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Nursing Students’ 1st Entree Into Clinical Rotations: Initial Behaviors Addressing Shift Work, Sleep, and Safe Practice

Oregon Health & Science University – $24,883
4/1/15 – 3/31/16

This occupational health study addresses fatigue, sleep schedules, and perceptions of clinical practice in nursing students as they transition into different work hours. Clinical practice and personal health behaviors are examined at three points over 15-weeks. The goal of the study is to identify opportunities to provide the health workforce with anticipatory information addressing health, safety, and shift work.


Nursing students make an abrupt transition from traditional classes into clinical rotations and shift work. Novice students enter clinical practice from their prerequisite classes, moving into a schedule that requires (in addition to classes) an additional 6-30 hours/week of clinical rotations in regional hospitals. Students are assigned rotations on day, evening, or night shift. Prior to each clinical day, students are expected to prepare for their clinical assignment (e.g., reviewing the patient’s history, plan of care, medications and procedures), sleep, and, be ready to go on their assigned unit. Little is known about students’ sleep, sleep problems, and safe practice behaviors during this critical and singular phase of professional development. What is known is that practicing nurses report a number of sleep-associated problems; many practicing nurses report difficulties sleeping or experience excessive sleepiness; prevalence rates for self-reported sleep problems among new and practicing nurses range from 24-45%. Sleep problems in nurses are associated with adverse health events in patients (i.e., medication errors) and nursing staff (i.e., needlestick injuries) alike. Understanding student nurses’ initial behavior patterns in response to clinical rotations can yield insights into opportunities for occupational interventions at the university and hospital level. The purpose of this study is to describe students’ sleep patterns and perceptions of safe practice during their first semester of evening clinical rotations. Two complimentary approaches will inform this Total Worker Health study: 1) measurement of key concepts selected from OHSU’s Healthy Workforce Center cross-study measures, and 2) the implementation of Henning’s participatory process for workplace health/safety interventions.

Primary Investigator

Patricia Butterfield
Patricia Butterfield, PhD