2. Tamp Down External Cues
Imagine a clinician wrapping up a 12-hour shift at the hospital to go home and get some rest, only to feel themselves suddenly perking up as they walk outside and are greeted by sunshine and bustling streets.
That wakefulness will likely persist once the worker is at home, lying in bed, desperately trying—and failing—to fall asleep.
Along with circadian rhythms, people rely on external cues to tell them when it's time to get up, go to sleep, or eat meals. Even if a worker has been awake for a long time, it can be difficult to fall asleep after exposure to bright sunlight and street noise.
Rogers suggests encouraging shift workers to wear dark sunglasses on their way home from the hospital and discouraging caffeine use during the latter part of their shifts. She also advises that workers use earplugs to block out daytime noises and to hang dark curtains in their bedrooms if they need to sleep during daylight hours.
3. Set Rules for Shift Work
Even with environmental checks in place, it's up to hospital managers and administrators to set rules that can protect workers and patients.
The first is to ensure proper scheduling so workers can get the proper amount of sleep, says Rogers. She has written that the likelihood of a clinician making an error can increase by as much as 36% after working 12-hour shifts on consecutive days.
"We know that workers only use half of their time off to sleep," says Rogers. "If a nurse has 10 hours off, they will sleep for about five hours, which is not enough rest for anybody," she says.
It's also important to ensure shift workers take breaks. Because fewer restaurants and shops are open at night, many shift workers neglect taking lunches and scheduled breaks. Have clinician supervisors and managers encourage their reports to take their scheduled time off, and keep an eye out for workers who skip lunches or work through their breaks.
Additionally, most hospitals don't allow workers to nap during breaks, says Rogers. She believes this policy is a missed opportunity. "Allowing a nurse to do that will encourage alertness for the rest of the night," she says.
The night shift may not be the first choice for most healthcare workers, but by acknowledging its unique challenges, hospital administration can help keep workers awake, alert, and present in their jobs.
Lena J. Weiner is an associate editor at HealthLeaders Media.