By Linda Beattie, contributor
Sleeping on the job used to be considered a big mistake—one that could even endanger a nurse’s job—but a new qualitative study shows that naps should be encouraged for nurses who work the night shift. It turns out that “catching a few Zs” has benefits for nurses and their patients, and the study’s researchers believe that hospitals should find ways to make sure nurses get the rest they need.
According to researchers, night-shift nurses should be encouraged to take a nap during their breaks. Photo courtesy of Victoria General Hospital,Winnipeg, Manitoba, Canada.
The study found that without naps, the demands of critical care patients place nurses at risk for sleep deprivation, which in turn leads to threats to patient safety and the health and safety of nurses.
“When nurses got a nap during their break times, most felt very refreshed and had more energy,” reported Diana McMillan, Ph.D., RN, co-lead investigator of the study. “Those who wanted a nap but couldn’t take one reported foggy thinking and more uncertainty about calculations and decisions that they were making. They would go to great lengths to triple check their preparations. We need to look more carefully at how, as institutions, we can support nurses to take a brief nap during breaks.”
At this year’s meeting of the Associated Professional Sleep Societies (APSS), McMillan and her fellow researchers from the University of Manitoba in Winnipeg identified several health, safety and patient care issues that support the need for nurses to take a restorative nap during the night shift. Despite existing barriers to getting this kind of rest on the job, they noted that a strategy to help nurses balance their sleep needs with their work and lifestyle demands is greatly needed for both critical care nurses and the patients in their care.
The research team originally set out to conduct a randomized, controlled study but after talking to some nurses who worked the night shift at Victoria General Hospital in Winnipeg, they decided that they first needed a better understanding of how nurses functioned with and without naps.
The team conducted in-depth interviews with 13 critical care nurses, looking at their work schedule and environment, and napping/non-napping experiences, perceptions, barriers and preferences.
“We found that some were regular nappers, some napped occasionally and a few preferred not to nap because it just doesn’t work for them,” reported Wendy Fallis, Ph.D., RN, co-lead investigator on the study and director of research at Victoria General. “For those who like napping, they feel revived and alert after a few minutes of rest, which is very important when you are caring for patients.”
“Just a 20-to-30 minute nap gave many of these nurses increased energy and helped them be more alert in terms of patient safety,” Fallis continued. “As a nurse, you need to think on your feet and be alert. Monitoring patients and administering medications are very important, so being an alert, vigilant nurse is certainly a must in critical care, and the napping seems to really help that.”
Another important aspect of the team’s findings was how important rest was for the nurses themselves, even after their shift. Fallis reported, “Those who napped told us that they were more alert even when driving home, while some who didn’t feel rested sometimes found themselves falling asleep behind the wheel.”
Fallis, McMillan and their colleague, Marie Edwards, Ph.D., RN, found that the nurses they surveyed were extremely concerned about their patients and co-workers, and would choose not to rest during their breaks if the unit was short or some of the staff was too inexperienced to handle emergencies alone. They were also careful to let everyone know where to find them, just in case.
The nurses reported that they haven’t always been allowed to take naps at the different places they had worked, and that—even with management support—finding a good place to get a restorative nap is not always easy to do.
“They told us that they try to find a quiet place, sometimes there was a couch or perhaps two chairs that they put together,” Fallis said, but mentioned that hospitals rarely offer a separate place for nurses to rest. “A lot of emergency rooms have a sleep room for doctors, but they don’t seem to have the same spot or accommodation for nurses. This really should be taken into consideration, especially when remodeling a unit. That is where management needs to rethink their priorities. We should support nurses in getting the rest they need.”
“The reaction to our initial study has been overwhelmingly positive,” said McMillan, and the research team plans to do further surveys and studies to see if the information they found will vary across hospitals throughout Canada. They also want to get managers’ perspectives on accommodating naps for nurses.
Considering the lack of research on the subject of nurses and napping, this Canadian team is pleased to bring more attention to this issue. “We feel privileged to be able to give back to our profession in a positive way,” said McMillan.
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