Working in the ER, I am forced into an odd sleep schedule.  This past year, I have been working a lot of 6pm to 2am shifts.  I find that the benefit of the 6pm-2am rather than the traditional 12 hour overnight shift is that I can easily work until 2am without having to waste my afternoon napping.  Unfortunately, I am also not very good at sleeping in resulting in a lot of 5 hour nights of sleep.  Is this lack of sleep affecting my job performance?  Studies (and I) say definitely.  

I find myself often running through patients in my mind the day following a 2am shift suddenly worried that I forgot to order a certain test or write someone a necessary prescription.  I can’t remember what I did or did not forget to do.  This showed me how tired I really was at the end of my shift but it had never to my knowledge resulted in an actual mistake.  My wake up call came one night when I was driving home at 2:30am and accidentally ran a red light at a busy intersection near my house.  I was pulled over by a police officer who asked if I knew why he had pulled me over.  I had no idea.  I was in such a tired daze I had simply missed the traffic light.  (Thank you to the fellow night-shifter police officer who was very understanding and did not give me a ticket)

Studies show that lack of sleep and working shifts longer than 12 hours can drastically impact job performance among healthcare providers.  The Joint Commission published an article highlighting the data surrounding this topic.  The article states that nurses who work shifts of 12.5 hours or longer are three times more likely to make mistakes at work.  Studies of residents show that working a 24 hour shift rather than a 16 hour shift results in a 300 percent increase in fatigue-related adverse events that lead to a patient’s death.

As nurse practitioners, our jobs are unique compared to much of the rest of the United States workforce.  We deal with people.  Our behaviors directly affect our patient’s health and safety and an error in judgement can carry significant consequences.  I have started napping.  And attempting to sleep in.  Barbara Olson, a nurse and blogger for Medscape recommends the use of blue blocking sunglasses.  These glasses filter out the sun’s rays that are responsible for resetting your sleep-wake cycle.  If you wear them while driving home in the morning from your night shift, they will prevent your body’s sleep cycle from resetting allowing you to fall asleep more easily once you get home.

Do you work the night shift?  What tricks do you use to stay alert at work?  What sleeping patterns or work schedule do you find work the best for you?

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