Shift Work and Nurses' Health: Understanding the Consequences to Take Action!

Shift work has negative impact on nurses’ physical, mental and social health. It affects patient and staff safety as well as quality of care.  Nurses who work night shift may experience professional isolation. Awareness of these risks will help nurses who work shift work and those nurses who are in the managerial roles to identify strategies to minimize the risk by life style modification and policy revisions.

            Evidence supports the association between night shift work and several disease conditions such as certain malignancies, cardio vascular disease, gastrointestinal disease, metabolic syndrome, diabetes mellitus, sleep disorders and fatigue. Disturbed sleep- wake cycle has negative impact on mental health as evidenced by an increase in incidence of depression, anxiety disorders, and problems with concentration and memory among nurses who work night shift.

            Fatigue and lack of attention or impaired concentration negatively affect patient safety. Rotating shifts challenge biological clock and adjustment.  Strategies to improve nurses’ ability to stay awake at work such as provision for ‘power nap breaks’ and presence of bright lights at nurses’ station, may help nurses to remain alert and reduce errors. After night shift work, there is an increased risk of motor vehicle accidents due to the inability to stay awake while driving. Work place solutions to minimize the harm will improve patient safety and nurses' safety.

            Shift work sleep disorders are preventable and managable to a great extend with life style modification. Nurses needs to identify helpful strategies to improve the quality of sleep. There are technological assistance which might offer help prior to pharmacological agents.

            Management can organize activities to ensure professional involvement of nurses who work night shift. Today’s technology allows nurses to be part of work place committees without needing to attend meetings in person during day time when they are not at work. Involvement with professional organizations and preparing for specialty certifications as a team, organizing and being part of a journal club and similar activities will ensure professional development of nurses who continues to work the night shift.

       Activities designed for health promotion and prevention of shift work disorders can influence the life style and modify these risk factors. They should focus on improving the quality of sleep, social interaction, health status and work-life balance. Knowing the individual risk factors and identifying personal strategies to minimize the risk may help those ‘night owls’ to remain healthy and productive.