Running Head: THE EFFECTS OF SLEEP DEPRIVATION ON NURSES

The Effects of Sleep Deprivation on Nurses

Jeff A. Fernandez
Prof. P. Taylor

THE EFFECTS OF SLEEP DEPRIVATION ON NURSES

The Effects of Sleep Deprivation and Fatigue on Nurses

Benjamin Franklin once said, Early to bed, early to rise, makes a man healthy, wealthy
and wise. Having adequate sleep is crucial to the proper functionality of our mind and body.
Because it is common for nurses to work through extended shifts, which could be as long as 12
hours, it may be difficult for them to maintain a healthy sleep cycle (Johnson, Brown, Weaver,
2010). Although these shifts allow for a simple schedule rotation, it contributes to sleep
deprivation throughout the nursing staff. Consequences such as injuries and patient-care errors
may be derived from this lack of sleep. The amount of sleep lost throughout a scheduling rotation
adds up and may become detrimental to nurses and everyone around them. This essay will
discuss the importance of sleep for our mind and body, the effects fatigue has on a nurse,
physical burnout, patient dissatisfaction and possible solutions to this issue.
The Importance of Sleep
It is common for nurses to experience work-related sleep deficiencies and fatigue. This
can lead to many negative outcomes in the healthcare environment. Nurses may experience a
decrease in quality of work performance and low levels of alertness. These problems can put
patient safety at a hazardous risk as well as the other workers in their surroundings (Kunert,
King, Kolkhorst 2007).
Our mind and body are highly dependent on sleep (Hodgson, 1991). Sleep affects many
aspects of our daily lives, one of which is brain functionality. Adequate sleep can help the brain
learn better compared to a brain that is deficient in sleep. It affects our overall abilities to make
decisions, solve problems and handle our emotions (Johnson, Brown, Weaver, 2010). Depression
can be linked to a lack of sleep. One can be at a higher risk for heart disease, kidney disease,
high blood pressure and stroke if sleep deprivation is prolonged (Johnson et al. 2010).

THE EFFECTS OF SLEEP DEPRIVATION ON NURSES

The Effects of Sleep Deprivation and Fatigue on Nurses

Nurses working the night shift experience more problems related to. Reports of feeling
depressed and experiences of poor sleep quality were more prominent from nurses working night
shifts than those working day shifts sleep (Carter, Dyer, Mikan 2013). Poor sleep quality resulted
in sleepiness during their shift in the night and early mornings. This is due to a disruption in their
circadian rhythm, which is a physical and mental behavior clock that follows a 24 hour time span
and is regulated by the hypothalamus (Circadian Rhythm Fact Sheet 2012). Night shift nurses
require adaption to such irregular sleep schedules (Carter et al. 2013). In many cases it is evident
that our body experiences difficulty when trying to adapt to these abnormal circumstances.
As a result of the many sleep issues, fatigue plagues the nursing environments. Fatigue
then leads to many medical problems, work related errors, burnout and patient dissatisfaction
(Johnson, Brown, Weaver 2010). A large amount of nurses that have made errors related to
medication administration reported fatigue as the reasoning behind the mistake. A study has
shown that someone who has been awake for 17 consecutive hours exhibits cognitive and
psychomotor skills of someone with a blood alcohol level of 0.05%. Someone who has been
awake for 24 consecutive hours has the cognitive and psychomotor skills of someone has the
blood alcohol level of 0.1%, which is considered to be legally drunk (Kunert, King, Kolkhorst
2007).
Fatigue may induce several physiological symptoms. One may yawn more than usual
disrupting focus, eyelids may be drooping and other abnormal sensations of the eye. Digestion
and speech are also affected (Kunert, King, Kolkhorst 2007). Nurses may have a change in the
way they act. Irritability, and lack of motivation are very common. Fatigue may also decrease the
nurses cognitive abilities. Lack of concentration, decrease in attention span, and poor memory

