The majority of ICU nurses (69%) preferred early activity, or morning .
Morning chronotype nurses were more likely to nap before night shifts compared to evening chronotype nurses.
Many morning chronotype nurses had young children living at home, which may affect their shift work tolerance.
Increased sleepiness and fatigue were reported during night shifts, but no impact on psychomotor vigilance was observed.
Problem-solving accuracy remained high during night shifts, although productivity decreased.
Simplified
PURPOSE: In general, sleeping and activity patterns vary between individuals. This attribute, known as , may affect night shift performance. In the intensive care unit (ICR), night shift performance may impact patient safety. We have investigated the effect of chronotype and social demographics on sleepiness, fatigue, and night shift on the performance of nurses.
METHODS: This was a prospective observational cohort study which assessed the performance of 96 ICU night shift nurses during the day and night shifts in a mixed medical-surgical ICU in the Netherlands. We determined chronotype and assessed sleeping behaviour for each nurse prior to starting shift work and before free days. The level of sleepiness and fatigue of nurses during the day and night shifts was determined, as was the effect of these conditions on psychomotor vigilance and mathematical problem-solving.
RESULTS: The majority of ICU nurses had a preference for early activity (morning chronotype). Compared to their counterparts (i.e. evening chronotypes), they were more likely to nap before commencing night shifts and more likely to have young children living at home. Despite increased sleepiness and fatigue during night shifts, no effect on psychomotor vigilance was observed during night shifts. Problem-solving accuracy remained high during night shifts, at the cost of productivity.
CONCLUSIONS: Most of the ICU night shift nurses assessed here appeared to have adapted well to night shift work, despite the high percentage of morning chronotypes, possibly due to their 8-h shift duration. Parental responsibilities may, however, influence shift work tolerance.
Key numbers
61 of 96
Prevalence of Morning
Total ICU nurses participating in the study.
1.40
Increase in Sleepiness Score
Comparison of sleepiness scores between night and day shifts.
0.69
Increase in Fatigue Score
Comparison of fatigue scores between night and day shifts.
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