Purpose Healthcare organizations often have to provide patient care around the clock. Shift work (any shift outside of 7 a.m. to 6 p.m) and long work hours increase the risk for short sleep duration and sleep disturbances. Thirty‐two percent of healthcare workers report they do not get enough sleep. The purpose of the article is to give an overview of the wide range of risks to nurses, patients, and employers that are linked to shift work, long work hours, and poor sleep from other sources. Findings Shift work and long work hours increase the risk for reduced performance on the job, obesity, injuries, and a wide range of chronic diseases. In addition, fatigue‐related errors could harm patients. Fatigued nurses also endanger others during their commute to and from work. Conclusion and Clinical Relevance The key strategy to reduce these risks is making sleep a priority in the employer's systems for organizing work and in the nurse's personal life.