Sleepless nights in hospital affecting not just patients

The first comprehensive study in New Zealand of the effects of shift-work and fatigue on nurses has just been launched.

The $890,000 research project, led by Dr Philippa Gander from Massey University’s Sleep/Wake Centre and the School of Nursing in Wellington, is surveying fatigue-related errors to better manage the issue within the profession.

Project manager Karen O’Keeffe says nurses are often overlooked and haven’t been studied a lot.

“There are 50,000 nurses working in New Zealand – they’re the biggest part of the healthcare workforce - so they’re important.”

Nurses from six particular practice areas: child health and neonatology, cardiac care and intensive care, emergency and trauma, inpatient mental health, medical and surgical, are being studied anonymously, Ms O’Keeffe explained.

“We don’t have a lot of systematic information across New Zealand about what and how nurses are working, which is why we’re doing the survey.”

Ms O’Keeffe said they want to find out how long nurses’ shifts are, what breaks they take, and even how long it takes them to get to work.

“We want to know what their sleep patterns are, and how these affect fatigue-related outcomes: clinical error, excessive sleepiness and drowsy driving.”

Their goal is to get as much information as possible to be used to find useful tools for DHBs and individual nurses, including the development of a Code of Practice to manage nurse fatigue.

A 24-year-old nurse, who wished to remain anonymous, said she struggled with the rostering at Middlemore Hospital, working day and night shifts.

The pressure and fatigue got to be so great at times she’d call in sick, leaving the ward short-staffed, so nurses unfamiliar with the ward would cover, which was “unsafe”, she said.

“Nights were horribly fatiguing if you had a few in a row. The second night I was always shattered.

“Some people were fine with it, but I don’t sleep well as it is, so I struggled with having no sleeping pattern.”

She said that there is a supportive network of nurses who always ensure medication doses are double-checked, but that she didn’t want to just rely on others when she was fatigued.

“I did call in sick a few times because I was so tired that I didn’t think those measures were enough. I would have felt unsafe being on the floor.”

Dr Leonie Walker, principal researcher for the New Zealand Nurses Organisation, said the study will help them find the “pros and cons” of nurses rostering to work out what is safe and appropriate.