Shift Work Disorder
Healthcare, manufacturing, and other sectors heavily depend on a 24-hour workforce to keep operations running smoothly. Since so many people work nontraditional shifts, shift work disorder is on the rise. The purpose of this article is to discuss shift work disorder.
Circadian rhythms are physical, mental and behavioral changes that follow a roughly 24-hour cycle, responding primarily to light and darkness in an organism's environment (NIGMS, 2012). Shift work disorder, also known as shift work sleep disorder (SWSD), is a health problem that occurs when the body's natural circadian rhythm goes directly against the employee's work schedule. This disruption of the circadian rhythm results in excessive drowsiness during daylight hours and difficulty sleeping during the night hours.
Shift workers can normally adjust to working nontraditional shifts if the change is permanent. For instance, even though a night shift worker is sleeping during the daylight hours, this person's circadian rhythm is usually able to adjust to the new sleep/wake pattern. However, shift workers who must constantly rotate from days to nights tend to suffer more severe disturbances with their personal circadian rhythms than people who strictly work the night shift.
The most common signs and symptoms associated with shift work disorder include insomnia, excessive drowsiness, mood problems, headaches, lethargy, inability to concentrate, appetite disturbances, irritability, sleepiness, and diminished energy. If allowed to progress, shift work disorder may eventually lead to workplace errors, traffic accidents, illnesses, and lost productivity.
Shift work disorder is treatable as long as the shift worker is ready to make his or her sleep schedule the primary issue at home. People who work the night shift should make an effort to limit the number of shifts worked to no more than four in a row. Moreover, night shift workers need a minimum of two days off in a row prior to returning to work. If possible, shift workers should avoid rotating shifts altogether, especially if the rotation involves a day-to-night schedule.
Practicing strict sleep hygiene is also very important. The shift worker may be helped by using blackout drapes when attempting to sleep during the daylight hours. In addition, adhering to the same bedtime on a daily basis greatly helps. The shift worker should create a sleep schedule, stick to it, aim for seven to eight hours of sleep per day, and avoid ingesting substances such as alcohol, caffeine, and nicotine within a few hours of the scheduled bedtime. Furthermore, getting adequate sleep during one's days off helps tremendously.
Shift work disorder remains a challenging health problem for the masses of workers who do their parts to maintain our 24-hour society. However, plenty of diligence, preparation, and coping skills will go a long way in conquering this disorder.
Last edit by Joe V on Jul 8, '12
About TheCommuter, BSN, RN Senior Moderator
TheCommuter is a moderator of allnurses.com and has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a registered nurse.
TheCommuter has '10' year(s) of experience and specializes in 'Case mgmt., rehab, (CRRN), LTC & psych'. From 'Fort Worth, Texas, USA'; 35 Years Old; Joined Feb '05; Posts: 36,719; Likes: 65,929.Jul 8, '12 by mama_dI've often wondered if those of us who are "natural" night owls see less of the health detriment long term than those who fight to adjust. I do nights at work (3 in a row) but then have to bounce to a day schedule during the week for school. It's getting harder as I get older but still nowhere near the challenge it was to work days when I was in my early 20's. Still SO looking forward to when all the kids are in school and I'm done with my RN bridge so I can do all nights all the time though.
Thanks again for another good article...keep 'em coming!Jul 8, '12 by VivaLasViejas, ASN, RN GuideI loved night shift back in the early days of my career; indeed, would still rather work nights if my brain would cooperate! Unfortunately, it wasn't too long after I turned 40 that I began to get horribly mixed up and would almost forget my own name, if it hadn't been on my ID badge. I'd wake up in the afternoon and literally have no idea what day it was, or even where I was.....and when I'd run a patient through the mental status checks, I had to first make sure I was A&O x 3.
