Rates of burnout among healthcare staff are well documented, but the extent of the challenge was illustrated by a recent study from New York University, which highlighted how nurses typically sleep an hour and a half less before a shift than they do afterwards.

“Nurses are sleeping, on average, less than recommended amounts prior to work, which may have an impact on their health and performance on the job,” the researchers explain.

The challenges of the nursing profession are well known, from the intense nature of the work itself to the shift patterns that mess with the circadian rhythms of the nurses.  When you add in the traditional 12-hour shifts that often spill over into overtime and the strain on nurses is tremendous.

Sleep deprivation

Sleep deprivation has tremendous implications for the ability of nurses to handle the kind of complex and stressful tasks that are a common feature of their working life.  Critical mistakes such as incorrectly administering medication or making incorrect clinical decisions have all been documented as a result of sleep deprivation.

The researchers conducted two surveys of over 1,500 nurses over a two year period to explore their sleep patterns and subsequent work practices.  Questions included how much sleep was typically achieved in the 24 hours prior to a shift, and then before any days off they have.

Patient care was also measured via the surveys alongside patient safety data from the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture.

The data revealed that nurses are typically getting just under 7 hours of sleep prior to a work day, and over 8 hours prior to a day off.  In total, there was an 83 minute gap between the two.

Patients at risk

This lower level of sleep was strongly associated with poorer outcomes for patients, both in terms of the quality of care they received and their overall safety.

At an individual level, this is likely to be because nurses who haven’t had enough sleep are inevitably going o be more fatigued.  At an institutional level, however, it’s perhaps more indicative of staffing issues that may result in nurses having to take unexpected overtime or put in excessively long hours.

What’s more, the researchers don’t believe this is a problem that can be resolved easily.  It’s not a case of ‘catching up’ on sleep between shifts.

“Research on chronic partial sleep deprivation in healthy adults shows that after several days of not getting enough sleep, more than one day of ‘recovery sleep’—or more than 10 hours in bed—may be needed to return to baseline functioning,” they explain.  “But considering a nurse’s schedule, which often involves consecutive 12-hour shifts and may only offer one or two days off between shifts, the risk of complete recovery, or ‘catching up,’ is low.”

As such, they urge healthcare leaders to take on board their findings and try to employ smarter scheduling strategies and limit the use of overtime on wards, whilst also reminding nurses about the huge importance of sleep to the quality of care they can provide.

“It is in everyone’s interest to have nurses well-rested so they can perform their critical function within the healthcare system and keep patients safe,” the researchers conclude.