Guest Author: Debra A. Wolff
I’m very excited to welcome my colleague Debra A. Wolff, DNS,
PCNP, RN as a guest author for the last post of the month. Dr.
Wolff is the president/chief executive officer of NURSES-Ready for
the Next Step, a business to help prepare nurses for success in the
next step of their education and career. She also is the author of
the new book, Advancing Your Nursing Degree: The Experienced
Nurse’s Guide to Returning to School. For more information about
Dr. Wolff, scroll to the end of the post.
The topic of Sleep is perfect for July’s theme of personal
health and wellness! So wake up and let’s get on with it!
woman under covers sleep
Get a Good Night’s Sleep!
Photo by Nomao Saeki on Unsplash.com
It seems so simple when you say to someone “get a good
night’s sleep;” yet, for many nurses, a good night’s sleep is a
luxury rather than an expectation. So why is sleep so elusive,
especially when we know how rejuvenating a good night’s sleep can
be?
Sleep deprivation, whether due to stress, circadian rhythm
disruption, or poor sleep conditions (e.g., a partner who snores,
uncomfortable pillow), can have a profound effect on your health
and safety (Stokowski, 2012). In fact, the majority of studies on
sleep deprivation report the detrimental effects it can pose.
While this may be interesting to learn, let’s concentrate on
the positive. I would like to focus this blog post on techniques
that have been demonstrated over the years to help you “get a good
night’s sleep!”
Lessons Learned From Other Industries
For starters, healthcare is not the only industry that
employs individuals to work night shifts or extended hours. The
mining, trucking, aeronautical, and railroad industries all have
considerable populations of night shift workers. In fact, these
industries have led the way in developing employee training
sessions on ways to mitigate the effects of circadian rhythm
disruption and fatigue due to sleep deprivation (Hauck, Avers,
Banks, & Blackwell, 2011). In addition, they have been
proactive in passing legislation to protect workers from unsafe
practices (Federal Motor Carrier Safety Plan of 1987, 2012; Natural
Resource Mining Safety Plan of 1990, 2010; Railroad Fatigue
Mitigation Plan of 1991, 2011).
Interestingly, nurses make up a good proportion of employees
who work a night shift position. So, let’s learn from other
industries and find out what they suggest.
Naps Are Good!
Naps are Good! Photo by Alexandru Zdrobău on Unsplash.com
When I was researching this topic I was amused to find that
naps were at the top of the list as a way to combat sleep
deprivation. My family has a saying – “naps are good.” Many years
ago I learned the benefits of a power nap from my father. He was a
pharmacist and worked long days, so he often came home for dinner
and took a 20-minute power nap before returning to work for the
evening. Throughout my nursing career, I have found that when I
work long hours on a project it helps to take a short 20-30 minute
power nap. I set my cell phone alarm and literally pass out for
20-30 minutes. When I wake up I feel refreshed and ready to begin
where I left off.
Below are some other tips on naps and rest periods if you
work an evening or night shift (Johnson, Brown, & Weaver, 2010;
Oriyama, Miyakoshi, & Kobayashi, 2014; Smith & Eastman,
2012; Stokowski, 2012):
Take a two-hour nap before the start of your first shift
Take a 30-minute nap or two 15 minute naps during your shift
break(s)
Go to sleep as soon as possible after your shift ends
Try to get at least six hours of sleep between consecutive
shifts
Take all scheduled meal and rest breaks during work time
Avoid rapid shift rotation (e.g., working different shifts in
the same work week)
Avoid scheduling appointments or other activities during your
routine sleep hours.
Limit Distractions
Over the last several years I have interviewed hundreds of
student nurses on how they cope with a return to school. Many of
these nurses also work full or part-time. A concern voiced by the
majority of these nurses has been about getting enough sleep. Often
they have additional responsibilities, such as the care of an
elderly family member or infant, financial concerns, or marital
issues which impact the quality of their sleep.
I have made a habit of asking what tips they would pass on to
other nurses on how to get a good night’s sleep. A common theme has
been to limit distractions. Here are some of their suggestions:
Use ear plugs or a sound machine to block out extraneous
noises such as a snoring partner, barking dogs, or street noises.
Use room darkening shades or curtains.
Turn off any computer screens or other ambient light.
Wear an eye mask.
Limit distractions close to bedtime such as video games,
political news, or crime watch.
Create a Comfortable Sleep Environment
The National Sleep Foundation (NSF) has a special section on
how to make your bedroom a sleep sanctuary using all five senses
(NSF, 2017). Among other things, they suggest you keep your bedroom
temperature at 65 degrees, invest in a good mattress and pillow,
and keep your bedroom free from clutter. Find comfortable sleep
attire that won’t bind or cause you to sweat. If you are going
through menopause and have night sweats, I have a few tips to pass
along that helped me during that period. My husband bought
microfiber sheets and blankets that helped to keep me cool. He also
installed an overhead fan which we kept on all night.
Lavender helps you sleep. Photo by Annie Spratt on
Unsplash.com
Using your sense of smell may also help you relax. A recent
article in American Nurse Today (Greenberg & Narain, 2017)
suggested that lavender products such as lavender infused oils or
lotions, aromatherapy, or sachets may have a calming and
restorative effect. I can attest to the benefits of lavender. This
past winter I broke my wrist and ankle and had to sleep downstairs
on the sofa. Suffice it to say, my quality of sleep was not good.
It wasn’t until I purchased some lavender scented body wash and
used this to wash up prior to bedtime that I finally was able to
relax and get a good night’s sleep. Try it and see what you think!
