Napping on the Night Shift: A Two-Hospital Implementation Project
The purpose of this article is nurses who work the night shift or 12 hours shift, fall asleep between 0200 hours to 0500 hours, so they can assess the barriers to successful implementation of the night- shift naps and to describe the nap experiences of night shift nurses who took naps. In this two-hospital pilot implementation project, napping on the night shift was offered to six nursing units for which the executive nursing leadership had given approval. Unit nurse managers’ approval was required, and where approved, further clarification was given to the unit’s staff nurses. A nap experience form, which included the Karolinska Sleepiness Scale, was used to review pre-nap sleepiness level, nap duration and perceived sleep experience, post-nap sleep inertia, and the perceived helpfulness of the nap. Nurse Managers and staff nurses were also interviewed at the end of the three-month study period. Parts of the questionnaire are who should nap? Where should naps occur?, How long should a nap be?, What time should naps be taken?,
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Barriers primarily occurred at the point of seeking the unit nurse managers’ approval. On the successful unit, 153 30-minutes naps were taken during the study period. These data suggest that when barriers to napping are overcome, napping on the night shift is feasible and can reduce nurses’ workplace sleepiness and drowsy driving on the way home. Addressing nurse managers’ perceptions of and concerns about napping may be essential to successful implementation Inclusion these data suggest that when barriers to napping are overcome, napping on the night shift is feasible and can reduce nurses’ workplace sleepiness and drowsy driving on the way home. Addressing nurse managers’ perceptions of and concerns about napping may be essential to successful
Imagine a nurse who has to go to work for 12 hours and how much energy he or she puts in? It feels like a never ending story and the character begins to exhaust his or her energy. As much as 12 hours may seem, the 12 hours spent in something one like to do would make it better. It may involve less sleep for someone who works 12 hours. Nurses in the past and today have been working 12 hour shifts or more, which shouldn’t be a big deal now than it actually seems. I think 12 hour shifts are a productive way for more nurses to connect with patients and complete their work effectively. Therefore, nurses should have the right to want to work for 12 hour shifts despite the negative outcomes.
There are several approaches to take in solving the problem of nurse fatigue. Firstly, the nurse has an obligation to not going to work if too tired. Schedules should be designed to help with this where nurses are held accountable to pick days that does not contribute to fatigue. In addition, nurses can work as a team and cover each other effectively for breaks. Nurses should be able to take stress free breaks and not have to worry that their patients will not be taken care of. Lastly nurses should be educated on sleep hygiene and the effect it has on patient
Over the past several years extended work shifts and overtime has increased among nurses in the hospital setting due to the shortage of nurses. Errors significantly increase and patient safety can be compromised when nurses work past a twelve hour shift or more than 40 hours a week. Hazardous conditions are created when the patient acuity is high, combined with nurse shortages, and a rapid rate of admissions and discharges. Many nurses today are not able to take regularly scheduled breaks due to the patient work load. On units where nurses are allowed to self-schedule, sixteen and twenty-four hour shifts are becoming more common, which does not allow for time to recover between shifts. Currently there are no state or federal regulations that restrict nurses from working excessive hours or mandatory overtime to cover vacancies. This practice by nurses is controversial and potentially dangerous to patients (Rogers, Hwang, Scott, Aiken, & Dinges, 2004). Burnout, job dissatisfaction, and stress could be alleviated if the proper staffing levels are in place with regards to patient care. Studies indicate that the higher the nurse-patient ratio, the worse the outcome will be. Nurse Manager’s need to be aware of the adverse reactions that can occur from nurses working overtime and limits should be established (Ford, 2013).
A considerable amount of literature has been published on the impact of working hours (8 vs. 12 hour shifts) on fatigue among the nurses. These studies revealed that twelve-hour shifts increase the risk of fatigue, reduce the level of alertness and performance, and therefore reduce the safety aspect compared to eight-hour shifts (Mitchell and Williamson, 1997; Dorrian et al., 2006; Dembe et al., 2009; Tasto et al., 1978). Mills et al. (1982) found that the risk of fatigues and performance errors are associated with the 12-hour shifts. Beside this, Jostone et al. (2002) revealed that nurses who are working for long hours are providing hasty performance with increased possibility of errors.
In the recent past, nursing has come to the forefront as a popular career amongst students across the globe. The demand for nurses has kept increasing gradually over the years. In fact, the number of registered nurses does not meet the demand of the private and public health sector. This phenomenon has resulted in a situation where the available registered nurses have to work extra hours in order to meet the patients’ needs. With this in mind, the issue of nurse fatigue has come up as a common problem in nursing. According to the Canadian Nurses Association (CNA), nurse fatigue is “a feeling of tiredness” that penetrates a persons physical, mental and emotional realms limiting their ability to function normally. Fatigue does not just involve sleepiness as has been assumed before. It involves utter exhaustion that is not easily mitigated through rest. When nurses ignore the signs of fatigue, they risk the development of chronic fatigue and other health problems that may not be easily treated. Additionally, fatigue may cause nurses to lose more time at work as they may have to be away from work for several days to treat it. The issue of nurse fatigue has permeated the nursing profession to the extent of causing errors in the work performed by nurses. Fatigue causes a decrease in a nurse’s ability to make accurate decisions for themselves and their patients. It is therefore important to find ways to curb nurse fatigue such that it is no longer a problem. Nurse fatigue is a danger to the patients, organizations and to the nurses themselves and must be mitigated adequately.
