Your Nurse Could Be More Exhausted Than You Think

By Kirstin Kelley

Fatigue takes a serious toll on shift workers. One study found that nurses who reported to work fatigued were 3.4 percent more likely to err or have a near miss while caring for a patient. The mistakes ranged from excessive needle sticks to improperly administered medications.

Valerie Brady is an RN living in Cape Cod, Massachusetts. Her private practice offers in-home care to a few clients at a time. Brady also picks up regular shifts at a local nursing home to ensure her skills stay sharp. Nursing changes often, as new best practices are developed, and keeping a close connection with others serving elderly patients gives Brady a chance to regularly learn new information or new techniques.

Right now, Brady’s three private clients are in good , so the shifts she takes on are daytime shifts. But when their health declines, she works overnight shifts so that she can be there if something goes wrong. She does the same for the nursing home.

When night shifts are unavoidable, Brady schedules an entire week of them. “I never would take one night shift,” she said. It would throw the whole week off. “It would take me three days to recover from that,” she said.

The science supports Brady’s fears. According to UCLA’s Sleep Disorder Center, a consistent schedule is the best way to mitigate the effects of working nights, and if you have to rotate, try to work with the clock, working progressively later shifts, rather than switching to earlier shifts right away.

The negative impacts night shifts have on a worker’s body are serious. Brady has experienced visual hallucinations and exhaustion. “I would look at things and see halos around them,” she recalled. She described being unable to process information as well as she should—something that poses a real danger to some clients, since she needs to be able to accurately dispense medications and accurately perceive changes in her clients.

But Brady’s experiences are just the beginning. She described seeing overnight workers who look like “ghosts” when they come in to work. Regular overnight shifts can lead to an increased risk of breast cancer, especially for those who work nights for their entire careers.

Careworkers like CNAs and RNs are disproportionately women, who make up 92 percent of all CNAs and RNs in the United States, and they often have children at home. While the overnight shifts pay $2.00 an hour or more above the rate of a dayshift worker, it seriously cuts into parents’ time with their kids.

“I was mostly working with young mothers—so they were missing out on a lot of their kids’ lives,” Brady explained. “They missed out on field trips, and they had to sleep during the day. That’s what their life was about. They’d wake up to make dinner and then they’d come to work.”

As long as people are getting sick or elderly, people like Brady are going to need to be available 24 hours a day, but public policy can help make their shifts less detrimental to their overall health. Creating a rotating schedule that moves in a clockwise direction and avoiding erratic scheduling practices have both been shown to mitigate some of the adverse health effects of working night shifts and give workers a chance to spend quality time with friends and family.

Tags:  health shift worker series Sleep

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