Night shift is a common part of many aged care worker’s lives. Some enjoy it and come to prefer to work at night, while others never get used to the disruption night shift causes to the physical, emotional and social fabric of their lives.
There’s a huge amount of interest – both anecdotally as well as in the field of academia – in the topic of managing to get enough sleep while working at night.
Here at HelloCare, we became aware that one of our readers was heading off to work – more than half an hour’s drive away – to work a full night shift having had less than two hours of sleep.
This situation obviously is far from ideal, however, it’s one that all too easily can occur when working night shift. With all the best intentions, sleep sometimes doesn’t come.
Could the destructive effects of lack of sleep be counteracted if shift workers were allowed to take a short nap at work when needed?
HelloCare has discussed the topic with Professor Shantha Rajaratnam from the School of Psychology and Psychiatry at Monash University, and also a board member of the Sleep Health Foundation.
Prof Rajaratnam told HelloCare studies have shown that taking a short nap can improve alertness for a time, but napping should only be used as a short term solution to tiredness while working night shift.
“Napping is a strategy in the short term to help us manage sleepiness,” Prof Rajaratnam said.
“But you wouldn’t want for the worker to think the short nap is somehow going to replace the opportunity to sleep.”
Prof Rajaratnam said, “It’s very important when preparing for a night shift to plan appropriately.
“Part of that plan is ensuring the person has had an adequate amount of rest and prioritizing the opportunity to sleep before commencing the night shift.”
“We know that over the night, when we challenge the biological clock to remain awake, it can have a significant impact on our alertness and cognitive function. One of the key ways to prevent that impact is to commence the night shift with an adequate amount of sleep.”
“If, even after having an adequate amount of sleep, the person is experiencing significant tiredness during the night shift, there are several studies that have shown that a short nap can have benefits for improving your alertness and cognitive function for a period of time.”
Napping isn’t a long term strategy, Prof Rajaratnam said “because an adequate amount of sleep is the only thing that’s going to make the person feel rested and able to function from a long term perspective.”
“An inadequate amount of sleep and disruption to the biological clock, which of course happens because of shift work, can have really widespread effects on our mental health, our physical health and also our performance,” Prof Rajaratnam said.
“Some of the documented impacts on our physical health include increased risk of cardiovascular disease, diabetes and so on, and in terms of mental health, we see increased risk of depression, anxiety, stress, and occupational burnout.”
“In terms of the performance impacts, we see impairment in our alertness, which causes fairly widespread impacts in cognitive function, which then translates to impaired safety and risk of injuries and accidents.”
Dr Rajaratnam said workers driving home after night shift are at risk of having a car accident in the early morning – something our reader should consider before their long drive to and from work.
“The drive home after a night shift occurs usually when the person has been exposed to sleep deprivation and it also often occurs at a time of day when the biological clock is sending a strong signal to sleep.
“The combined effects of sleep deprivation and the signal from the biological clock can increase the risk of a motor vehicle crash in the early morning hours,” he said.
Prof Rajaratnam said employers need to support shift workers to ensure they don’t become dangerously tired.
“Given the widespread documented impact of shift work on health and safety and productivity, a coordinated strategy needs to be put in place to try and support people who are employed in shift work,” he said.
But it’s not a “one-size-fits-all” solution, Prof Rajaratnam said. There will be solutions at an organisational level, but there also needs to be support for individuals to help them better plan their sleep and optimise their sleep opportunities, he said.
Employers might consider sleep disorder screening and introducing environmental factors, such as lighting, which is known to have an effect on the biological clock and can have an immediate “alerting effect”, Prof Rajaratnam said.
Napping is a strategy to manage sleepiness only in the short term.
“You wouldn’t want for the worker to think the short nap is somehow going to replace the opportunity to sleep. It’s important a facility (to nap) is made available, but with clear education that it’s important to ensure an adequate opportunity to sleep outside of work hours as well.”
We have had day staff, RNs and AINs come onto the night shift to spy (as one EN personally told me just weeks ago) on the night staff. To catch staff sleeping! A few weeks ago 2 staff members were cought sleeping. One went to lie down in the unused cinema in the early hours of the morning and the nurse on duty opened the door and discovered the staff’s little hideaway. The other staffer was found on a wing sleeping on a lounge at the back of the wing and woke in fright as the RN stood over him in the dark. The staff discovered were on their break and the only alternative for a nap is to sit in hard plastic chairs in the staff room leaning over the table. All courses and staff meetings are held at 1.00pm mostly when night staff are in bed at home. I stopped going in to these a few years ago when I was going for two to sometimes 3 days without sleep. No exaggeration here. The company I work for don’t like to pay trainers to come in early for night staff. It has always been an issue here.