Environmental services and policies related to rest breaks for night nurses in Montana hospitals
Kellam, Anita Marie
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The nurses who work at night in acute care and critical access hospitals often must cope with a decreased amount of sleep, increased fatigue, and disruption of multiple physiological circadian rhythms. There is increased demand and rigor placed on night nurses in acute care adding to overall stress and demands on the nurse's ability to function safely and accurately. Simple environmental changes related to rest breaks, naps, and environmental services (work areas, break areas, eating facilities) can optimize the working environment and facilitate the nurse's self care during the challenges of night work. The goal of this descriptive study was to describe the environmental services and policies regarding rest breaks and naps in Montana acute care and critical access hospitals. The Hospital Environment and Policy Survey was developed for this purpose. Method: An anonymous electronic survey was done regarding breaks, policies related to rest breaks (written and unwritten), naps and environmental services available for night shift nurses. Results: There was a 52% response rate (4 of 15 acute care and 26 of 43 critical access hospitals). Of the respondents, 83% of hospitals do not provide night nurses with access to a cafeteria at night; however, 73% have vending machines. Almost half of the hospitals provide an area for night nurses to exercise, but few had a well-lit area to walk outside. Only 2 hospitals have a policy that allows night nurses to take a nap on their break, but 37% of respondents reported that nurses nap during the night shift. Seventy percent of the nurses reported getting their breaks "routinely" or "most of the time". Conclusion: Results of this study indicate a need for various improvements in the policies related to naps and environmental services particularly break areas, food services and exercise areas. These improvements can help address nurses' challenges of working at night.