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Night vs. day shift: How does it affect nurses?

SPOKANE, Wash. - In the hospital, your life may be in the hands of your nurse. A nurse who could have already worked nine, ten or more hours by the time they see you.

Do those long 12 hour shifts affect the care you get? Does one shift make nurses more tired than the other? Is it safe for them to drive home after working all those hours? These are the questions researchers at Washington State University are trying to answer.

"This is Ms. Jill Smith, and she is in here because she had fractured her hip and had a hip replacement," said Kevin Stevens, director for clinical performance and simulation at WSU College of Nursing.

The 'Jill Smith' that Stevens is referring to isn't a real patient — it's a mannequin.

"So they would walk in here, just as they would a patient room," Stevens said.

As part of a three-year study, researchers are using simulators to test 100 local nurse practitioners. One to represent a day on the job at a hospital, and one to represent the drive home from work.

"Look at the impact of cumulative 12-hour day versus night shifts on nurse safety and performance," said Lois James, assistant professor for WSU College of Nursing.

Nurses treat a couple dozen patients in just one shift. How well they do their job starts with their wellbeing.

"They'll get into medications, they'll get into IV fluids. Whatever else is needed, based on what is going on with her and her scenario," Stevens said, referring to the mannequin.

Nurses come in one at a time and treat the 'patient' as if she were human. Researchers, in turn, study several factors, including accuracy.

"When I'm looking at the simulation, I'm looking at — are they doing the correct medications, and are they taking care of a patient like any other nurse would," Stevens said.

They're also studying a nurse's judgment after all those hours on the job.

"If she's in pain, are they addressing the pain? If she's low on oxygen, are they addressing that," Stevens said.

The simulator was like being in a video game, only more serious. You have to watch your speed and make sure you're paying attention to any obstacles that may come up.

"There's been a lot of anecdotal evidence that nurses are at increased risk of collisions when they drive home due to fatigue," James said.

Results won't come out for another year or so, but researchers say they already see a trend.

"Sleep results do seem to indicate that nurses following their consecutive 12s seem to be pretty sleepy and this appears to be the shift for night versus day shifts," James said.

The study needs 100 participants. As of late August, they're about 75 percent of the way there. Researchers said they'll wrap up testing in about a year. Then, they'll spend the rest of the study analyzing all the results they collect.



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