Mar 30, 2017

The Shift of a Nurse: Long Hours and Short Staffed

There are two realities about being a nurse. Firstly, there will be long hours, and likely multiple shifts in a row. And secondly, there will not be enough of your fellow nurses on staff to share the workload.

Some nurses work long hours voluntarily, while others do it out of necessity because where they work are grossly understaffed. Whatever the reason, working long hours is exhausting and chances are these nurses at times feel compromised to work to the best of their ability.

But who can blame them? Though rewarding, being a nurse can often be thankless. They’re on their feet all day, rushing between various patients or residents, dealing with other staff and senior management.

And it’s even worse when short staffed. Short staffing results in nurses being fatigued and eventually burning out. And when the job is stressful and too much to handle, they will eventually be dissatisfied by their role, and may eventually quit.

Being a nurse isn’t a 9-5 job. It isn’t a job you get weekends off and can unwind on every Friday night. Many don’t routinely get the public holidays off. It’s shift work, and probably one of the hardest jobs out there.

Shift work is the norm for nurses. Traditionally, nurses could vary their shifts between a few options during the day and night. It was tricky to juggle, and obviously disruptive to normal eating and sleeping habits, but some could find this manageable every few weeks.  

Some nurses, particularly hospital nurses, are working 12-hour shifts. Something unheard off in most other jobs. One of the biggest drawbacks of 12 hours shifts is the increased fatigue, seeing more hours means more patients and more workplace stressors. A 12 hour shift may also not have sufficient break or opportunities for the nurse to eat and rest.

One American-based study showed that working longer shifts or working overtime was one of the causes for reduced sleep times, having trouble staying awake during a shift and that these people had three times the risk of making an error.

The most significant error risk was seen in the nurses that worked for more than 12.5 hours. The study also found that the kind of errors that were most common when a nurse was fatigued included:

  • Administering wrong doses
  • Dose omissions
  • Extra doses

Worst of all when a nurse is tired, stressed and over-worked, it’s not just the nurse that suffers, but the patients too. The last thing any workplace wants is a higher risk of injury or compromised care.

There have been other studies that show that higher nurse to patient ratios lead to better patient outcomes, and lower rates of patient deaths.

The adverse effect of long hour and short staffing on nurses go way beyond fatigue. Nurses, without adequate sleep, rest and food are at risk of obesity, diabetes, depression and cardiovascular disease.

Changes need to be made so that no nurse has to deal with negative long term effects of their careers and that no patient goes through any short term problems.

How can we ensure we taking care of the people that care for us in need? Funding alway seems to be the number one issue. How about education – are there enough nurses being trained to handle our society’s demands?

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Helpful Tips for the Helpful Nurse

There are a number of things nurses can do to help themselves, as well as other nurses, to decrease the risk of harm to themselves and others.  

  • Care for themselves, make sure you are able to get adequate sleep, and eat proper nutritious meals.
  • Be able to recognise the signs and symptoms of fatigue, and seek help when necessary – this could be anything from more sleep to saying no to extra shift or getting medical attention.
  • Be mindful of your practice and focus on your patients. This can be difficult when you are tired or stressed, but the patient’s care and safety is the number one priority of the job. If you need annual leave don’t be afraid to ask for time off.
  • Support your fellow colleagues, and support each other through difficult shifts and workloads.
  • Become a member of nursing associations (such as ANMF) and partake in their legislative initiative to help the nursing field.

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