In the conclusion of this three-part series comes the most comforting subject: solutions. Though shift work has proven disadvantages and risks, there are ways to improve the situation for those working them. Below is a brief list and explanation of methods to combat the struggles that shift workers frequently face, particularly when it comes to regulating body processes and preventing fatigue:
Solutions:
- Adjust Circadian Rhythm: To increase healthy sleep patterns and reduce harmful effects of shift work on nurses and patients alike, nurses can attempt to trick their internal clock. After being subjected to bright lights during night shifts, researchers found that nurses who wore sunglasses on the way home and slept in very dark bedrooms were able to shift their circadian rhythm almost flawlessly within a week.[1] Maintaining consistency on the days not worked is important as well; going to bed as late as possible and waking up as early as possible can help reduce the jet-lag feeling circadian disruption can cause.
- Consistency with Shift Scheduling: While it is difficult enough to adjust to working at night, it is much worse to alternate between night and day shifts irregularly, as many nurses do. Consistency is what keeps one’s circadian rhythm in check and fatigue at bay. Hospitals should do their best to schedule nurses regularly as either day or night workers with as few overlaps as possible. Nurses, in turn, can follow through with this scheduling and do their best to maintain the regularity of their shifts.
- Guaranteed Breaks: As aforementioned, nurses are too frequently called from their breaks early or not given a chance to take them at all. Without food and rest, fatigue is sure to set in. Hospitals need to insure that they are not understaffed, and nurses need to know when to demand their rights. Breaks are not a luxury; they are a safety precaution.
- Caffeine: Though not the most natural or best long-term solution to a larger problem, caffeine is probably the most commonly used fatigue combatant.[2] Significant increases in alertness and performance has been found when one to two cups of coffee are consumed, and furthermore, when paired with naps, the stimulus of the caffeine is even more effective. [3] If nurses can followed a nap with a cup of strong coffee, the outcome can lead to safer practices and higher effectiveness on the job.
- Maintaining Good Habits: Basic diet and sleep habits cannot be stressed enough. Healthy snacks are important nourishment for one’s body at work and as well as at home. As mentioned above, naps are extremely effective and should be taken prior to work, and though caffeine can be helpful after the fact, it should not be consumed before daytime sleep, along with alcohol and smoking.[4] Seven to nine hours of sleep a day is a must!
Shift work cannot be eliminated, but hopefully with the practice of good health habits a nurse can take care of his or herself with the avoidance of any potential errors. After all, everyone deserves the ability to end their shift falling asleep under a successful sunrise.
As legal nurses we consider all possible scenarios and contributing factors to potential negligence cases. Unfortunately, when an event occurs on the night shift, there is a possibility that the health care providers are exhausted and sleep deprived.