A descriptive exploratory study was conducted to describe the effect of night shift on Jordanian nurses working in critical care units. Results showed that female nurses had a significant difference on sufficient sleep, and interpersonal conflicts. Study urges the need to design proper nursing manager interventions that help nurses to improve nursing care quality.
A descriptive exploratory study was conducted to describe the effect of night shift on Jordanian nurses working in critical care units. Results showed that female nurses had a significant difference on sufficient sleep, and interpersonal conflicts. Study urges the need to design proper nursing manager interventions that help nurses to improve nursing care quality.
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A descriptive exploratory study was conducted to describe the effect of night shift on Jordanian nurses working in critical care units. Results showed that female nurses had a significant difference on sufficient sleep, and interpersonal conflicts. Study urges the need to design proper nursing manager interventions that help nurses to improve nursing care quality.
Copyright:
Attribution Non-Commercial (BY-NC)
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Download as DOCX, PDF, TXT or read online from Scribd
experience to night shift frequent headaches backache persistent tiredness feet ailments loss of sleep muscular strain others 0 0.1 0.2 0.3 0.4 0.5 0.6 Mean 5.5.1. Problems of night shift There is a diversity of problem encountered by nurses in a normal working situation. Some of these may be physical, physiological, psychosocial and social. Night work intensifies problems since the individual is working when the body clocks is naturally telling the majority of the people to rest. Problems vary with each individual since the biological structure is different. The findings revealed that 57% of nurses have experienced a problems to fall a sleep. and most of nurses 92% of sample stated that night shift doesn’t suit their life style(see figure 2). Furthermore 94% stated that night shift is uncomfortable and doesn’t pay better salary. 5.5.2. The influence of circadian rhythm on the night workers As previously, mentioned differences in the circadian rhythm make other people to be at their peak in the evening and some to reach their peak in the morning Meckenzie J(2001) The study also examined if nurses felt more energetic when working on night shift. The results showed that 67% of the nurses did not feel energetic. Tiredness may be due to insomnia, changes in sleeping patterns, variations in length of shift periods, and circadian rhythms. The fact that about 20% of the respondents experienced persistent tiredness implies that their performance could be impaired. This inefficiency in performance could have deleterious consequences on the health care of patients. 5.5.2. The influence of circadian rhythm on the night workers As previously, mentioned differences in the circadian rhythm make other people to be at their peak in the evening and some to reach their peak in the morning Meckenzie J(2001) The study also examined if nurses felt more energetic when working on night shift. The results showed that 67% of the nurses did not feel energetic. Tiredness may be due to insomnia, changes in sleeping patterns, variations in length of shift periods, and circadian rhythms. The fact that about 20% of the respondents experienced persistent tiredness implies that their performance could be impaired. This inefficiency in performance could have deleterious consequences on the health care of patients. Effect of Night Shift on Nurses Working In Intensive Care Units at Jordan University Hospital 81 5.5.3. Sufficient sleep The major problem faced by night shift workers is the lack of sleep or insomnia (table 3). 72 % of the respondents working on day shift indicated that they do not get enough sleep when on night shift. Among the whole group of respondents, 49% sleep for less than 5 hours, another 44% of respondents sleep for 6 to 7 hours. Among day and night nurses of all age groups, only 7% sleeps for eight hours or more, after night shift. The data obtained from the survey showed that 75% of the nurses have a problem with falling asleep after night shift, implying that 23% did not have a problem. Insomnia is a prevalent ailment that affects all categories of nurses who participated in this survey. Yamanchi h, et al,2001), have noted differences in the biological make-up of individuals. These differences can create difficulties for some people when they are expected to adjust from a diurnal working schedule to working on a night schedule. This is in line with suggestions by some nurses who have no problems with working on a night shift. They indicated that they were more energetic when they work on night shift. This evidence collaborates that of Rodgers et al., 1986 who pointed out that some people are “evening types” whereas others are “morning types”. Preferences towards shifts have an influence on each individual towards adaptation to night shift. Sleep is a major concern since it affects the health and the performance of nurses who are dealing with human lives. The health care workers in this study have indicated that they are exposed to such hazards and mistakes. Any mistake or accident resulting from fatigue or stress can cost a life of the next person, resulting in law suites and claims from patients. Table 3: Effect on sleep 6% 94 % 6 94 Yes No is night shift comfortable 42 % 57 % 42 57 Yes No . After night shift work do you experience any problem to fall a sleep? 49 % 44 % 7% 49 44 7 Less than 5h 6hrs_8hrs More than 8hrs How many hours do you sleep after night duty 72% 28 % 72 28 Yes No get enough sleep after night duty? 5.5.4. Strategies to induce sleep An important factor to note is that 54% of respondents use some form of strategy to induce sleep (chart 1). The respondents, who indicated that they have no sleeping problems when on night shift, have to use some form of strategy to induce sleep as well. Several options to induce sleep were mentioned and these included the use of beverages, reading and music. From the medical point of view, continued intake of medication or sleeping tablets affects the physiological and psychosocial well-being of the individual. It is not advisable to take medication without consultation with the medical doctor. An important fact to remember is that induced sleep is not restful and tablets can be habit forming. 