All of that disappeared once I went to a 3-11 schedule, and then to straight days. Now that I'm over 50, it takes a full two days for my body to recover from a single noc shift (and we won't even talk about what it does to my poor brain). I have never been, nor will I ever be enthusiastic about getting up at 0630 five days a week, but for the sake of everyone concerned, I have to stick to the ol' 8-to-5 grind.Jul 8, '12 by TheCommuter, BSN, RN Senior ModeratorI've always been a naturally nocturnal person who stays up all night and sleeps during the day, so night shift suits me well.
The worst working experience of my life was the day shift schedule (Monday through Friday from 6am to 2pm). Many people around here would kill for those hours, but I struggled to wake up at 0430 every morning and would feel sleepy until after 1000.Jul 8, '12 by JZ_RNI hate getting up early and I am a night owl. I was dying on nights though, it's too much. I can't function on a reversed schedule. The bank, the store, everything in my life is on day schedules. If I could do 3-11's I'd be happy but my job is 7:45 A to 5 p Mon-Fri, it's nice with no weekends, nights, or holidays though. I'll take sleepy morning for not spending every day off passed out trying to recover and never getting anything done because of the schedule.Jul 8, '12 by Cali_Nurse_209, BSNI'm currently a CNA that works the night shift. I was working full time but now I only work weekends since I'll be starting nursing school this fall. When I first started this shift my sleeping pattern was all over the place, it took me a while to get used to it. My body didn't feel right, I'd get confused, have mood swings, and my eating habits were bad. It's been a year and I had gotten into a nice little groove but lately on my days off I find my self not being able to go to bed until like 4am and I don't know why. I'm getting my self back into a schedule before I start school next month. This article had a lot of good tips that I can use.Jul 8, '12 by merleeI hate that they call this a 'disorder'. Don't know what else it should be called.Jul 8, '12 by duskyjewelIt's not a disorder. It's a normal physiological response to a complete disruption of a natural cycle. People can cope, but you can't fix normal. I have heard ads lately for a medication to treat this, and honestly, the list of side effects is far worse than the "disorder" it's supposed to treat! The cure for this "disorder" is for employers to have a modicum of respect for their employees (and for employees to demand it). Night shift or day shift, but don't make people work both!Jul 8, '12 by woohWorking nights is actually easier on me than having to get up early enoug to make my long commute for dayshifts. It's the switching around you inevitably have to do working nights to live in society that kills me.Jul 8, '12 by RNGriffinI am naturally nocturnal. I recall my first job was a 5am-3pm and then I would work from 3pm-2am. I realized I would be more coherent at 7pm rather than 5am-6pm. Even in school, my peers would plead with me to join them for study sessions or outings. I could not relay information from my brain until it was mid-evening. I think some individuals are just geared towards being more of the so called "night owls" than day. Even as I am aging, I am finding gathering information prior to a certain point of the day is useless. I can't even begin to hold a decent, coherent conversation until 5pm.Jul 8, '12 by applewhiternI no longer am willing to work nights, because with 12 hr back-to-back nights, you have no life. I wok 3-11 now, and really like it. The most annoying thing to me is people who assume you are lazy because you are still in bed at 10 a.m. If I get home at midnight or after, I can't just fall asleep the minute I get home; I have to unwind, etc. So if I get to sleep at 2 or 3 a.m., I will still be in bed at 10 a.m. People who have never worked shift-work just don't have a clue!Jul 8, '12 by DeLana_RNWell, looks like I have all the symptoms
After 4 months on night shift, this night owl concedes defeat. I am literally wiped out for two days after my usual 3 in a row 12-hour night shifts and having to switch back to a day schedule because I have elementary school age kids.
There is only one cure: day shift (which I expect to get within a schedule or two; can't wait!)Jul 9, '12 by frogdreamI have been a nurse in an acute care hospital for around 2 years, the last 9 months have been on the 7P-7:30A shift. After a few months of adjustment, I am surprised at how well I feel. I am also post menopausal and I am wondering if the lack of hormones help with the adjustment. I seem to do better than the 20-30 year olds. Any thoughts?
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