Working a 12-hour night shift affects a nurse’s performance more than working a 12-hour day shift does, according to a recent study by Marian Wilson, Ph.D., an assistant professor at the WSU College of Nursing.

Most hospitals in the United States operate on 12-hour nursing shifts now, because they’re easier for administrators to manage and nurses like them, research has shown.

But Wilson’s study, which will appear in the journal “Accident Analysis and Prevention,” shows declines in alertness and performance during a 12-hour night shift that could have implications for both patient and nurse safety.

Strategies to address the discrepancy between day-shift and night-shift performance could include sanctioned napping in the workplace, or a return to 8-hour shifts at night, the paper concludes.

Wilson’s co-investigators on the study were Hans Van Dongen, Ph.D., director of the Sleep and Performance Research Center at the WSU Elson S. Floyd College of Medicine, and Regan Permito, research assistant at the Sleep and Performance Research lab, plus registered nurses Ashley English, Sandra Albritton and Carlana Coogle, of Kootenai Health in Coeur d’Alene. Kootenai Health also supported the research with a grant and their staff donated time to assist with data collection.

The study tracked 22 nurses at Kootenai Health, 11 on the day shift and 11 on the night shift. The nurses took a brief test before, during, and after their shifts to measure behavioral alertness and sleepiness using validated tools. In addition, they wore activity trackers on their wrists to measure sleep duration and kept sleep diaries.

Dr. Marian Wilson
Dr. Marian Wilson

The dayshift nurses’ performance was relatively good and stable across their 12-hour shift. But the performance of nurses working the night shift gradually degraded as their shift wore on, the study found. Both groups slept about the same number of hours per day – 7.1 – and both had roughly the same workload.

“Because 12-hour shifts are becoming the popular norm for nurses, it is critical that organizations consider the potential risks to patients, particularly with regard to night shift employees,” the study concluded. The study also has implications for nurse safety, with nurses whose performance has declined driving home after a night shift, it said.

Added Wilson, “The bottom line – night shift nurses are fighting their natural biological drive for sleep and need more help in maintaining performance and alertness during 12-hour night shifts.”

“Performance and sleepiness in nurses working 12-h day shifts or night shifts in a community hospital” –  Accident Analysis and Prevention. Marian Wilson, Regan Permito, Ashley English, Sandra Albritton, Carlana Coogle, Hans P.A. Van Dongen.