The Well-Rested Nurse: A Frustrating Oxymoron?

Did you get a good night’s rest? Nurses, like many other health care providers, frequently work shifts that lead to sleepiness and fatigue. In fact, 55% of nurses work more than 40 hours a week, and one in five nurses works at more than one job. This can have effects that you need to take seriously when you consider your sleeping habits and sleep hygiene.

Going Without Rest: A Risky Business

Research from NASA and the U.S. military has established that there is a significant impairment in cognitive function following 15 to 17 hours of sustained wakefulness. Here are some examples of the impairment you risk due to lack of sleep:

After 24 hours of uninterrupted wakefulness, your impairment is comparable to that of someone who has had 2-3 alcoholic drinks
When you’ve been awake for 17 hours, your cognitive and psychomotor performance becomes roughly equal to that of someone who has consumed 1-2 alcoholic drinks. Staying awake for 24 hours creates a condition comparable to having a blood alcohol level of roughly .10 percent, which is over the legal limit for driving in all 50 states.
Individuals who work night shifts are six times more likely to be involved in a sleep-related auto crash, and can be prone to “drowsy driving,” which is every bit as dangerous as driving while intoxicated.
Nurses who work rotating shifts, according to one study, are nearly two times more likely to make medication errors than nurses who primarily work day shifts.

While there is still limited research into the effects of sleep deprivation on nursing errors, there has been a substantial body of work that studies the effects on rest-deprived people in other occupations, such as police officers, pilots, and air traffic controllers, and the findings are alarming. There certainly are parallels, and as NurseChoice.com remarks, “Experts note that lack of sleep in nurses is dangerous for patients and the RNs themselves.”

Sleep Hygiene

You cannot always change your work schedule to accommodate your rest schedule, so what can you do? For starters, the American Nurses Association wants to dislodge such thinking. The risk to both nurses and patients is serious enough that ANA has an official position on the issue of nurses and proper rest: “both registered nurses and employers have an ethical responsibility to carefully consider the need for adequate rest and sleep when deciding whether to offer or accept work assignments, including on-call, voluntary, or mandatory overtime.”

To ensure that you are getting the most restful sleep possible, the Centers for Disease Control and the National Sleep Foundation offer some basics. Check their recommendations to make sure you are not overlooking the obvious:

Go to bed at the same time each night and rise at the same time each morning.
Make sure your bedroom is a quiet, dark, and relaxing environment, which is neither too hot nor too cold.
Make sure your bed is comfortable and use it only for sleeping and not for other activities, such as reading, watching TV, or listening to music.
Remove all TV’s, computers, and other ‘gadgets’ from the bedroom.
Avoid large meals before bedtime. (CDC, 2015)

Clean Sheets and Lavender: Other Ways to Get a Good Night’s (or Morning’s) Rest

Literal hygiene can also help—for example, make sure you are sleeping on fresh, clean sheets. In a National Sleep Foundation (NSF) Bedroom Poll, some three-quarters of respondents said they get a more comfortable night’s sleep on clean sheets with fresh scent. The NSF suggests that you “wash sheets and pillow-cases at least once weekly, so they always smell fresh,” and regularly wash your pillows. And, while morning showers are more energizing, if you are a night-time shower person, timing is everything. Showering too close to bedtime can make it difficult to fall asleep, but if you shower no sooner than 90 minutes before going to bed, it can help you fall asleep an average of 10 minutes earlier than usual.

Some Final Tips for Becoming a Well-Rested Nurse

Four final recommendations come from Dr. Charles H. Samuels, medical director at the Centre for Sleep and Human Performance in Calgary, Alberta:

Catch up on your sleep on your days off.
Try to get two three-to four-hour blocks of sleep during the day when you work the night shift.
Learn to catnap. Take a short 20–30 minutes of time with eyes closed, situated in a comfortable and resting position. You do not have to sleep to get the benefit of a catnap.
Remember: The treatment for sleepiness and fatigue is SLEEP!

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Koren Thomas

Associate Editor at DailyNurse

Koren Thomas (pictured with Assistant) was the associate editor of DailyNurse from late 2019 through July, 2022—and she was not joking about the "issue postage stamps saluting US nurses" idea. Send your article ideas, submissions, Nurse of the Week suggestions, comments, and corrections to the current Editor in Chief at [email protected].