Sleeping on the job not a bad idea for ED docs and nurses
Staff who took naps awoke better performers
Emergency department physicians and nurses who are encouraged to take short naps while working the night shift experience fewer performance lapses and find themselves feeling more energetic and alert, according to an expert on sleep deprivation.
Steven Howard, MD, an associate professor of anesthesia at Stanford University, hopes that scientific data he and fellow researchers have generated that supports the benefits of napping will cause hospitals and other employers to consider policy changes that include nap breaks to help improve safety and performance levels.
"Napping is a very powerful, very inexpensive way of improving our work," says Howard.
The Stanford study found that emergency department doctors and nurses who were allowed to have a short nap while working the night shift were more alert, in better moods, and did a better job performing a simulated intravenous insertion than those who didn't get a nap.
Despite the findings, Howard and his co-authors acknowledge that there is strong bias against sleeping on the job.
Lack of sleep has serious effects
Stanford researchers created two teams from 24 nurses and 25 doctors who worked from 7:30 p.m. to 7:30 a.m. in Stanford Hospital's emergency department. One team worked the shift as usual, with no nap, while those on the other team took a 40-minute nap about two thirds of the way into their shift.
Each team was evaluated at the end of their shift with tests that included a written memory test, computer-based IV insertion simulation, a simulated car drive, and a series of questions designed to show moods or sensations (depression, fatigue, vigor, depression, confusion, etc.).
Those who had taken a nap were less sleepy, less fatigued, said they had more energy, performed the IV insertion and driving tests better, and experienced fewer performance lapses.
Howard is putting the results of the study into practice by launching a sanctioned napping program at the Veterans Affairs Palo Alto (Calif.) hospital. He says the Palo Alto program marks the first time a napping program has been put into place for health care workers.
Medical providers are not the only workers who could benefit from naps, according to sleep researchers.
According to statistics on America's need for sleep, plenty of people could use a nap. More than 50 percent of Americans are sleep-deprived — the recommended sleep hours for adults age 16 to 65 is six to nine hours per night. The National Sleep Foundation's 2002 Sleep in America poll indicated the average American adult sleeps only 6.9 hours a night. Shift workers — such as those working the night shift in hospital emergency rooms, —- often average only five hours of sleep in a 24-hour period.
Another of the Stanford researchers, Rebecca Smith-Coggins, MD, an assistant professor of surgery in emergency medicine, says she has been concerned about the effects of sleep loss on physicians, who she says commonly complain of being tired.
The study's authors hope that by providing scientific data that supports the benefits of napping, more hospitals and other employers will consider policy changes that include nap breaks to help improve safety and performance levels.
"Being up for 24 hours has the same effects as being legally drunk," Howard suggests. "Caffeine and nicotine mask the effects of sleepiness, but naps actually replace lost sleep. It's totally different mechanistically."
In the Stanford study, while the subject group who took naps were less sleepy and more apt when it came to inserting IVs and taking driving tests, those who did not get naps often experienced "collisions" and ran off the road in their driving simulation tests, the authors report.
Howard says that while evidence reported in the literature points to the benefits of letting workers nap, there remains a cultural bias against it in U.S. workplaces — a perception that people who nap at work are lazy.
"The social connotation of someone who naps is lazy [and] slothful," Howard explains. "Attitudes toward people who nap are hard to break."
The full report on the Stanford study is available in the November 2006 issue of the American College of Emergency Medicine's Annals of Emergency Medicine (Ann Emerg Med. 2006;5:596-604).
Source:
Steven K. Howard, MD, associate professor of anesthesiology, Stanford University School of Medicine, Stanford, CA. Email: [email protected].
Emergency department physicians and nurses who are encouraged to take short naps while working the night shift experience fewer performance lapses and find themselves feeling more energetic and alert, according to an expert on sleep deprivation.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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