Shift work: A doctor's advice on coping

20170219070000, Dr. Shunjie Chua
Healthcare professionals: coping with shift work
Many healthcare institutions operate around the clock, which means that the healthcare staff who are part of these institutions will often need to take on shift work in order to ensure that their patients can receive the necessary care. It is no secret, or surprise, that shift work has multiple negative effects on any individual who is required to undergo it. Yet, it is undeniably an unavoidable part of working in the healthcare sector, hence healthcare professionals have no other option besides finding ways to cope. Here is one doctor's take on making shift work work for you.

The negative effects of shift work

We know that shift work tends to have negative impacts on healthcare professionals in various dimensions. Socially, it may result in emotional isolation. When the healthcare professional takes on shift work, their schedule is likely to become different from that of other friends and families who work normal shifts, and if not managed properly, this disconnect would eventually lead to reduced interactions and estranged relationships.

Cognitively, the demands of shift work can lead to the depletion of memory, reaction time and attention. This could eventually result in a decreased performance at work and even possibly lead to harming a patient. Physically, studies have also found that shift work can contribute to weight gain, impaired glucose tolerance, increased risk for cardiovascular conditions and many other conditions. So what can be done to address these issues?

Method 1: Improving sleep hygiene

Sleep hygiene is defined as a routine of behaviours that helps to promote good sleep. Good sleep hygiene can optimise the quality of sleep when the opportunity arises, allowing one to be more refreshed from the same amount of sleep as compared to when good sleep hygiene is not practised.

Optimisation can be achieved by designing a quiet, comfortable bedroom for sleeping and practising a comfortable pre-bedtime routine. This routine can incorporate elements such as a warm bath, meditation and some quiet time. The bed should also not be a place for reading or computer work, to avoid letting the body associate it with wakefulness. Substances which cause fragmented sleep, like caffeine, cigarettes and alcohol, should also be avoided.

Method 2: Sleep schedules and naps

Healthcare professionals who are on rotational shifts can try to alter their sleep schedules by changing their sleep regime a few days before the night shifts begin. This can be done by waking up a few hours later than their usual timing at regular intervals, allowing them to be well adjusted when their night shift starts. Those on fixed night shift can try to stay on the same sleep regime every day of the week to align their circadian rhythm with their sleep pattern.

Naps can also be targeted for certain times of the day, as they can also help to keep one more alert during the job. While a nap at any time of the day is useful, one of the best times to nap is before the shift starts. Another good time to nap is during the break in a shift, which can lead to increased energy levels and feeling more refreshed.

Method 3: Ensure management steps up and plays a role too

While each have their own preferred methods of coping with shift work, the work schedules of healthcare professionals can also affect how well they adjust. Therefore, senior management at the various healthcare institutions need to play a part in helping employees cope better with the inevitable shift work. To yield the best benefits, management would plan work schedules with shifts rotating in a clockwise (morning-afternoon-night) direction. Individuals should be limited to night shifts in blocks of three, with each shift limited to eight hours. After each night shift, three days of recovery should be allowed for.

Fatigued healthcare professionals not only stand to compromise their own quality of life, but they could also endanger their patients and other staff. By improving their sleep hygiene, diet, sleep patterns, work schedules and taking naps, it is definitely possible for healthcare professionals to cope with the stresses of shift work, thus lessening such negative impacts. MIMS

Read more:
Shift workers face cognitive challenges
A guide to surviving the night shift for healthcare professionals
Overworked doctor coughs up blood after 32-hour shift in China

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1854972/
http://sleepcenter.ucla.edu/coping-with-shift-work
https://sleepfoundation.org/shift-work/content/living-coping-shift-work-disorder
http://oem.bmj.com/content/58/1/68.full
http://www.bupa.com.au/health-and-wellness/health-information/az-health-information/sleep-and-shift-work
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629843/