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A hard day's night: when was the last time you relaxed?

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When was the last time you felt properly relaxed? Dawn Querstret wonders if your working day is interfering with your evening’s rest …

Nurses have a demanding role in a fast-paced and varied work environment. For those who work shifts, many face the additional stress of needing to be awake and alert, when their body clock is telling them to rest.

While there is little doubt that rotating shift patterns are better than working long-term antisocial patterns (e.g. nights or weekends), research has shown that shift-work has a detrimental effect on health and well-being.

Some of these effects are acute and short-lived (e.g. disturbed sleep, digestive disturbances) but other effects lead to chronic health problems that persist well into retirement such as diabetes and obesity. However, many people enjoy shift work and do not experience the kinds of health difficulties reported above. One of the reasons for this may lie in what people do when they are not at work. For nurses, and other shift workers, adequate ‘recovery’ between shifts is imperative to maintain optimal health and well-being.

‘Recovery’ can be conceptualised as a process of psychological and physiological unwinding during which depleted resources can be replenished. When people are at work they must invest mental and physical resources to deal with work-related demands. Once people leave work, and are therefore no longer exposed to work demands, reactions associated with work demands should reverse and they should be able to recover.

Complete recovery is optimal because this enables us to face the challenges of the next day, without needing to draw on already depleted resources. Typically, we assume this is an automatic process; after all, the demands of work are no longer there. However, research has shown that simply being away from the work environment, and having sufficient time between work periods, does not necessarily result in an individual recovering adequately.

One thing that people do when not at work which may interfere with their ability to adequately unwind or recover, is that they ‘ruminate’ – they think about work-related issues and events.

Some people think about tasks they’ve left uncompleted; others ruminate about a problem that needs to be solved; and still others cogitate about relationship issues with colleagues or negative events at work. People don’t just think about events or issues that have already occurred, but they also ruminate anticipatively, about upcoming events and issues they may be expecting at work. Rumination however, does not necessarily need to be a negative experience; indeed, it can lead to the development of solutions for problems which in turn make the next shift easier to manage.

The problem with rumination (whether it is for positive or negative reasons) is that it prevents people from taking adequate time to recover between shifts. And if people are not properly recovered, this means they must work even harder to cope with the same level of demand in their next period of work. If this continues, people can develop fatigue and can experience other health problems. Research suggests that rumination may provide a vehicle for work-stress to disrupt sleep; and sleep is one of the most important restorative processes we have.

With an ever changing working world, it is imperative to identify and understand the factors that enhance or prevent nurses from effectively unwinding from work. Nurses represent a unique sub-population of the work force and given the health implications of inadequate recovery between shifts for both nurses and patients; it is imperative we understand the factors interfering with recovery processes.

We are currently inviting nurses to take part in our research. Taking part is very easy. Simply log onto the link below to complete our web-based survey. This should take approximately 20 minutes. There are no difficult or too personal questions, and you can get a personalised report showing how you compare to nurses in general if you wish. This research is important to us and it will help us to develop interventions designed to aid the unwinding process.

If you have any questions or comments, or if you would prefer to complete a paper copy of the questionnaire, please contact the lead researcher, Dawn Querstret.

We would like to thank the Nursing Times for their support of this research; and thank you in advance for completing our survey.

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