Less regular sleep for ICU nurses may lead to errors

It is about time someone looks into sleep and nurses and errors.

Now they need to do a causative study to figure out why ICU nurses aren't getting as much sleep... too much adrenaline? Stress from what we see? Hard to say.

Where is the the "no kidding, Captain Obvious" button?

Canoe, it's next to the "no sh.. sherlock" button.

I am truly interested in the cause of the problem. I think you're referring to the fact that lack of sleep = more errors... am I right?

Personally, I've had problems sleeping when I come home after spending long hours caring for the adrenaline rushing, near-coding/coding patients, who need multiple drips and interventions. It's just to exciting. In essence, the effect is kind of like running before trying to go to sleep for me.

The worse off the patient is, the more I like taking care of them. I crave that type of situation, because it keeps me on my toes, and I really feel like I'm helping the patient when I can collaborate quickly with peers and docs to assist the patient. I rather dislike taking care of the chronic vent patients, and patients without many drips. I hate to say it, but I am turned off by patients who are ambulatory and talking in the ICU. Any other ICU nurses with me on this?

Hopefully I won't get flamed for this, but I'm pretty sure some of this has to do with a lot of us ICU nurses being "Type A"... what are your thoughts? I like being busy nearly every minute of my shift. That's when I'm the most focused. When I have two tele-type patients with minimal needs, I often find myself forgetting to do things.

I think your experiences and feelings are really common, cOntagion. I work with a lot of people who carry on something ridiculous when they're given the chronics. But I find that some of the ones who make the most noise are the least capable of dealing with the crashing, hectic, epi-rushing patients. Either they're trembling bundles of nerves who can't get their acts together or they're the cause of the crash and don't see it coming. We have more than one nurse whose patients are always sicker at the end of their shifts than they were at the start regardless of the shift they work.

I have a great deal of trouble getting a good sleep before a shift. Days are actually worse for me than nights - I often wake up at 3 am and cannot get back to sleep without drugs. Our unit has some really odd ideas about healthy scheduling - actually I don't think they'd recognize it if it bit them on the bum if the master rotation is any indication. The management essentially refuses to give nurses a permanent day or permanent night rotation so most of us work alternating days and nights with absolutely NO 8 hour shifts but frequently with short changeovers (ie coming off nights at 7:15 am on Monday and going back in for 7 am on Tuesday). For several years I worked customized rotation of 1 day, 1 night, 3 off that was really quite good for me. I slept better than I had for a long time and I had no problems with early morning alertness. Alas, that went by the wayside when the new master rotation came in.

I don't know what your unit's like but on mine the excrement typically hits the oscillatory ventilating device somewhere around 4 am when half the staff is in the back room taking a nap and the other half is trying to cover twice as many patients. The rest of this shift is a gong show and then we go home to bed. To replay all of the events and second guess everything we've done. I often dream about oversleeping and being late for work, even though I've never done that in 15 years. Shiftwork is difficult enough without doing it all twice!

What about other departments like the OR which is constantly moving and shaking , its not JUST ICU its all nurses and support staff that have this problem . Most areas of nursing are physically demanding and mentally overwhelming , and sleeping is always hard after a mind rattling shift that has left you completely exhausted !!!!!

I completely agree. That's why I think the authors of this article need to do a causative study to determine what makes the ICU nurses have less sleep. Otherwise, the data is rather useless IMHO.

Are ICU nurses less "able" to sleep or less "willing" to sleep? I find some people could sleep if they'd take the time to do so. (My non-nurse husband is one of those, he just keeps going until he realizes he has to be at work in 4 hours.) Maybe it's not that the ICU nurses in this study couldn't sleep, but that they didn't take the time to do so. Perhaps there's a connection between the typle of personality that chooses ICU and the type of personality that chooses to not get as much sleep as they need?
That they showed a difference between ICU and floor was slightly interesting, the rest does fall into the category of "Thank you Captain Obvious!"