As nursing staff, we often have the ethos of taking care of others before taking care of ourselves. When living with a long-term condition, this may be impacted by the working environment in which nursing staff are working, and therefore employers need to be considerate of the requirements of their staff. 

Member voices

As nursing staff, we often have the ethos of taking care of others before taking care of ourselves. When living with a long term condition, this may be impacted by the working environment in which nursing staff are working, and therefore employers need to be considerate of the requirements of their staff.
Here at the RCN, we have joined forces with Diabetes UK and Diabetes Africa to reach out to our members living and nursing with all different types of diabetes, to gather their views on what support they may need in the work environment. 63 responses were achieved across the different levels of practice, highlighting the importance of this work.
Whilst some statistics are reassuring, such as the time to access appointments given, areas still need some improvement. The experiences shared also highlight important differences between the needs of staff living with Type 1 and Type 2 diabetes, particularly around medication timing, hydration requirements, and the growing use of diabetes technology among people with Type 2 diabetes. We understand that working shifts and having a healthy balanced diet can be difficult, combined with long working days – often nursing staff may not be able to have access or prepare healthy meals to support their condition. Here we make some recommendations to support employers in practice.

Eating Habits

Stick to three balanced meals—breakfast, lunch, and dinner—at consistent times, even during overnight shifts where feasible.
Avoid large, carbohydrate-heavy meals late at night, which can disrupt blood sugar stability.
Prepare meals ahead to avoid relying on vending machines or processed convenience foods during breaks. Aim for nutrient-dense snacks with protein, fibre, and slow-release carbohydrates.
For staff with Type 2 diabetes, consider how oral medications interact with meal timing, and ensure opportunities for regular hydration—particularly when taking medications that increase dehydration risk.

 Sleep Hygiene

Track your sleep using apps or journals to understand your rest patterns and identify areas for improvement.
Use blackout curtains, white noise machines, or eye masks to create an optimal sleeping environment.
Avoid caffeine towards the end of your shift to support natural sleep rhythms and reduce sleep onset latency.

Physical Activity

Develop a flexible movement plan tailored to your shift schedule. If exercise on working days isn't possible, prioritize it on days off.
Reflect on how physical activity affects your sleep—some nurses find it promotes rest, while others may feel overstimulated.
Even short bouts of movement during shifts (e.g. stretch breaks or stairs) contribute to long-term wellbeing.

 Blood Sugar Monitoring

Understand how your work pattern impacts fasting measurements—overnight staff may need to adjust testing times.
Track blood glucose consistently during shifts, especially during physical activity or meal breaks.
Staff with diabetes who use CGM or flash monitoring should also be supported to use these devices openly and safely in the workplace.

Medication Management

Maintain consistent medication timing—this is critical for effective diabetes self-management.
If food is required with medication, plan your break times strategically.
Consider alarms, reminders, or buddy systems within your clinical team to help maintain adherence on busy shifts.
Liaise with your prescribing clinician to tailor dosing to your shift pattern.
Ensure staff have protected time to take oral medications at the correct intervals, and consider the impact of medications that may increase hypoglycaemia risk.

 Stress and Fatigue

Night or rotating shifts can impact mood, sleep, and emotional connection with others. Make intentional space for recovery.
Build a self-care plan with elements of joy—whether it’s a creative outlet, physical relaxation, or social connection.
Talk openly within your team about fatigue and wellbeing. Creating a psychologically safe culture helps everyone thrive.

Workplace Emergency Planning

Employers and employees should work together to develop an individualised emergency plan for both hypoglycaemia and hyperglycaemia. This may include: 
• where hypo treatment is stored 
• who (if anyone) the employee consents to inform
 • when to escalate concerns 
• how to access support during busy or lone working periods 

Ensuring access to hypo kits and creating a clear, shared understanding of emergency actions enhances safety for both staff and patients.

Reasonable Adjustments for Training and Appointments

Time off for diabetes education, insulin pump or CGM initiation, device training, and clinical reviews should be treated as reasonable adjustments under the Equality Act 2010. These should not be recorded as sickness absence or require the use of annual leave.

Technology Support in the Workplace

Modern diabetes management increasingly relies on technology. Employers should ensure: 
• access to private areas for injections or sensor changes 
• charging facilities for pumps, CGM receivers, or smartphones 
• permission to use phones for diabetes monitoring apps 
• safe storage for diabetes supplies 
Supporting technology use helps staff maintain stable glucose levels and work safely.

References
Diabetes UK; NICE NG17 (Type 1 diabetes); NICE NG28 (Type 2 diabetes); NHS Employers guidance on long term conditions;

RCN Peer Support Service and Health Ability Passport resources.

Providing high quality care starts with ensuring that nursing staff themselves take care of their conditions, and therefore employers need to ensure that the adequate support is in the workplace to help ensure health and happiness is achieved. Whilst it may not always go to plan, having open honest discussions can help ensure you receive the help you may need. Take a look at our Health Ability Passports.