From The Floor
Why Power Napping Might be Right for the Nurses at Your Hospital
Research shows the benefits of catching 40 winks during a long shift.
Not long ago, the administration of a local hospital conducted a surprise visit to its NICU unit and found many of the nurses sleeping at the bedside and at the nurses’ station. The hospital promptly fired these nurses for dereliction of duty. Though it may have been a harsh action for management to take, it was appropriate since sleeping at the bedside should never be condoned. I have seen this practice growing in NICU and it concerns me.
However, this doesn’t mean that nurses should not be allowed to nap when it’s their break time. Unfortunately, many hospitals prohibit nurses from sleeping, even on their own time. The negative connotation of “sleeping on the job” is commonly held throughout the American workplace. It shouldn’t be. The good news is that there is a great deal of recent research on what has been termed “power napping” and its relationship to work performance. Studies, both controlled and anecdotal, have been published showing an increase in employee efficiency and productivity after a 15- to 20-minute nap. The challenge for nurses is to get hospitals to acknowledge that napping can make nurses sharper and more alert, expecially during a 12-hour shift.
Back when I was a Director of Nursing, I had a very different opinion on this issue. I thought a nurses using his or her breaktime to nap was unprofessional. I began to alter my opinion on the matter after doing a quality assurance project at a Los Angeles, CA area hospital. That was before the chief physician in one of the specialty units assigned me, as a consultant, to track down an ongoing infection problem that no one seemed to be able to solve. So, off to work I went as a NICU/PICU/Transplant nurse for several months.
It was during these long days and nights that I learned that the hospital had set aside a room on each floor where the nurses could sleep during breaks. The room wasn’t fancy and the beds were just reclining loungers, but it was a quiet, dark place where a tired nurse could catch 40 winks. The only rules were: nurses could only use the room during breaks, and they must answer if an urgent page was sent—both good rules. After finishing my six months undercover work (and yes, we did track down the source of infection), I began to rethink my position on sleeping during breaks. I hope that this article will encourage my nursing peers to bring this topic up with their nursing administration—using the appropriate chain of command, of course.
Quick Facts on Power Naps
• According to the National Sleep Foundation, naps can restore alertness, enhance performance, and reduce mistakes and accidents.
• A study at NASA on sleepy military pilots and astronauts found that a 40-minute nap improved performance by 34% and alertness 100%.
• A recent piece in the New York Times reported an experiment at the Salk Institute for Biological Studies. Led by Dr. Sara C. Mednick, researchers put 30 well-rested people through the same set of tasks -- distinguishing between shapes that were displayed very briefly -- four times in the course of day, starting at 9 a.m. and ending at 7 p.m. Some subjects were allowed 20-minute naps throughout the day, other subjects stayed awake the whole time. They found that performance dropped by more than 50 percent in those who stayed awake the whole time.
• Who needs artificial stimulants when a quick nap can make nurses feel more alert and healthy? According to a report in Psychology Today, one California firm that implemented napping reported a 30 percent decrease in employee consumption of caffeinated soda and coffee.
• Additionally, studies done by Alan Hobson, MD, Robert Stickgold, PhD., and other Harvard colleagues show that short naps after lunch enhance information processing and learning.
And the list goes on and on.
Setting Up Nap Rooms
It may not be easy for nurses to get the administration to agree to set up “nap rooms.” If your hospital is more progressive, and you already have designated places where employees can sleep during their time off (and by this I don’t mean your car), then congratulations! However, remember to obey the rules on usage and always keep the area neat so privileges don’t get revoked. Then share the information with fellow nurses from other hospitals where they don’t have designated nap rooms, and offer to help them if they call upon you to speak about it to their superiors.
For those among you who would like to advocate for nap rooms, try some of the following procedures. Remember, the objective is to provide the nurses, especially those working 12-hour shifts, a safe place to sleep away from the bedside:
• Open up the topic of discussion with your peers. Are they interested in having a designated nap room? If there is interest, then take it to the next level.
• You and your peers should approach your Head Nurse/Charge Nurse with the idea. If you know of a local hospital that has designated nap rooms, ask someone from that hospital to come speak to your superiors and share firsthand information. Share with data on the positive benefits of “power napping.”
• If your idea receives a warm welcome, be sure to make it clear that you are willing to speak on the subject to the “big wigs” if your superior desires it. Be sure to ask your superior what they think the next steps are and how they think the nurses can be of assistance.
• You can also put your request in writing, documenting your idea and providing supportive documentation, and then submit it for consideration to the nursing management.
• And remember to talk it up, talk it up, talk it up. You want to create buzz.
Expect Any Reaction From "What a Great Idea" to "No How, No Way."
Once you put the campaign into motion, you want to keep track of its progress. Don’t assume that if everyone seems enthusiastic that it will get the seal of approval and just magically get done. In almost all instances, even the most perfect idea has its detractors. For example, at a large urban hospital, the administration is so opposed to employees sleeping on the job that even if that employee is on break (and they make employees clock in and out for breaks, so this is the employee’s own time), they aren’t allowed to sleep in their own car. Now this is an extreme example. But I use it to remind my readers that they will face a reaction ranging from, “Wow, what a great idea, let’s get right on it,” to, “No way, no how.”
The key is to first hope for a positive reception. If you have a more hard-nosed administration, it may require more effort and long-term planning. Decide if your nursing colleagues and you are in it for the long haul. If the answer is yes, then begin slowly and keep the discussions ongoing. For example, whenever you find an article in the newspaper or research journal, cut it out, copy it, and paste it on the bulletin board; or, if in email format, forward as necessary. Keep the discussion alive by bringing it up at staff meetings whenever appropriate. Note, the key word here is appropriate.
Where NOT to Sleep
Remember, never sleep at the bedside or at the nurses’ station; it is unprofessional and unbecoming of nurses. Instead, encourage your nursing administration to designate nap rooms. Nurses work long shifts and do deserve to have a safe place to sleep or relax when they are on break. As a result, the hospital can reap the benefits of a nursing staff that is happy, refreshed, more productive, and less likely to make medical errors.
Geneviève M. Clavreul RN, PhD, is a healthcare management consultant who has experience as a director of nursing and as a teacher of nursing management.
Recommendations for Making the Most of a Nap
—by Dr. Sara C. Mednick, a Harvard psychologist and sleep expert
1. The first consideration is psychological: Recognize that you’re not being lazy; napping will make you more productive and more alert after you wake up. (We nurses have a way of "guilt-tripping" ourselves. Stop!)
2. Try to nap in the morning or just after lunch; human circadian rhythms make late afternoons a more likely time to fall into deep (slow-wave) sleep, which will leave you groggy. (Of course, breaktimes can't always be controlled.)
3. Avoid consuming large quantities of caffeine as well as foods that are heavy in fat and sugar, which meddle with a person’s ability to fall asleep.
4. Instead, in the hour or two before your nap time, eat foods high in calcium and protein, which promote sleep.
5. Find a clean, quiet place where passersby and phones won’t disturb you. (Why we need to advocate for designated nap rooms.)
6. Try to darken your nap zone, or wear an eyeshade. Darkness stimulates melatonin, the sleep- inducing hormone.
7. Remember that body temperature drops when you fall asleep. Raise the room temperature or use a blanket.
8. Once you are relaxed and in position to fall asleep, set your alarm for the desired duration—20 minutes is ideal.
This article is from workingnurse.com.