JNPD
Journal for Nurses in Professional Development & Volume 29, Number 6, 316Y320 & Copyright B 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Hidden Shift How Do Night Shift Nurses Learn to Adapt to Circadian Disruption? Mary Lawson Carney, MSN, RN-BC, CCRN
Disruption of circadian rhythm has a significant impact on the physical, psychosocial, and professional lives of night shift nurses. How night shift nurses learn the coping techniques they employ to adapt to this disruption was examined in a qualitative, cross-sectional survey of 42 nurses. A template analysis technique was used to categorize the responses, which were then compared to industry ‘‘best practices’’ in fatigue countermeasures. Results documented the variety of sleep/wake routines nurses employ to cope with circadian disruption as well as a wide-ranging variety of behaviors related to driving while fatigued.
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n a healthcare inpatient setting in which staff work 12-hour shifts, patients spend 50% of their stay being cared for by staff working on the night shift. Yet the unique lifestyle needs of these workers are seldom factored into the training provided for new or experienced employees (Moore-Ede, 2011; National Institute for Occupational Safety and Health, 1997). Healthcare employers devote millions of dollars and untold hours on an annual basis designing, developing, and presenting programs aimed at protecting workers from the risks inherent in their jobs. Sharps injuries, ergonomic injuries, and exposure to toxins are very real and significant risks in the healthcare workplace and are rightly the subject of these massive expenditures (Perkins, 2001). However, an even more fundamental risk exists. Night shift healthcare workers operate with disruption to their circadian rhythm and all the associated physical and psychological risks (Wright, Hull, Hughes, Ronda, & Czeisler, 2006). In addition, poor task performance is a documented outcome of the chronic sleep debt indicated in the survey. Patients are at increased risk of medical mistakes when cared for by fatigued nurses (Scott, Hofmeister, Rogness, & Rogers, 2010). Mary Lawson Carney, MSN, RN-BC, CCRN, is Staff Nurse, Pediatric Intensive Care Unit, Peyton Manning Children’s Hospital at St. Vincent, Indianapolis, Indiana, and Adjunct Faculty, Western Governors University, Salt Lake City, Utah. The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. ADDRESS FOR CORRESPONDENCE: Mary Lawson Carney, MSN, RN-BC, CCRN (e
Journal for Nurses in Professional Development & Volume 29, Number 6, 316Y320 & Copyright B 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Hidden Shift How Do Night Shift Nurses Learn to Adapt to Circadian Disruption? Mary Lawson Carney, MSN, RN-BC, CCRN
Disruption of circadian rhythm has a significant impact on the physical, psychosocial, and professional lives of night shift nurses. How night shift nurses learn the coping techniques they employ to adapt to this disruption was examined in a qualitative, cross-sectional survey of 42 nurses. A template analysis technique was used to categorize the responses, which were then compared to industry ‘‘best practices’’ in fatigue countermeasures. Results documented the variety of sleep/wake routines nurses employ to cope with circadian disruption as well as a wide-ranging variety of behaviors related to driving while fatigued.
I
n a healthcare inpatient setting in which staff work 12-hour shifts, patients spend 50% of their stay being cared for by staff working on the night shift. Yet the unique lifestyle needs of these workers are seldom factored into the training provided for new or experienced employees (Moore-Ede, 2011; National Institute for Occupational Safety and Health, 1997). Healthcare employers devote millions of dollars and untold hours on an annual basis designing, developing, and presenting programs aimed at protecting workers from the risks inherent in their jobs. Sharps injuries, ergonomic injuries, and exposure to toxins are very real and significant risks in the healthcare workplace and are rightly the subject of these massive expenditures (Perkins, 2001). However, an even more fundamental risk exists. Night shift healthcare workers operate with disruption to their circadian rhythm and all the associated physical and psychological risks (Wright, Hull, Hughes, Ronda, & Czeisler, 2006). In addition, poor task performance is a documented outcome of the chronic sleep debt indicated in the survey. Patients are at increased risk of medical mistakes when cared for by fatigued nurses (Scott, Hofmeister, Rogness, & Rogers, 2010). Mary Lawson Carney, MSN, RN-BC, CCRN, is Staff Nurse, Pediatric Intensive Care Unit, Peyton Manning Children’s Hospital at St. Vincent, Indianapolis, Indiana, and Adjunct Faculty, Western Governors University, Salt Lake City, Utah. The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. ADDRESS FOR CORRESPONDENCE: Mary Lawson Carney, MSN, RN-BC, CCRN (e