Establish a Bedtime Ritual
Another tactic that is often suggested is to establish some
kind of bedtime ritual. In this way, you prime your body to wind
down for sleep. For example, several nurses described how they took
a hot bath or shower prior to going to bed. Some liked to complete
a mild exercise, yoga, or meditation routine close to bedtime. The
July 11, 2017 blog post on mindfulness had some great apps you
could use if you are interested. In addition, there are YouTube
videos on chair yoga that would be easy to incorporate into your
bedtime routine.
Other bedtime rituals could include brushing your teeth,
taking your medicine, using lotion or face creme, praying, or
stretching. Whatever you do, try to make it a routine so your body
knows it is time to go to sleep.
One thing to keep in mind, follow a regular sleep schedule
regardless of which shift you work. Constantly switching your
bedtime can wreak havoc on your ability to fall asleep easily.
Things to Avoid Close to Bedtime
While it may be common sense, the following are some things
to avoid close to bedtime:
Avoid spicy, rich, and fatty meals within four hours of going
to sleep.
Avoid alcohol or nicotine before going to sleep.
Unless absolutely necessary, avoid the use of sleep
medication as many can be habit forming.
Avoid caffeinated beverages or foods except for early in your
shift. This includes coffee, tea, chocolate, and soda.
Do Your Professional Duty – Get a Good Night’s Sleep!
The American Nurses Association recently updated its Code of
Ethics for Nurses (2015) in which it provides direction for how
nurses should conduct themselves as professionals.
Provision 5.2, Promotion of Personal Health, Safety, and
Well-Being states, “As professionals who assess, intervene,
evaluate, protect, promote, advocate, educate, and conduct research
for the health and safety of others and society, nurses have a duty
to take the same care for their own health and safety” (p. 19,
emphasis added). The provision also notes, “nurses should eat a
healthy diet, exercise, get sufficient rest, maintain family and
personal relationships, engage in adequate leisure and recreational
activities, and attend to spiritual or religious needs” (p. 19).
Use the tactics noted in this blog as well as other sources,
such as the NSF website, to overcome any obstacles that stand in
your way of getting quality sleep. In a nutshell, as a nurse, you
owe it to yourself, your family, and your patients to get a good
night’s sleep.
References
American Nurses Association. (2015). Code of ethics for
nurses. Silver Spring, MD: Nursebooks.org.
Federal Motor Carrier Safety Plan of 1987, 49 U.S.C. §§
385-395 (2012).
Greenberg, M. J., & Narain, A. (2017). Relax with
lavender. American Nurse Today, 12(6), 39-41.
Hauck, E. L., Avers, K. B., Banks, J. O., & Blackwell, L.
V. (2011). Evaluation of a fatigue countermeasures training program
for flight attendants. [Report]. Oklahoma City, OK: Civil Aerospace
Medical Institute, Federal Aviation Administration. Retrieved from
https://allaplusessays.com/order
Johnson, A., Brown, K., & Weaver, M. (2010). Sleep
deprivation and psychomotor performance among night-shift nurses.
AAOHN Journal, 58(4), 147-154. doi:10.3928/08910162-20100316-02.
Oriyama, S., Miyakoshi, Y., & Kobayashi, T. (2014).
Effects of two 15-min naps on the subjective sleepiness, fatigue,
and heart rate variability of night shift nurses. Industrial
Health, 52(1), 25-35.
National Sleep Foundation. (2017). Inside your bedroom. Use
your senses. Retrieved from https://allaplusessays.com/order
Natural Resource Mining Safety Plan of 1990, 20 U.S.C. §§
242-261 (2010).
Railroad Fatigue Mitigation Plan of 1991, 49 U.S.C. §§
228.407-228.413 (2011).
Smith, M., & Eastman, C. (2012). Shift work: Health,
performance and safety problems, traditional countermeasures, and
innovative management strategies to reduce circadian misalignment.
Nature and Science of Sleep, 2012(4), 111-132. doi:
10.2147/NSS.S10372.
Stokowski, L. A. (2012). Help me make it through the night
shift. Ohio Nurses Review, 87(2), 12-16.
Guest Author Bio:
Debra A. Wolff, DNS, PCNP, RN, is president/chief executive
officer of NURSES-Ready for the Next Step, a business launched in
2013 to help prepare nurses for success in the next step of their
education and career. She also teaches online at Empire State
College. During her 38-year career in nursing, she has been a
lifelong learner. Dr. Wolff earned a bachelor’s degree from the
State University of New York, Plattsburgh; a master’s degree and a
certificate as a nurse practitioner in community health from
Binghamton University, and a doctoral degree in nursing science
from The Sage Colleges, where she was inducted into the Phi Kappa
Phi Society.
From 2011 to 2013, Dr. Wolff was the project coordinator for
the newly established Future of Nursing and New York State Action
Coalition, as well as the coauthor and data analyst for the New
York State Nursing Schools and Faculty Report: 2010–2011. Before
2010, she was the project director for a cancer research project
that enrolled 115 sites nationwide and collected data on over 4,500
patients receiving chemotherapy. She had the privilege of being the
only nurse working with this interdisciplinary, multicultural team.
She has published extensively in Cancer, Journal of Clinical
Oncology, Journal of the National Comprehensive Cancer Network,
Annals of Oncology, American Journal of Managed Care, Academic
Medicine, Journal of Rural Health, and Clinical Orthopaedics and
Related Research.
You can email Dr. Wolff at [email protected]
Dr. Wolff’s new book is available on AMAZON.COM and at
Springer Publishing. If you go to the Springer site, don’t forget
to use the discount code SS10CJT for 10% off your order.
Going back to school? I’ll let you know more about this book
in August. Stay tuned!
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