Learning Objective #1: Examine nurses' activity level over the span of 5, 12-hour shifts.

Learning Objective #2: Evaluate the nurses' sleepiness and fatigue in relation to number of worked hours, patient acuity and shift activity.

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This presentation is the report of a triangulated exploratory descriptive and phenomenological research study concerning the sleepiness and fatigue of nurses working 5, 12-hour shifts in a row. Research objectives were to: Investigate changes in movement during a 12 hour shift, nurse activity patterns and nurse report of fatigue; Discover the variability in activity from day 1 to day 5 of a consecutive series of 12-hour shifts; and Examine the correlation between nurse report of sleepiness and Actigraph recording.

The subjects were recruited by email sent to all registered nurses describing the research study. Voluntary subjects replied to the researcher by email or telephone. A meeting took place to further describe the study, obtain written consent and demographic data. The researcher met with the study subject at the beginning of the first 12-hour shift to place the Actigraph watch on the subject's non-dominant wrist. During the 5 day study time the researcher collected data by email. At the end of the 5 shifts the Actigraph was removed and the subjects participated in a 10 minute interview.

The study convenience sample consisted of 10 volunteer registered nurses working in acute care settings. The study was approved by the health system and university IRB committees.

Transcripts of the interviews were analyzed using thematic coding and a search for patterns. The themes are a slow, or non-hectic, work environment, end of shift/week, and having a long drive home after work. Fatigue and sleepiness on the job are impacted primarily by the physical status of the nurse and by the work environment.

Preliminary analysis of quantitative data revealed a significant difference between the amount of movement of night nurses and day nurses. Individual variations in level of activity existed within and between 5, 12-hour shifts. Nurses' sleep between shifts is often minimal and restless.