Sleep-Deprived Nurses Struggle to Remain Vigilant During 12-Hour Shifts

A small percentage of nurses have lapses of attention and struggle to remain vigilant during successive 12-hour shifts, according to a new study.

Researchers at the University of Maryland School of Nursing (Baltimore, USA) followed 80 registered nurses (RNs) who were working three successive 12-hour shifts, either day or night. Lapses of attention and median reaction times were measured with the five-minute Palm Psychomotor Vigilance Test.

The results indicate that lapses of attention among nurses working successive 12-hour shifts ranged from zero to 48 lapses per vigilance test; although half of nurses committed no more than one lapse, 10% of nurses had nine or more lapses during the testing period. Further analysis revealed that 39% of the nurses had moderate lapses and 7% had frequent lapses. Some of the factors associated with lapses included sleep prior to shift, caffeine use, and fatigue levels. The study also found that the average total sleep time of the nurses between 12-hours shifts was only 5.5 hours; night-shift nurses slept even less, averaging only about 5.2 hours of sleep, and the quality of their sleep was extremely fragmented. The results of the study were presented at the 24th annual meeting of the Associated Professional Sleep Societies (SLEEP 2010), held during June 2010 in San Antonio (TX, USA).

"There are a small percentage of nurses that appear to have impaired ability to maintain vigilance during a neurobehavioral test,” said lead author Associate Prof. Jeanne Geiger-Brown, Ph.D., R.N. "The primary role of the nurse is to maintain a vigilant presence and detect subtle changes in patients' conditions in order to head off complications. Impaired vigilance can reduce their effectiveness.”

"We were surprised at the short duration of sleep that nurses achieve between 12-hour shifts," added Dr. Geiger-Brown. "Over 50% of shifts were longer than 12.5 hours, and with long commutes and family responsibilities, nurses have very little opportunity to rest between shifts.”

Recent evidence of the safety risks involved with long work hours are challenging the current nursing scheduling paradigm, causing experts to propose that it may be time to end the practice of scheduling 12-hour shifts.

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University of Maryland School of Nursing