July 07 2013 Sleep

Railroad workers, professional drivers and flight crews all have federally mandated sleep requirements. These requirements are designed to help minimize fatigue and maximize on the job performance.  For instance, the Federal Aviation Administration (FAA) now requires flight crews to have a minimum of 10 hours in between shifts and at least 30 consecutive hours free from flight duty every week – along with several other requirements focused on fatigue management.

At this time, healthcare workers do not have a federally mandated rest period. It’s up to the hospital management and staff to come together to create a safe and effective work environment – and it’s in the best interest all parties involved to do so.

Research by the National Institute of Health (NIH) discovered when nurses worked more than 12.5 hours on a shift, they became significantly more likely to make a professional error or become injured on the job.

This issue is apparent in doctors as well. When compared to those working a 16 hour shift, physicians in training who worked a traditional 24 hour or more on-call shift were found to be 300 percent more likely to make a fatigue related medical error which leads to the death of a patient.

Administration should:

1) Schedule rotation shifts clockwise (day-evening-night)
     - shifts which move in a clockwise direction are much easier to adjust to
2) Set aside a dark and quiet area where healthcare workers on long shifts can nap
     - sleeping 15-20 minutes every three to four hours significantly increases cognitive performance
        over an extended work schedule 
3) Allow healthcare workers to participate in selecting their shifts
     - Allowing those affected by a work schedule to choose when they work lowers stress and
4) Provide access to a taxi service 
     - Many healthcare workers are involved in after shift accidents because they are too fatigues to
       drive safely. Having access to a safe way home protects employee.

Employees should:

1) Maintain a consistent bedtime
     - Going to bed at the same time on work nights and days off maximizes your body’s ability to fall
       asleep quickly and easily at the time you need to. Develop a half hour routine and follow it
       every time.
2)  Do not rely on alcohol to help you sleep
     - Alcohol may initially help you fall asleep, but as the alcohol level in your blood drops through
       the night, you wake up or “rebound”. This means you get less effective sleep.
3) Exercise regularly
    - It’s good for your body and will help you sleep when you need it. However, do not exercise two
      to three hours before you intend to go to bed. For the first several hours, exercise will wake
      you up
4) Don’t eat too late
     - You shouldn’t go to bed hungry, but avoid a heavy meal for several hours before bed.

Work together and create a system that works for you and your employer. It’s good for business and it’s good for people.

Stay safe,
Indiana Department of Labor