NIGHT NIGHT NURSE
Expert says power naps vital
DOCTORS and nurses should be allowed 20-minute power naps on night shifts to avoid crashing while driving home, says a study.
Half of trainee doctors, consultants and nurses have had an accident or a near miss driving home after working during the night.
An expert is now calling for fatigue risk management to become the norm in the NHS, as it is in the airline industry.
But a nursing union fears the necessary breaks for already exhausted nurses will not happen because of staff shortages.
Research shows getting behind the wheel after being awake for 20 hours when the body most needs sleep – at night or very early in the morning – is as risky as drink-driving.
Studies have found being awake 16 to 18 hours effects medics’ ability to interact with patients and colleagues and those driving home after a 12-hour shift are twice as likely to crash as those on eight-hour shifts. Experts also found two or more nights of restricted sleep creates a sleep debt which takes at least two nights of good kip to recover from.
Dr Nancy Redfern, of Newcastle Hospitals NHS Foundation Trust, said a power nap in the early half of the night meant staff were far less likely to have a microsleep – switching off for a few seconds – driving home.
She said: “When fatigue sets in, we in the medical and nursing team are less empathic with patients and colleagues, vigilance becomes more variable, and logical reasoning is affected, making it hard to calculate, for example, the correct doses of drugs a patient needs.
“We find it hard to think flexibly, or to retain new information, which make it difficult to manage quickly changing emergency situations. Our mood gets worse, so our teamwork suffers. Hence, everything that makes us and our patients safe is affected.” Dr Redfern, presenting data at the Euroanaesthesia congress in Milan, Italy, said there is currently no fatigue risk management in the NHS.
Pat Cullen, of the Royal College of Nursing, said: “Regular breaks that allow nursing staff to rest, rehydrate and refuel are a critical part of remaining alert to deliver safe and effective patient care.
“Sadly, with tens of thousands of nursing vacancies in health and social care across the UK, this is not the reality for nursing staff who are already exhausted.
“Without a fully funded workforce plan, nursing staff will continue to leave non-stop shifts exhausted. Rest and recuperation for health care staff must be central to decision making on patient safety in the workplace.”
An NHS spokesman said: “We expect trusts to support staff, including ensuring they have a quiet space for breaks when needed, so that they can continue to deliver high quality care.”