eight-hour shift, or even transferring to a day or night shift to see if it works better for your schedule.

Tip #4: Build regular exercise into your week.

It sounds like it would only add more to your plate, but it actually helps your health in many ways. A 2015 study found that a minimum of three 30-minute weekly exercise sessions was associated with reduced symptoms of stress and burnout, and it also increased feelings of well-being in nurses who were previously inactive.

Tip #5: Keep an open mind.

If you’re burned out in one area of nursing, keep your mind open to possibly switching positions or specialties down the road. Nursing is a robust profession and there are many opportunities to create a work schedule that better suits your needs. Many nurses feel guilty for wanting a position that feels fulfilling, but in the end, a happy, healthy nurse is better able to care for patients. So don’t hesitate to explore other options if your current role is not working for you. And, hey, don’t forget: There’s always chocolatiering!


The views expressed in this article are those of the author and do not necessarily reflect those of Berxi™ or Berkshire Hathaway Specialty Insurance Company. This article (subject to change without notice) is for informational purposes only, and does not constitute professional advice.

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