THE EFFECTS OF SLEEP DEPRIVATION ON NURSES

are typical. Nurses decision making abilities and reaction time are unsteady when sleep is not
sufficient (Kunert et al. 2007).
Facts related to sleep deprivation/fatigue and nurses were discovered. Nurses are twice as
likely to make an error when working more than 12 and a half consecutive hours. If more than 40
hours have been put into a week, error is more prone to occur. Errors when administering
medication is the most common error derived from fatigue. Less than half of the amount of break
time is spent outside of the healthcare environment. Fatigue may lead to unintentionally sleeping
on the job and drowsiness while driving (Edwards, McMillan, Fallis 2013).
Napping During Night Shifts
A few experiments were done where nurses on the night shift took naps during their shift.
Their performance after the naps were not recorded, but they did explain how they felt more
revamped when getting up (Edwards, McMillan, Fallis 2013). Another study was done to
examine nurses and the amount of time they napped. One group napped for 2 and a half hours.
The results were not what they had expected. Nurses went through what they called sleeping
inertia, which describes the post-nap mood of the nurse (Edwards et al. 2013). Nurses that took
the 2 and a half hour nap felt very groggy, irritable and, ironically, sleepiness. A second study
was done that had nurses take 40 min naps. Those nurses demonstrated less errors and less
feelings of sleepiness. (Edwards et al. 2013)
Sleep Education
Another solution to this issue is to hold staff briefing with the purpose to educate nurses
about the importance of sleep and introduce techniques to better the quality of their sleep.
Cognitive therapy may lead to positive result. It allows the nurse to understand the physiology
behind sleep and apply it to themselves so that they can properly evaluate their sleep tendencies

THE EFFECTS OF SLEEP DEPRIVATION ON NURSES

(Carter, Dyer, Mikan, 2013). Advice such as going to sleep only when tired, getting out of bed
when you are not able to fall asleep and avoiding long naps are examples of stimulus control
(Carter et al. 2013). It is important to maintain efficient sleep hygiene. This may include
refraining from using caffeine 4-6 hours before your projected bedtime, avoid intense physical
activity at least 3 hours before projected bedtime (day shift nurses), and adjusting your
environment to your comfort, like temperature, noise, and lighting. (Carter et al. 2013).
Relaxation techniques such as meditation and muscle relaxation can also be taught.
Conclusion
Sleep plays a very important role in our lives. The functionality of our mind and body is
highly influenced by whether or not we received a sufficient amount of sleep. Nurses who work
during night shifts are more likely than day shift nurses to undergo series of prolonged sleep
deprivation which ultimately leads to fatigue in the workplace. A nurse in that condition is highly
susceptible to making errors that can compromise patient safety as well as those in the
environment. Although this is a very common issue, there are ways that reduce such mishaps,
which include and is not limited to naps during night shifts, cognitive therapy, stimulus control,
and improvements in sleep hygiene.

THE EFFECTS OF SLEEP DEPRIVATION ON NURSES

References
Carter, P., Dyer, K., Mikan, S. (2013). Sleep disturbance, chronic stress, and depression in
hospice nurses: testing the feasibility of an intervention. Clinical Journal of Oncology
Nursing. 40(5). 368-373. Retrieved on February 27, 2015.
Circadian rhythm fact sheet. (2012). National Institute of General Medical Sciences. Retrieved
on February 27, 2015.
Edwards, M., McMillan, D., Fallis, W. (2013). Napping during breaks on night shift: critical care
nurses managers perceptions. Dynamics. 924(4) 30-35. Retrieved on February 27, 2015.
Hodgson, L. (1991). Why do we need sleep? Relating theory to nursing practice. Journal of
Advanced Nursing. 16. 1503-1510. Retrieved on February 27, 2015.
Johnson, A., Brown K., Weaver M. (2010). Sleep deprivation and psychomotor performance
among night-shift nurses. Workplace: Health & Safety. 58(4), 147-156. Retrieved on
February 27, 2015.doi: 10.1177/216507991005800404
Kunert, K., King M., Kolkhorst. (2007). Fatigue and sleep quality in nurses. Journal of
Psychosocial Nursing. 45(8), 31-37. Retrieved on February 27, 2015.

