Sleep, Sleepiness, Fatigue, and Performance of 12-Hour-Shift Nurses

Abstract

Nurses working 12-h shifts complain of fatigue and insufficient/poor-quality sleep. Objectively measured sleep times have not been often reported. This study describes sleep, sleepiness, fatigue, and neurobehavioral performance over three consecutive 12-h (day and night) shifts for hospital registered nurses. Sleep (actigraphy), sleepiness (Karolinska Sleepiness Scale [KSS]), and vigilance (Performance Vigilance Task [PVT]), were measured serially in 80 registered nurses (RNs). Occupational fatigue (Occupational Fatigue Exhaustion Recovery Scale [OFER]) was assessed at baseline. Sleep was short (mean 5.5 h) between shifts, with little difference between day shift (5.7 h) and night shift (5.4 h). Sleepiness scores were low overall (3 on a 1-9 scale, with higher score indicating greater sleepiness), with 45% of nurses having high level of sleepiness (score > 7) on at least one shift. Nurses were progressively sleepier each shift, and night nurses were sleepier toward the end of the shift compared to the beginning. There was extensive caffeine use, presumably to preserve or improve alertness. Fatigue was high in one-third of nurses, with intershift fatigue (not feeling recovered from previous shift at the start of the next shift) being most prominent. There were no statistically significant differences in mean reaction time between day/night shift, consecutive work shift, and time into shift. Lapsing was traitlike, with rare (39% of sample), moderate (53%), and frequent (8%) lapsers. Nurses accrue a considerable sleep debt while working successive 12-h shifts with accompanying fatigue and sleepiness. Certain nurses appear more vulnerable to sleep loss than others, as measured by attention lapses.

Perception of Fatigue in Female Nurses Employed in Hospitals

“…24 Nurses working in 12-hour shifts get more drowsy and fatigue. 35 Female nurses with a second job other than nursing or those who worked as a nurse in several places perceived more fatigue compared to those with only one work shift, yet, the correlation was not significant. According to Zamanian and coworker 36 increased work load from the previous years has led to extensive fatigue among nurses.…”

Sleep quality, level of daytime sleepiness and fatigue among working nursing students

“…Druge studije izveštavaju da su, u sestrinstvu kao predominantno ženskoj profesiji, sestre često izložene problemima koji utiču na njihovo blagostanje, nivo umora, dnevnu disfunkcionalnost i porodične i društvene odnose [16,29,30].…”

“…Ovaj rezultat je u saglasnosti sa istraživanjima koja pokazuju da je smenski rad faktor rizika za loš kvalitet spavanja i umor medicinskih sestara [29,31,32]. Studija Ferreira i De Martina ukazuje da pohađanje nastave neophodne za ispunjavanje zahteva studijskih programa pogoršava kvalitet spavanja studenata koji rade, dovodi do prekomerne dnevne pospanosti i umora [11].…”

Impact of Work Schedules on Sleep Duration of Critical Care Nurses

“…1 Increased sleepiness and poorer neurobehavioral performance are associated with less than 5 to 6 hours of time in bed, even for a single night. 2 Increasingly, evidence 3 indicates that sleep deprivation in health care professionals adversely affects performance and may have adverse effects on patient and occupational safety.…”

“…Additionally, time required for responsibilities at home may further limit opportunities for sleep. 2 Sleep duration may be even less between consecutive night shifts, because the internal biological (circadian) clock reduces sleep drive during the daytime. 4 Although registered nurses are the largest group of health care providers in the United States, the impact of work schedules on sleep patterns of nurses has not been well studied.…”