Napping During Night Shift: Practices, Preferences, and Perceptions of Critical Care and Emergency Department Nurses

Abstract

BACKGROUND Nurses working night shifts are at risk for sleep deprivation, which threatens patient and nurse safety. Little nursing research has addressed napping, an effective strategy to improve performance, reduce fatigue, and increase vigilance.OBJECTIVE To explore nurses' perceptions, experiences, barriers, and safety issues related to napping/not napping during night shift.METHODS A convenience sample of critical care nurses working night shift were interviewed to explore demographics, work schedule and environment, and napping/ not napping experiences, perceptions, and barriers. Transcripts were constantly compared, and categories and themes were identified. RESULTS Participants were 13 critical care nurses with an average of 17 years' experience. Ten nurses napped regularly; 2 avoided napping because of sleep inertia. The need for and benefits of napping or not during night shift break were linked to patient and nurse safety. Ability to nap was affected by the demands of patient care and safety, staffing needs, and organizational and environmental factors.CONCLUSIONS Nurses identified personal health, safety, and patient care issues supporting the need for a restorative nap during night shift. Barriers to napping exist within the organization/work environment. (Critical Care Nurse. 2011;31[2]: e1-e11)

Empowering a Healthy Practice Environment

“…55,56 Working at night increases the chances of sleep deprivation with a high prevalence of patient errors, near misses, and personal injuries during a specified shift and while driving home. 54 In lieu of this, why would it not be a necessity to have the opportunity for nurses to take a nap on their given break? Nurses have a sworn duty to provide efficient care to those individuals who are in need of medical treatment.…”

“…53,54 However, with the major impact of health and safety of nursing staff and patients, napping on the job warrants exploration. Two reasons for napping on the clock would include fatigue and shift work (mainly working night shifts).…”

Napping on night shift: Powerful tool or hazard?

“…However, many workers avoid this strategy because they presume naps need to be longer than 30 minutes to be beneficial and they worry the ensuing sleep inertia will make them feel worse. Additional perceived barriers to napping on night shift include safety, being too busy, understaffing, perception of laziness, concern relating to safety-critical tasks, discontinuity of care, the absence of a comfortable napping space, interruptions during the nap and perceived lack of management support for sleeping at work (10). With favourable risk-benefit data, brief naps could be the ideal solution to these barriers.…”

“…Not only does driving place significant demands on multiple aspects of cognition, but the nature of driving can often exacerbate sleepiness and associated performance impairment. Consequently, reports of extreme sleepiness, near accidents, and having "no clue how I got home" are common after driving home from night shift (10). In industries such as healthcare and emergency services, where people are required to perform complex cognitive operations (planning, risk assessment), an understanding of the impact of naps on higher executive functions is important.…”

Night Shift Work and Sleep Wake Cycle in Nurses: an Integrative Review

“…Other studies mentioned those symptoms, in which nurses also reported gastrointestinal disorders [appetite disturbance, feelings of indigestion, heartburn or burning], weight gain, irritability, insomnia, headaches, concentration difficulty, feelings of depression or unhappiness, feelings of decreased self-esteem and mood lability [4,13,9,19,20].…”