Nurses and Fairness

As a group, it seems to me that we are pretty obsessed with numbers and fairness.  

How many patients we each have, how many holidays that nurse worked, how many weekends this nurse has done, how many admissions that nurse got, he’s only scheduled for two Fridays on this schedule, she has to work every Monday, the time two years ago when I had five patients and another nurse only had two.

Sound familiar? 

This is not a new issue for nurses.  In researching the topic of nurses and fairness, I ran across a letter to the editor in a 1947 issue of the American Journal of Nursing (AJN) about rotating shifts.  Flora Murray of Georgia responded to a proposal in a previous issue of AJN that married nurses be allowed to work only during those hours when their husbands and children were at work and school so that she could attend to their needs when they were home.  Flora had a good point – why were the current husbands of married nurses more important than the prospective husbands of single nurses who couldn’t date and find a husband because they were forced to evenings and weekends?  

It’s all about perspective. 

We’ve come a long way from worrying about freeing up nurses to tend to husbands or find husbands, but we still have a way to go when it comes to letting go of our obsession with numbers and fairness.

Reference

Murray, F. (1947). Fairness to all nurses in rotating shifts. AJN, 47(7), 491.

Why is Napping Still an Issue?

Three years ago, I wrote in this blog about napping for night shift nurses.  You can read it here.

Why is napping still not widely encouraged for night shift nurses?  I don’t understand it.  We know that night shift workers are sleep deprived, we know that sleepiness contributes to errors, we know that sleepiness contributes to motor vehicle crashes, and we know that the only cure for sleepiness is sleep. 

Most importantly, we know that naps help.   

Even the Joint Commission recommends that organizations support napping for night shift employees!  You can read about that here.

Yet, when I talk to nurses and question them about napping, they report that napping is expressly forbidden by policy in their hospitals.  

We need more nurses and nurses need more sleep.  The answer seems simple to me.

Another Rehab Thanksgiving

So much talk this year about how stores shouldn't open on Thanksgiving because their employees should get to celebrate the holiday.  Seems like there's been even more talk about it than last year.  Pledges on Facebook, stores advertising how wonderful they are for not opening on Thanksgiving, etc. 

When I was first confronted with this issue I was as indignant as those Facebook pledgers.  Of course they should get to be home with their families!  Then I thought about it a little.  Nurses have ALWAYS worked Thanksgiving.  So have firefighters, soldiers, paramedics, and everyone else who works in health care or defense...oh, and those in the hospitality industry, gas stations, state parks, public transportation, private transportation, airports, and even toll booths.  So why not retail? 


Anyway, as I looked back at last year's post on Thanksgiving, I realized that I was thankful last year for the people working at the rehab where my mother was recovering from a broken hip.  As (bad) luck would have it, she's recovering from a second broken hip this year.  So...thank you to the people at Gateway Vista Rehab for taking are of my mom yesterday.  Thank you also to my brothers and sister and their spouses and kids who took an entire Thanksgiving dinner over to the rehab and had dinner with her.  I love you all.

Brain Drain

Talking about a bunch of shift work
A big ol' pile of shift work
Seven to three
Three to eleven
Eleven to seven

                        From “Shift Work”, Kenny Chesney

So, we already knew that working shifts leads to increased chance of cardiovascular disease, breast cancer, and reproductive dysfunction.  We can now add shrinking brains to that delightful list.

An article this month in the Journal of Occupational and Environmental Medicine reveals that a study showed that working shifts leads to cognitive impairment.  The authors don’t specify what kind of shift, but the assumption can be made that it’s “off shifts”, nights and evenings, as it is attributed to circadian rhythm disruption. 

Goodie!  It’s not just nurses’ bodies but also their minds that go bad from doing nights.