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.”