Night duty. Personally, I hate, hate, hate, hate it.
But I have the greatest respect for those nurses who either do a lot of it. Or chose to make it their life.
A study to be published in the Journal of Advanced Nursing looks at the experiences of nurses working the night shift at three regional hospitals in Australia.
Data was collected via questionnaires, interviews and diary entries over a six month period in 2010 and was augmented by a series of semi structured interviews.
Of the 14 study participants, 10 were on permanent night duty and all were female.
The results of the study found a very strong cohesive team amongst the night shift. But it also fond evidence of the night shift crew operating somewhat as a silo (or separated unit) from the rest of the shifts. And there were several themes around this:
Staff felt that they had to deal with a poorer working environment that their daytime colleagues, particularly around distribution of workload and staffing.
They also felt that they were required to work with much less resources and “sub-optimal” leader ship support from department managers.
They expressed feelings that the night shift nurses appeared to be considered of lesser value or ‘lower status’ than other shifts.
There was also a sense of disconnectedness from the organization that might stem from the organization not trying to involve night nurses in hospital activities and processes or from the night-shift nurses actively choosing not to become involved. The disinterest in governance issues could be ambivalence or direction of energies to departmental concerns.
Other concerns included access to professional development and educational opportunities.
With respect to the personal impact of working the night shift, participants felt that it had a major impact on their lives. Health, sleep and fatigue were a common theme along with expressions of feeling socially isolated.
Although some participants felt the choice to work night shift afforded them a unique opportunity to have a more flexible lifestyle.
The study also produced a set of recommendations to drive a positive change around the issues raised.
- Managers review current policy and develop new policy and practices as required.
- Managers consider how to build on the teamwork, co-operation, and collegiality practised by night staff.
- Managers consider strategies to improve communication and co-operation related to the night-shift role, responsibilities, and position
- Managers explore professional development needs of night nurses and develop strategies comparable to non-night-shift nursing staff to meet these needs
- Managers recognize that while night staff work with minimal supervision, they still need and desire leadership. Managers examine leadership options for night staff.
- Managers overtly recognize the contribution of night-shift nurses.
- Replication of this study in different geographical areas and facility settings.
The authors go on to conclude:
It is important that the key areas of interpersonal relationships, effective leadership, work environment, clinical competencies, and recognition of the critical role of night nurses be taken on board by managers to inform decisions that have an impact on night staff. This knowledge will assist ward staff, managers, and clinical educators to improve the work environment and potentially maintain a sustainable and effective workforce in regional hospitals. While management has a key role, non-night-shift co-workers must also rethink their approach towards their night-shift colleagues. Just as managers and non-night-shift nurses have a role in change, so do the night-shift nurses themselves, who must accept responsibility for implementing change through co-operation with management and peers.
Although this study had a relatively limited number of participants and was also limited to a small geographical area and particular type of rural healthcare setting, it provides some thought generating reading of any night shift worker.
If you are a regular night shift worker you might like to read the whole study and reflect on its relevance and similarity to your own experience.
Powell, Idona. “Can You See Me? Experiences of Nurses Working Night Shift in Australian Regional Hospitals: a Qualitative Case Study.” Journal of Advanced Nursing (2013).