Optimising sleep for night shifts

Optimising rotas, not doctors’ behaviour, will improve safety

“…A recent article in The BMJ may give the false impression that changing individual behaviour will solve the problem 4. The authors underestimate the barriers to implementing the measures suggested; individual choices are frustrated by unfavourable environmental and organisational structures.…”

“…Frequent shifts in junior doctors’ rotas cause harm to patients and doctors due to tiredness, fatigue, attentional failures, and cognitive impairment 1234. A recent article in The BMJ may give the false impression that changing individual behaviour will solve the problem 4.…”

“…In a randomised trial in an NHS hospital, a 48 hour week rota (compliant with the European Working Time Directive) was associated with a 33% fall in medical errors, a rise in total daily sleep time, a substantial recovery sleep after the evening shift, and more frequent naps in the hours preceding the start of the night shifts compared with a standard rota of 56 hours a week 4. The “intervention” rota also limited consecutive night shifts to three nights maximum and shift duration to 12 hours maximum.…”

Making doctors better

“…To coincide with the tenth annual conference of the Practitioner Health Programme, the wounded healer, on 4 and 5 October, we have curated an online collection of articles published in the past few years (www bmj.com/wellbeing15 how to deal with a bullying colleague,16 and optimising sleep for night shifts 17. We are also considering how best to redesign health systems18 to move away from a production line mentality towards co-production of services with patients 19…”

Night shifts: chronotype and social jetlag

“…McKenna and Wilkes’s review on optimising sleep for night shifts is insightful and useful 1. Chronotypes and social jetlag are important relevant factors 2345…”