We healthcare workers are pretty much locked in to shift duties.
Whether a full night on ward, or a sleepless night with numerous consults. We cannot avoid it.
But, to be honest, how does such a lifestyle affect us?
Let’s find out.
Fatigue
Funny enough, us healthcare workers are often the ones with the most unhealthy lifestyle.
Research has found that the single most important factor related to work fatigue is the disruption of circadian rhythms.
Because fatigue originates from disrupted circadian rhythm, insufficient recovery time, and high work demands.
This one factor trumps all other scheduling characteristics in terms of fatigue.
So, no matter how well you schedule your roster, as long as you don’t have enough rest between shifts, you will be fatigued.
Fatigue is the key concept that leads to our next section:
Mental Stress
Fatigue is very correlated to mental stress.
Because the disruption of circadian also disrupts the hypothalamus-pituitary axis (HPA).
And cortisol, the hormone of HPA axis, affects your stress.
Shift works and on call infer a highly stressed nurse (or doctor).
Ever wonder why sometimes healthcare workers have insensitive attitude towards patients?
Now you know why.
Physical health
Shift work can severely impact your diet.
Emergency procedures and admin work constantly eating into your time for meals.
Not only that, studies have shown that healthcare workers on shift are more susceptible to gastro-esophageal reflux disease (GERD).
Moreover, when you spend so much time on work, you have less energy to take care of your health.
Your exercise frequency, your eating habits, your diet, could all plummet.
Therefore, when we tell people to eat healthier, we often binge McDonalds in hurry in preparation for our next task during shifts.
That is not good.
Medical Errors
The average Hong Kong doctor works 61 hours per week.
Every 1 in 7 doctors has experienced dozing off during surgeries.
And almost 1 in 3 has had some medical errors or accidents.
Again, it is due to the long working hours, and poor roster patterns.
Some roster patterns are especially dangerous for healthcare workers.
For instance, in nursing shifts, an AM shift following a Night shift is often discouraged.
But occasionally nurses are forced to do that.
And medical errors thereby arise.
Remember the Swiss cheese model for medical errors?
The more staff overworked, the more holes the cheese will have.
And as a result, more medical errors occur.
What should we do?
With all that being said, shift work is inevitable in this industry.
The real dilemma, therefore, is what to focus on when you plan rosters, such that we can minimize the negative effects of shift work.
The HK Labor department actually provided a nice booklet on this.
Linked here: https://www.labour.gov.hk/eng/public/oh/ShiftWork.pdf
But in general, for rosters, you want to space out shifts for employee rest, prevent extended shifts, and have more rest breaks.
Most importantly, try to cultivate a nice workplace culture: your teammates are all working extra hard to deliver best care!
Get enough rest and have good support. These are the most important things.
Best wishes to every reader!
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10144026