Welcome to 2013! I had a wonderful New Years Eve that ended with me snuggling into my warm, cozy bed just after midnight. As I drifted off to sleep I was reminded of all the years I worked shift work and thought of the nurses and other staff who had to work while I settled to sleep. I discovered long ago that it is a privilege to sleep when you are tired and truly relish the opportunity to do so. Even though I regularly worked 12-hour nightshifts alternating with days for over a decade, I never really adjusted to the constant assault on my circadian rhythms. In fact, the continuous exhaustion I felt affected my health and home life and was one of the strongest reasons that I searched out a day job in nursing.
Sleep is an interesting and complicated phenomenon that is not completely understood. Sleep is a basic necessity of life. Our bodies are programmed to have periods of sleepiness and wakefulness; our circadian rhythms. Our internal clocks push for alertness during the day, which leaves us struggling to stay awake at night as well as difficulty getting restful and restorative sleep the next day. Those who don’t work shift work usually don’t understand. Take, for example, my mother-in-law, who at one point insisted on waking me up at 11 am after a 12 hour night shift, explaining to me that I’d had enough sleep.
Studies suggest that shift work is associated with increased risk of developing cancer, cardiovascular and gastrointestinal disease. Effects of sleep disturbance range from headaches, increased or decreased appetite, gastrointestinal problems, irritability or mild depression. There is a sleep diagnosis called Shift Work Sleep Disorder. It is characterized by insomnia and excessive sleepiness, unintended dozing, impaired mental acuity, reduced performance and accident proneness. These are not the sort of characteristics patients want in the nurses who care for them! It’s no wonder that nurses have difficulty searching for and implementing new evidence in practice.
Some people work a continuous night shift rotation and their bodies adjust to the change. However, most nurses work the most difficult schedule, a rotation of days and nights. There are plenty of good tips about sleeping that may help you adjust more easily to shift work. A quick search of the internet will point you in the right direction, however, I’d like to point out a couple of things. In the past few years, attention has been focused on a hormone produced by the pineal gland of the brain, called melatonin, that is involved in sleep rhythms. However, there has been no evidence to show that it will fix sleep disorders http://on.webmd.com/WieUN8. We all know the nurses who love working night shift. They easily adjust to the time change and prefer the pace and ‘culture’ of the wee hours. However, many more are like me…nurses who just cannot adjust to the constant back and forth. In retrospect, it may have helped my situation if I had chatted with my supervisor and looked for solutions such as working only dayshifts or nightshifts. If you’re struggling, think about searching out a position with a work schedule that you think might work better for you.
There are some special things about caring for people during the night. Conversations are often more meaningful and patients learn a great deal about the constancy of nursing in health care settings. The night shifts can also strengthen bonds among staff. There are many things that I miss from those busy, crazy shift work years! Yet, it’s unfortunate that nights can have negative effects on nursing and nurses’ lives. As a profession, and individually we should lobby to ensure the best possible work environment for ourselves. Our goal should be a healthy and well-rested nursing workforce.
All the best in the New Year!
Roberta Heale