Long Hours and Double Shifts: Knowing the Risks

Healthcare professionals are infamous for working 12-hour shifts, night shifts, and even double shifts. For many, 12-hour shifts and night shifts simply come with the territory, and double shifts are part of their ingrained responsibility to patients. For better or worse, healthcare professionals often think of patient safety before their own, so the risks of long hours and double shifts are rarely discussed.


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The risks associated with long work hours are not solely due to being at work for more than eight hours a day, but due to lack of sleep or not sleeping in accordance with circadian rhythms. These risks could just as easily apply to someone who works eight hours a day but has another job or family commitments that limit their time in bed. As everyone knows, life does not magically turn off when they the workday is done. Once home, the bills still need to get paid, meals need to be prepared, and obligations continue. With that said, it's easy to understand why one study found that 32% of healthcare professionals reported that they do not get enough sleep (Caruso, 2014).

A Midwest study found that nearly one third of night-shift workers and a quarter of rotating-shift workers reported having long-term insomnia and excessive sleepiness (Drake, Roehrs, Richardson, Walsh, & Roth, 2004 as cited in Caruso, 2014). Additionally, a national study found that workers lost half an hour of sleep for every additional hour of work per day (Basner et al., 2007 as cited in Caruso, 2014). There have been many studies that demonstrate that the sleep of healthcare workers suffers due to shift work and long hours, but lack of sleep also contributes to other issues, including chronic health and psychological issues as well as impaired work safety and the potential to make critical medical errors impacting patient safety.

When discussing chronic health issues, the causative factors differ. Some issues are related to a lack of sleep, while others are due to circadian rhythm disturbances, whereas even others are due to working too many hours in a day (i.e. 12 hours or double shifts). Regardless of the causative factor, the chronic health issues that face many in the healthcare field include obesity, diabetes, sleep dysfunction, decreased physical activity, and cardiovascular issues such as heart attacks, high blood pressure, and strokes.

Depression, irritability, anxiety, personality changes, and trouble with personal relationships are also commonly reported among shift workers (Caruso, 2014). Shift workers, particularly those with regular night shifts, are also at an increased risk for digestive disorders, including an increased risk for colon cancer (Caruso, 2014). In addition to chronic health issues, poor coping mechanisms were also found, such as smoking and alcohol use. The theory is that these poor coping mechanisms are due to the stress of chronic fatigue.

One study also found that shift work makes it more difficult for people to manage their chronic diseases due to a decrease in medication efficacy associated with disturbances in the circadian rhythm (Caruso, 2014). So while shift work and longer hours puts healthcare professionals at risk for chronic diseases, it simultaneously increases the likelihood that those chronic diseases will be ineffectively managed.

While the health of healthcare workers faces these risks, their patients also face increased risks because healthcare workers are not getting enough sleep. A healthcare worker suffering from chronic fatigue is less alert and more likely to involuntarily fall asleep, and no matter whether that happens while at work or in the car, both are very dangerous propositions. Lack of sleep also reduces a person's ability to concentrate, remember, and learn, as well as slows the reaction time (Caruso, 2014). A healthcare worker lacking adequate concentration, memory, and reaction time can lead to potentially fatal occurrences for patients.

One study estimated that approximately 20% of those who tried shift work were unable to adjust to the disruptions in sleep and circadian rhythms. This estimation demonstrates that shift work and long hours associated with them are not for everyone, but also that the health consequences of these work schedules prove that shift work and long hours are not conducive to anyone's health. While the healthcare field requires their workers to work long hours and through the night, take extra steps as a healthcare worker to protect your health, as well as your patients', by leading a healthy lifestyle through exercise, diet, and, of course, sleep.

Caruso, C.C. (2014). Negative impacts of shiftwork and long work hours. Rehabilitation Nursing Journal, 39(1), 16-25. Retrieved from Negative Impacts of Shiftwork and Long Work Hours

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