Shift work — so many nurses do it or have done it at least once in their careers. While patients definitely need care around the clock in certain settings, the nurses who care for them also need sleep.
According to Amy Witkoski Stimpfel, PhD, RN, an Assistant Professor at the NYU Rory Meyers College of Nursing, “Shift work—particularly nights and evenings—misalign our body’s natural circadian rhythms. Simply put, as human beings we were not made to be awake late at night or very early in the morning,” she explains. “Thus, there is a cascading effect on this circadian misalignment on the rest of our body’s functioning.”
The biggest problem with this is that nurses must be able to provide safe care and going without sleep can be problematic. “Obviously sleep disruption is one of the biggest and most dangerous consequences of circadian misalignment caused by shift work. Being sleep deprived is also especially difficult because we are not good judges of how impaired our functioning is when we are sleep deprived. So, as nurses it can be very dangerous to practice when sleep deprived,” Witkoski Stimpfel says.
She cites the National Academy of Medicine, which recommends that nurses not work more than 12 hours every 24-hour period or 60 hours per week. There is also evidence that shows nurses should work a maximum of two to three shifts in a row.
Witkoski Stimpfel gives the following tips for nurse on how to best perform at their jobs when working overnight shift work:
Achieve enough adequate sleep during off shifts
Judicious use of caffeine
Use blue-blocking sunglasses on the way home after a night shift
Use blue-blocking apps/filters on smartphones and other electronic devices before getting sleep
Limit voluntary overtime hours
Have a bedtime routine that doesn’t include alcohol, nicotine, or other drugs
The bedtime routine can include taking a bath, listening to music, medication, talking with a spouse, friend, or family member—these will all help the body to shut down for rest.
Know that you can make mistakes when working nightshifts. “One of the biggest mistakes nurses can make when working night shift is to not sleep before a shift. Most studies on this topic indicate a small portion of nurses simply do not sleep before going into night shift, which is very dangerous,” says Witkoski Stimpfel. “Using melatonin or other sleeping aids should only be used under a provider’s guidance.”
If you have to switch from dayshift to nightshift in one week, Witkowski Stimpfel suggests the following, “It will be challenging to get “good” sleep when working one off night shifts, which is why that kind of scheduling should be avoided. If it happens occasionally, the nurse should try to get a nap before the night shift and definitely sleep as much as possible following the night shift. Using caffeine at the beginning of the shift and taking a walk or going up a few flights of stairs around 4 a.m. can help with alertness during the shift. If possible, using public transportation or having a friend or family member drive the nurse home after the shift could help to avoid drowsy driving,” she says.
Remember that these present, strange times we’re in have caused a lot of additional stress on everyone, especially health care workers. So it’s important to get the sleep you need. “The COVID-19 pandemic has placed additional and unprecedented stress on nurses, often resulting in disrupted sleep,” states Witkoski Stimpfel. “It is really important to reach out for help, whether it is therapy or counseling, meditation, a consultation with a sleep medicine physician, etc. Sleep is crucial for functioning across the board, both mentally and physically.”
Nurses have a love/hate relationship with sleep – love it when you can get it, hate it when you have to struggle to stay awake during a 10-hour workday or a graveyard shift.
Here’s the latest news on how you can catch more restful shut-eye, starting tonight.
1. Gadget power!
There are all kinds of new devices and apps on the market for improving personal health habits, including sleep hygiene. Take a look at some and see what appeals to you. Some are spending, and others are quiet reasonable.
One example: the Philips Wake-Up Light (usa.philips.com) costs $100 and makes waking up a more pleasant, more natural experience. The light simulates a sunrise by getting brighter over a 30 minute span, rather than jarring you awake with a spotlight of bright artificial light. If you tend to hit the snooze alarm over and over because you can’t face the morning, this light just may be the thing to gently welcome you to the new day.
2. Toss out your old mattress and pillows.
If your mattress is getting elderly (10 years is the recommended lifetime for even a deluxe mattress) then you may want to retire it. You’ll know when it’s time because you’ll wake up stiff and sore even though you haven’t changed your habits.
While you’re at it, consider replacing your old, flattened out pillows too. (Two years is the recommended lifetime for those.) You may find that you don’t suffer as many allergy symptoms, either, with your new bedding. Dust mites are the culprit there.
3. Get in a work-out.
Exercise will improve your sleep, even if you work up a sweat up to four hours before bedtime. Even 30 minutes of exercise three times a week have a positive effect on insomnia. The only drawback? It can take up to four months to see results. Nobody knows what the mechanism is that improves sleep but one theory is that it’s a domino effect: exercise improves mood, which then impacts sleep patterns.
What works for you when you have difficulty sleeping when you want to? Let us know!
Jebra Turner is a freelance writer in Portland, Oregon. Visit her at www.jebra.com.
Does any nurse out there get more than enough sound sleep on a regular basis? Probably not. Nurses are notoriously sleep-deprived.
Everybody’s aware that getting a restful night’s sleep — seven or eight hours are recommended for most adults — is one of the foundations of good health. (The others are eat well and exercise regularly, of course.)
A new public health campaign called “Sleep Well, Be Well” seeks to raise awareness among Americans about the necessity of a good night’s sleep.
It’s crucial that we get sufficient sleep each and every night — don’t delay sleep because you think of it as a luxury or try to “bank it” by sleeping in late on your days off. Remember, there are health risks that go along with chronic sleep deprivation and untreated sleep disturbances, such as sleep apnea.
The “Sleep Well, Be Well” campaign is part of the National Healthy Sleep Awareness Project, they are partnering with the American Academy of Sleep Medicine, the U.S. Centers for Disease Control and Prevention, and the Sleep Research Society.
To learn more about the campaign, visit www.healthfinder.gov, from the U.S. Department of Health and Human Services.
Here are a few Don’ts to follow during the day, so that better sleep is a Do at night.
Don’t exercise right before bed — it’ll get you too revved up to snooze.
Don’t consume caffeine late in the day: nix coffee, tea, certain soft drinks, as well as chocolate.
Don’t nap during the day, unless it’s for short durations of less than an hour.
Don’t drink alcohol, or drink it in moderation — alcohol can make sleep more elusive.
Don’t large quantities of food late in the day, and especially not before bedtime.
Don’t smoke cigarettes, as nicotine interferes with sound sleep.
How do you go about getting the recommended daily dose of restful sleep? Please share your strategies for sleep success with other nurses so that we can all sleep well and be well.
Jebra Turner is freelance writer in Portland, Oregon. Visit her at www.jebra.com.
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