When most people think of sleep, they think of it as a relaxed but yet not a very important part of our daily lives. What most people don’t understand is although we are not up and moving around and getting tasks completed, our brains are still very active. Without sleep our bodies do not function correctly on a daily basis, and our mental state is at risk.
Sleeping while on duty hours can negatively affect that soldier, their battle buddies, and even their mission. It’s an act that can only do harm, whether that soldier be in an active warzone overseas, stationed at a base within the homeland, or even training. It takes discipline to stay awake when it is necessary to, and not being able to keep awake when necessary shows a lack of discipline and effort on that soldier’s part. As a result, that soldier ends up hurting themselves and everyone around them.
Sleep is one of our basic needs to survive and to function in day to day operations, but not everyone needs the same amount of sleep. Some people can survive on very little sleep, i.e. five hours a night, and some people need a lot of sleep, to the extend that they are sleeping up to 10 to sometimes 15 hours a night (Nature, 2005). According to Wilson (2005) the general rule states that most people need from seven to eight hours of sleep. The deprivation of sleep in our society in continually increasing with the demands in society increasing work loads, the myth that a few hours of sleep is only necessary to function properly and that sleep is sometimes considered as killing time (Nature, 2005). Sometimes sleep deprivation is also caused by other situations like sleep disorders, i.e. sleep apnea, chronic insomnia or medical conditions such as stress (Wilson, 2005).
“When the going gets tough, the tough take a nap.” This statement by Tom Hodgkinson perfectly describes the solution to the life of the average American high schooler, who wakes up early, rushes to school, and undergoes several grueling classes, only to later participate in extracurricular activities and return home to complete homework. Due to all these activities, only a vast minority of teenagers obtain the amount of sleep they need in a night; Tom Hodgkinson’s quote proposes a solution to this problem. By instituting naptime in high schools, students could simply nap to refresh themselves when the going gets tough, whether that be an excessive amount of homework, an extremely demanding test, or a sports practice that lasts long into the
This article has shown me that new strategies are needed to reduce sleep disturbances, improve sleep quality, and support the need for supplemental daytime sleep in hospitalized individuals. These strategies include monitoring patients’ sleep and assess quality of sleep and duration, resolving the problems of sleep disturbance, recognizing that nighttime noise, light, and other factors potentially interfere with patient sleep, minimize lighting in shared patient rooms and turn off lights earlier at night, frequently assess for pain and administer prescribed pain medications to minimize sleep disruption. This article taught me more about sleep cycles and disturbances in hospitalized patients. As a future nurse, I have to accurately assess the patients’ personal characteristics and health education needs, and share this knowledge with my classmates.
The authors and scientists from a different study by the U.S National Library of Medicine National Institutes of Health on long and short-term sleep deprivation state directly that “in certain jobs, people face sleep restriction. Some professions such as health care… require working at night. In such fields, the effect of acute total sleep deprivation (SD) on performance is crucial” (Alhola & Polo-Kantola, Sleep deprivation: Impact on cognitive performance). Depending on their schedule, nurses can often be susceptible to sleep deprivation and are no exception, especially if they are working long hours. The study performed research on how acute and chronic sleep deprivation can affect the brain and how it can slow down or worsen thought process and rationality throughout the day for working adults. The authors also explain that “motor function, rhythm, receptive and expressive speech, and memory ...deteriorated after one night of SD.” (Alhola and Polo-Kantola, Sleep deprivation: Impact on cognitive performance) Although everybody is affected by a lack of sleep differently, some might have the ability to handle it a lot better than others, but it is fair to say that no one can perform their jobs perfectly if their brains are being affected by sleep deprivation. This organization concludes this study by explaining that there is still much research that needs to be
Milner, C. E., Cote, K. A. (2008). Benefits of napping in healthy adults: Impact of nap length, time of day, age, and experience with napping. Journal of Sleep Research, 18(2), 272-281
Furthermore, there are clear distinctions in the type of naps that are commonly used. Some people may choose to nap to replace lost sleeping time, which is referred to as “replacement napping”, others may want to prepare for an extended period of wakefulness by napping, which is also known as “prophylactic napping”, and a third motivation to nap is described as appetitive napping, when a person naps for pure enjoyment of falling asleep (Milner & Cote, 2008). These three types of naps could apply to the subject of this particular study, which is a college student. College students are subject the enormous amounts of stress and pressure from parents and teacher to get all their work done, perform in the classroom, obtain good grades, etc… and they form a group that could profit largely from napping.
Important public policy issues have arisen in our modern 24-hour society, where it is crucial to weigh the value of sleep versus wakefulness. Scientific knowledge about sleep is currently insufficient to resolve the political and academic debates raging about how much and when people should sleep. These issues affect almost everybody, from the shift worker to the international traveler, from the physician to the policy maker, from the anthropologist to the student preparing for an exam.
The four stages of sleep are REM (rapid eye movement sleep), NREM1 (non-rem), NREM2, and NREM3. During the REM stage “your heart rate rises, your breathing becomes rapid and irregular, and every half-minute or so your eyes dart around in momentary burst of activity behind closed lids” (Myers, 2014, p. 96).