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Energy naps recommended for doctors and night nurses

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According to a new study, doctors and nurses should take power naps when working at night.

In a presentation at the Euroanaesthesia Congress in Milan, Nancy Redfern of Newcastle Hospitals NHS Foundation Trust argued that “health care should have formal risk management systems like those required by law in all other safety-critical industries. “. She said doctors and nurses should take 20-minute naps during night shifts to ensure patient safety, adding that no doctor or nurse should work more than three night shifts in a row to ensure the safety of patients and themselves.

Dr Redfern said she and her colleagues realized more action was needed on the issue when a trainee anesthetist crashed on his way home from work in 2015. He and his wife were expecting their first child.

“If you take a nap early in the night, which is equivalent to 20 minutes of rest, you’re much less likely to have a microsleep where you shut down for a few seconds,” she explained. She said fatigue guidelines already exist for healthcare professionals, but “we’re not putting them into practice.”

Good fatigue risk management should be “the norm”, she added, and that if airlines were to have fatigue management as part of health and safety procedures, “we don’t ‘have nothing in the health service’. She said healthcare workers were no different from any worker in any other sector and “it’s about being a human being”.

She said a national fatigue task force has been established. She also hopes that the legal guidelines for rest in hospitals will be changed in the future.

“Over the past 30 or 40 years, this discipline…has grown massively,” she said, adding that senior consultants trained many years ago would not have learned the importance of circadian rhythms. . She said the same guidelines as in airlines or traffic control could not be implemented in hospitals because “compulsory breaks” or more staff would be too difficult, but that other measures, such as ensuring that teamwork was used and that there were experienced personnel on the night shifts. to help.

After the pandemic, she said, “people suddenly realized that you actually have to look after the human if you’re going to get good quality care for patients.” Younger Generation Y and Z employees would also be less likely to admire senior executives telling them they hadn’t slept and would simply choose to work elsewhere.

During his speech, Dr Redfern discussed evidence from a variety of sources revealing that around half of trainee doctors, consultants and nurses suffered either an accident or a ‘near miss’ on their way home after a shift. by night. Research has shown that driving after being awake for 20 hours or more and at the body’s circadian low point (at night or very early in the morning, when it needs sleep the most) is as risky as drink-driving.

Workers who drive home after 12-hour shifts are also twice as likely to have an accident as those who work eight-hour shifts. Studies show that “sleep debt” begins to develop after two or more nights of restricted sleep, and it takes at least two nights of good sleep to recover.

After being awake for 16-18 hours, cognitive function is impaired. This leads to medical staff finding it harder to interact effectively with patients and colleagues.

“When fatigue sets in, we in the medical and care team are less empathetic with patients and colleagues, alertness becomes more variable, and logical reasoning is affected, making it difficult to calculate, for example, correct doses of medications a patient needs,” said Dr. Redfern. “We have difficulty thinking flexibly or retaining new information, which makes it difficult to manage rapidly changing emergency situations.

“Our mood deteriorates, so our teamwork suffers. As a result, everything that keeps us and our patients safe is affected.

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