THE EFFECTS OF SLEEP DEPRIVATION ON NURSES

Topic 3
Research
(20%)

Dimension
Choice of topic
Scholarly sources
Recent scholarly
sources

Subject
Matter
(30%)
15

Exceeds Expectations
Very original topic
Sufficient, relevant
sources At least 2 from
nursing journals
Recent, appropriate
sources

Approved topic

Needs Improvement
Not appropriate for paper

2 sufficient sources; some few or no scholarly

irrelevant
sources

Use of sources

data and arguments from

sources are appropriately
used

Content

Comprehensive and
accurate; key elements of
assignment covered

Support

Major points supported

by specific examples and
references

Recent but some

inappropriate sources;
none within last 2 yrs.
Statements are factually
accurate but irrelevant to
the topic.
Sources are over used
Most statements are
accurate; missing one of
the key elements of the
assignment.
statements are adequately
supported. Minor opinion
statements

Excellent section
transitions

adequate section
transitions

lack of section transitions

clear and concise intro

and conclusion
Introduction slightly weak
or conclusion does not
match the topic

no clear intro and/or

conclusion. The
introduction does not
follow topic directions

A few errors, minimal

distraction

Many errors. Mechanics

interfere with reader's
understanding of text

Paraphrased: the other

source is identifiable as
the origin of the style and
structure. No individual
thoughts. Citations are
lacking

close paraphrase:
presentation of the
information is clearly the
work of someone else.
Lacking citations. This is
unacceptable.

few errors in formatting

cover page, headers, intext citation, and/or
reference page

cover page, headers, intext citation, reference

page formatted
incorrectly

15
Organiza Structure
tion (25%)
9
Transitions from
one idea to the
next
7
Introduction and
conclusion

Use of APA format

Line spacing

none within last 5 years

misrepresents some
sources' data or
conclusions. Sources
are over used.
generalized statements
Not all areas are covered

Statements are made

without providing
support. Many opinions
stated
Entire paper is very clear paper is clear and
entire paper lacks clarity
and organized
organized for the most part and structure

Introduction provides
sufficient background on
the topic and conclusion
follow logically from the
body of the paper.
Follows directions for
paper
9
Mechanic Sentence structure Excellent mechanics
grammar, spelling,
s (22%)
sentence structure,
abbreviations
Run on sentences
7
Paraphrasing
Not paraphrased!
Sources are
mined for facts but the
student
provides style and
structure
8

Meets Expectations

cover page, headers,

running head,
subheaders, in-text
citation, reference page
correctly formatted

TOTAL

Comments

THE EFFECTS OF SLEEP DEPRIVATION ON NURSES

1/5/15/pt

Check off List

_____ Title page including Running head correctly formulated
_____ Title on first page of body of paper
_____ Compose a First paragraph that indicates what will be discussed, and in what order.
_____ Correct citations for all ideas that are not your own
_____ Correct form of citation using APA use the APA book
_____ Double spacing exactly throughout entire paper
_____ Spelling
_____ Punctuation: commas, semicolon, colons
_____ Page numbers
_____ Conclusion paragraph
_____ Check for opinion words, (such as fortunately, should, personally, I think/believe/suppose, I
am of mixed opinions about / on, this it seems to me that)
_____ Fonts all fonts are the same size and type.
_____ Reference page APA, hanging indents, less than 5 years old
_____ Follows rubric for all requirements of paper
_____ Rubric pasted at end of paper
_____ Check off list pasted after the rubric.
_____ Sent to Brainfuse for review
_____ Find the Mark up tool on your computer and turn it on