AJN, American Journal of Nursing:
Karen Farmilo recently finished nursing school and currently works as a certified nursing assistant at John Muir Medical Center, Walnut Creek, CA. Contact author: email@example.com. The author has disclosed no potential conflicts of interest, financial or otherwise.
An underutilized strategy for staying sharp and engaged in the course of a shift.
Would you try to run your car without gas, choose to fly on a plane with an exhausted pilot, or expect your child to do well in school without recess? Would you want to receive the wrong medication because your nurse is too fatigued? The answer is obvious—so why do we allow nurses to reach the point of physical and mental exhaustion in the workplace?
Figure. Karen Farmil...Image Tools
Patient safety and advocacy for the well-being of patients are at the heart of nursing, yet nurses often fail to advocate for their own well-being. During a typical shift, nurses become so engrossed in the care of their patients that they often cannot find the time to use the restroom or hydrate themselves, let alone take a break. This has become the new norm.
With increasing workloads and long hours, it's no surprise that nurses sometimes lack the stamina to perform their duties to the best of their abilities.
According to a 2011 Joint Commission Sentinel Event Alert, “The link between health care worker fatigue and adverse events is well documented, with a substantial number of studies indicating that the practice of extended work hours contributes to high levels of worker fatigue and reduced productivity.”
Fatigue and drowsiness don't afflict just night-shift workers. An Agency for Healthcare Research and Quality handbook published in 2008 cites a finding of the Study on Staff Nurse Fatigue and Patient Safety that 40% of drowsiness episodes reported by participants and 23% of episodes in which nurses reported having actually fallen asleep occurred between 6 am and midnight.
In recent years, a number of studies have indicated that a short nap improves alertness—a finding consistent with centuries of human experience. One often overlooked strategy for rejuvenating nurses in the course of a 12-hour shift is to promote 10 to 20 minute power naps.
This time should be in addition to a lunch break, but may take the place of an afternoon break. Perhaps the most obvious obstacles to the use of power napping at work include designating a separate room from meal break rooms and ensuring that it is used for the sole purpose of rejuvenating nap time rather than for eating, socializing, or the use of smartphones. Ideally, the designated nap room should permit drinking water but prohibit food.
Other potential obstacles include the common misconception that napping at work promotes laziness and the argument that integrating nap time into the work schedule would be too difficult.
Yet a recent experience suggests that, in the right circumstances, power napping can work. I had the pleasure of helping an RN set up a designated quiet relaxation room on a medical–surgical trauma unit. The employer agreed to dedicate this room for a six-week trial period. The room was intended to be used for meditation, yoga, and rest and relaxation. It was set up with reclining chairs, a mattress, pillows, yoga mats, blankets, soft lighting, and calming music.
As a nursing assistant on this unit, I was able to make use of the room. On two consecutive 12-hour shifts, I buddied up with a coworker for the day so we could cover for each other when using the room. Before using the room, the one who planned to rest or nap would give her work phone to the other to prevent any interruptions.
I emerged from my 15-minute breaks reenergized and prepared to provide the quality of care that patients deserve. I'm excited to say that plans to incorporate this room as a permanent feature are already under way.
Changing attitudes is difficult, but when employers see the many benefits of preventing burnout among their staff, they will be more likely to embrace the idea of power napping. It's our job to educate employers on the positive aspects of integrating power nap rooms. Nurses deserve an environment that nurtures their well-being, so let's provide it.
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