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Impact of Night Shift on Nurses

Photo: Impact of Night Shift on Nurses
According to the Australian Journal of Advanced Nursing, 46% of nurses worked a rotating shift in 2015. As nurses make up the largest group of health workers in Australia, they are also the most at risk to the deleterious consequences that come with working night shifts on a routine basis.

Adverse effects of night shifts

Health effects
Clearly disrupting the body’s natural clock has adverse consequences on an individual’s health and wellbeing. Studies have shown shift work can be detrimental to the body’s circadian rhythm resulting in carcinogenic effects on numerous body systems.

This is due to suppression of melatonin — a critical hormone regulating the body’s sleep-wake cycle. It is the reason behind an increasing tendency to sleep, and consequently decreased alertness, that results from increased duration of wakefulness. Along with inadequate night sleep, getting enough sleep during the day is also sometimes a challenge for nurses working night shifts as they struggle to carry out family responsibilities.
There is also emerging evidence supporting a strong connection between shift work and breast cancer in females, as well as prostate cancer in males. The effects of shift work also have a negative impact on the gastrointestinal tract (GIT).

The GIT relies on adequate gastric secretions to function optimally. The disruption in the circadian rhythm caused by shift work alters these gastric secretions. Overall, the result is a range of bowel and acidity problems that can increase with time.

Insufficient sleep has also been linked to an impaired immune response. Sleep deprivation diminishes our body’s ability to fight off infections such as colds and flus. Proper sleep is required for immune cells to carry out their functions.

In 2015 the Australian Health Survey (AHS) found that 40% of men and 45% of women working night shifts were suffering from chronic health conditions, including back-pain, diabetes and chronic obstructive pulmonary disease, in comparison to 36% and 39% of the remaining population. As well, a higher incidence of obesity has been observed amongst shift workers.

Impact on family life and wellbeing
Domestic disruption has been shown to be a key consequence of night shift work affecting relationships with partners, children and friends. One study found that 53% of people were not happy due to the nature of their partner’s shift work.

A large number of shift workers experience social isolation owing to the nature of their work as they find it difficult to spend time with friends and relatives. As a further consequence many nurses reportedly use smoking and binge drinking as coping strategies.

Nurses on rotating shifts generally find it difficult to balance their work and family life. Balancing daily household tasks, including finding time for quality family time is a constant challenge.

The psychological effects of these social disturbances can have negative implications on the quality of service the nurses provide to their patients. This is mainly because they are less likely to be willing to show compassion, care, and sensitivity towards their patients’ needs — all vital components of a nurses’ role at work.

Poor sleep quality and generalised fatigue from shift work have significant impacts on the nurses’ overall mood. As such irritability, lack of interest in social events, and exhaustion are common among shift workers.

Common coping strategies
A range of strategies are adopted to reduce the impact of shift work on nurses. Regular checkups, including breast screening, cardiovascular monitoring, and blood tests are important to ensure that no serious health issues are present.

Ensuring that adequate sleep is obtained is another vital coping strategy. This is usually achieved by prioritising sleep and obtaining family support to create an environment that encourages better sleep.

Reducing the number of night shift hours, as well as the number of consecutive days worked at night is another coping strategy widely adopted. The primary aim of these coping strategies is to promote better health and social wellbeing for nurses on regular shift work.


Sources:
http://www.ohsrep.org.au/hazards/fatigue,-impairment-and-shift-work/shiftwork-health-effects
http://www.sciedu.ca/journal/index.php/jnep/article/viewFile/7294/4497
https://www.mja.com.au/journal/2013/199/8/sleep-loss-and-circadian-disruption-shift-work-health-burden-and-management
http://www.ausmed.com.au/blog/entry/shift-work-nursing
https://www.researchgate.net/publication/6860200_Impact_of_Shift_Work_on_the_Health_and_Safety_of_Nurses_and_Patients
http://thenursepath.com/2014/12/13/the-impact-of-shiftwork-on-nurses-what-you-need-to-know/

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