82 Raghad Hussein Abdalkader and Ferial Ahmed Hayajneh Chart 1: Ways in which nurses induce sleep 6. Summary and Conclusion Study shows that all age groups are subject to exposure to physiological and psychological hazards brought about by night shift as indicated in their subjective response. The recent developments regarding shift work is aimed towards improvement of health of shift workers, the physical and psychosocial well being as stated by International Labor Office ILO. ILO has highlighted that recommendation should be relevant to specific groups and work systems. Noted is that each sector has its own specific needs, especially health sector as it deals with patient care. The night shift worker is a man at odds with his own body rhythms as stated in Pheasnt,(1991) when managers are planning shift schedules should be aware of these biological rhythms as explained by other research's. Literature has explained that there is no perfect schedule; the main factor is consideration of the inputs from the participants in shift work. Shift work environment should be comfortable, safe and free from hazards such long hours at work. Further studies are required to find out the extent of night shift effect. Management will benefits with further research in this area. The purpose of this study to describe hazards affecting nurses working on night shift and to make recommendations based on the finding. 7. Recommendations The findings of this study suggest that it may valuable to replicate this study with larger and more heterogeneous randomly selected sample and well-defined valid instrument that fit and sensitive to Jordanian culture Assessment of advantages and disadvantages of shift system should be done based on objective criteria. Adjustment of physiological function to night work, level of well being, health problems, and disturbances in personal life, accident rate and performance efficiency, are all taken into consideration in shift work design. Upon the study findings, I recommended that nurses need a continuous medical screen. That supported by International Labor Office (1990), which was adopted that permanent and rotating night workers are generally a population at risk and are to be included in medical screening, and should be given special attention as they are exposed to work load and extended working hours. Effect of Night Shift on Nurses Working In Intensive Care Units at Jordan University Hospital 83 Other recommendation to managers include, appropriate health services for nightand shift workers, first aid facilities, option to transfer to day work for health reasons,measures for women on night shifts, and special maternity protection.Schedule planners should avoid quick change over from night to day on the same day or from morning to night. Every shift system should include some free weekend with at least 2 successive full days off. Time of recovery, and rest breaks must be considered schedule to be regular and predictable. However, managers must have responsibilities toward nurses, like to let nurses have a freedom of choice regarding shifts, and to formulate strategies to assist the nurses who find it difficult to work at night, identify the existing occupational hazards that affecting nurses, and they will be able to forecast on possible strategies that can help to reduce hazards in hospitals. Considerations of nurses needs for a particular shift and involvement is important for motivation and acceptance of shift schedules and work. Motivation could improve adaptation of the nurses to awkward hours of night shift. It can not be possible to meet all the needs of different nurses when planning Schedules, on the contrary, it is possible to make adaptations that can reduce the strain of the long hours worked on night shift. Other recommendations is encouraged to provide a psychologically supportive environment to the nurses. Rest room should be provided to relieve psychological stressors. Music, reading materials, and games provide relaxation to nurses. The comfort of the environment and the furniture used for resting is essential and conductive to complete rest. Those who feel tired can benefit from a separate resting area at the Cafeteria or the work area. Tips are recommended for shift workers, to be in health and good manner Sleeping Plan your sleeping time, keeping a steady schedule. Make and keep rules, train your children’s not to disturb you when you are sleeping. Do not work too many nights in arrow. At least, not more than four. Develop a good sleeping environment, have a dark cool, and comfortable room, black out light with heavy curtains. Eye-shades and ear–plugs can be used by those who are comfortable wearing them, turn telephone volume to off. If under stress, relax before going to bed, light exercise is one of that. Digestion Care about what you eat and drink, choose light healthy meals before going to bed. Avoid heavy, gassy, greasy or fatty meals during night shift. Avoid coffee or caffeine at least four hours before going to bed Herbal tees and warm milk are good before bed. Avoid using intoxicants or sleeping pills to get 84 Raghad Hussein Abdalkader and Ferial Ahmed Hayajneh in sleep, except in most unusual circumstances; the sleep architecture is altered thus sleep is less restful and you may be hung over poor performance at work Social Do not lose your connection with your family life, do not forget that your family is for whom you do it, and do not lose your spouse or significant other. Grocery shopping at off peak hours will be of benefits. Finally of recommendations, identifying effect of night shift on circadian rhythm among nurses working in critical care units can contribute to critical care nursing curriculum that can address psychological and physiological needs of nurses, which ultimately reduce stress level from night shift and improve the quality of nursing care. 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