Staying Rested and Alert Despite the Trials of Hospital Shift Work

By Stacey McKenna

The vast majority of today’s -based care providers work shifts, usually covering longer time periods than the standardized 8-hour day. in these settings are typically assigned 12-hour stretches while doctors — especially medical residents — may work upwards of 16 hours straight. These long days and rotating shifts are often lauded for providing flexibility and deemed necessary to ensure the requisite 24-hour care. However, studies associate the grueling schedules with persistent exhaustion, placing both patients and providers at risk.

Denise Ho, 33, has worked as a pediatric nurse in Toronto since 2008. While she appreciates the benefits of her schedule, she still struggles to get enough rest, explaining, “When doing shift work, I feel jet-lagged all the time, with moments of clarity, but only after some coffee.”

Similarly, Ashley Carlson, 30, worries she may never fully adapt to working the hospital night shift despite having spent years as an EMT in Fort Collins. “My is terrible,” she says. “Even on nights that I don’t work.

Julianne Imseis, 30, is a medical resident in Denver, so her schedule changes drastically from month to month. However, most rotations entail 12 days in a row of 10-16 hour shifts followed by two days off. Residents take turns working days and nights, doing months of one or the other at a time. Though she finds the lengths of her shifts manageable, she also struggles to feel rested, especially on her working days.

Juggling long hours, strange schedules, and sleep deficits makes it difficult to stay alert and properly care for patients. “I take laps around the nurse’s station, drink coffee,” Carlson says. Similarly, Imseis credits coffee for keeping her alert during long shifts. But all the caffeine in the world doesn’t help if you’re just not getting enough sleep. So it’s important to find a way to get that shut-eye.

All three women have used over-the-counter medications to assist with sleep, but try to limit this to a last resort. Though she says she would never advocate it, Imseis admits, “I drink lots of caffeine and take a chamomile pill at night to sleep. Occasionally, I’ll take an over-the-counter sleeping pill or Benadryl to sleep. Like I said, I do not manage them [sleep issues] in a healthy way. I would yell at my patients if they told me they basically medicated themselves to stay awake and asleep.”

Since becoming pregnant, Carlson can no longer turn to medical sleep solutions. Instead, she creates a sleep-friendly environment with blackout curtains and an air-conditioning unit. “I can’t take anything now, so… I just try to make it as dark and cool as possible and that does help,” she says.

Ho makes a conscious effort to prioritize sleep. “When I’m tired, I’ll cancel plans to sleep,” she says. “And I schedule in ‘bed days’ when my work schedule is especially hectic.”

There doesn’t seem to be a panacea for the fatigue that results from the hospital schedule. But for health workers caring for the most critical patients, the sacrifice seems to be worth it.

Tags:  health Hospital Nurses shift worker series Sleep

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