"We must look at our practices and attitudes about shift work"
Nurses need to look at how they can reduce the toll that night shifts can take on their health and wellbeing
Night shifts may be an essential part of working life for most nurses - but they are also bad for their health. There is an overwhelming body of evidence to suggest that working nights can be detrimental to our wellbeing. This is related to the fact that
night shifts disrupt circadian regulation, which is thought to be responsible for a wide range of physical and psychological disorders.
Night-shift workers are reported to experience sleep of a lower quality than their fellow day workers. The rotations of days to nights, and vice versa, disrupt circadian regulation still further. Worryingly, there appears to be some correlation between sleep deprivation and tiredness and the incidence of professional mistakes, such as drug administration errors, incorrect operation of medical equipment and needlestick injuries.
However, despite the difficulties they can cause, night shifts are a fact of nursing. Most of us knew when we began our careers that nursing was a 24/7 profession. But perhaps trusts and other healthcare organisations could do more to reduce the physical and psychological burden of night working.
Operationally this may be difficult. While shift pattern rotations have been suggested that reduce circadian disruption, these may not be practical in a service that needs to be dynamic and responsive to service requirement. The one thing that is likely to upset nurses more than having to do nights is changing their working
patterns and shift times.
The trend towards 12-hour shift patterns started in the 1980s, influenced by nursing staff shortages. And, while nurses grumble about long shifts, the chances are that suggesting working five days a week instead of three would not be popular.
The increase in pay due to working unsociable hours does soften the blow of nights - but then night workers often miss out on the services available to day duty staff, such as access to hot food, break times, and professional development and learning opportunities. Perhaps trusts could make more of an effort to ensure these services are available both day and night?
While trusts need to explore ways of offering more support, nurses also need to look at how they can reduce the toll working can take on their health and wellbeing. Nurses often arrive for a night shift having already done a day’s work at home - such as housework or childcare duties - without having had enough sleep. Yet surely we have a professional responsibility to make sure we are sufficiently rested to carry out our clinical duties and are fit for practice?
When it comes to reducing the burden of shift work, nurses will always suggest they lack adequate support. But we have to remember that organisations may find it difficult to provide such help. That’s why we need to look at our own attitudes and practices around shift work - if we do that we may be able to find ways that will help ease that burden.
Dan Higgins is senior charge nurse, critical care, University Hospitals Birmingham NHS Foundation Trust
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