Humans are not creatures of the night. Even if you are the type to find yourself binge-watching a TV show or working on a project at 3:00am, this doesn’t change the fact that we were never intended to be nocturnal. Staying awake through the night requires combating our bodies’ natural rest period, and even sleeping through the previous day can’t make up for the misalignment of a body’s instinctual rhythm.[1] With an estimated 30% of U.S. nurses working night shifts, both caretakers and patients can be impacted by the risks posed by this work. [2] To better understand the stressors your medical professional clients may be suffering, we will be doing an introductory three part series. Firstly, here is a basic snapshot of the effects shift work has on nurses:
- Increased Fatigue: When a nurse is battling against her body, due to a circadian disruption or a general lack of sleep, it becomes increasingly difficult to remaining alert and high-functioning. Fatigue worsens moods, decreases cognitive abilities and reflexes, and interferes with one’s decision-making abilities and effective management skills.[3] Furthermore, research suggests that during the breaks they take, nurses are free of patient care less than half the shifts they work; on average, they are not relieved of patient responsibility for more than 25.7 minutes total during a 12 hour shift.[4] Though this statistic reflects the plight of all nurses – day and night workers – sacrificing meal time and rest during a night shift, where the body is already trying to cope with fatigue and internal disorientation, is extremely wearing.
- Circadian Disruption: The circadian clock works as a timer to let the body know when to release hormones, and controls mood, body temperature, digestion, cell-cycle regulation, and alertness.[5] Exposure to electrical lights at night can upset the processes controlled by this internal clock, and nighttime melatonin production can be suppressed.[6] When melatonin is suppressed, hormone levels are altered, and the risk of breast cancer development is likely to increase.[7] Additionally, circadian disruption can influence cell cycle regulation, DNA repair, and other cellular processes in the tissues of other organs, such as the prostate, potentially causing normal cells to transform into cancer cells there as well.[8]
- Long-Term Health Risks: Beyond the risk of cancer posed by circadian disruptions, there are many other serious long-term effects of shift work. Sleep disruption and deprivation affect the immune functions and metabolism.[9] Furthermore, in an extensive, 22-year study of 75,000 female registered nurses, it was discovered that those who worked rotating night shifts for more than six years had an increased risk of depression, death by cardiovascular disease, lung cancer, and a generally shortened lifespan.[10]
The health of those working shifts can be at serious risk if preventative measures are not followed. However, the risks are just as high, if not higher, for the patients those nurses are assisting. The next upcoming article will focus upon the dangers shift work poses to patients and their consequences