Sleep: Life’s Rejuvenator

Guest Author: Debra A. Wolff

I’m very excited to welcome my colleague Debra A. Wolff, DNS, PCNP, RN as a guest author for the last post of the month.   Dr. Wolff is the president/chief executive officer of NURSES-Ready for the Next Step, a business to help prepare nurses for success in the next step of their education and career. She also is the author of the new book, Advancing Your Nursing Degree: The Experienced Nurse’s Guide to Returning to School. For more information about Dr. Wolff, scroll to the end of the post. 

The topic of Sleep is perfect for July’s theme of personal health and wellness! So wake up and let’s get on with it! 

woman under covers sleep

Get a Good Night’s Sleep!
Photo by Nomao Saeki on Unsplash.com

It seems so simple when you say to someone “get a good night’s sleep;” yet, for many nurses, a good night’s sleep is a luxury rather than an expectation. So why is sleep so elusive, especially when we know how rejuvenating a good night’s sleep can be?

Sleep deprivation, whether due to stress, circadian rhythm disruption, or poor sleep conditions (e.g., a partner who snores, uncomfortable pillow), can have a profound effect on your health and safety (Stokowski, 2012). In fact, the majority of studies on sleep deprivation report the detrimental effects it can pose.

While this may be interesting to learn, let’s concentrate on the positive. I would like to focus this blog post on techniques that have been demonstrated over the years to help you “get a good night’s sleep!”

Lessons Learned From Other Industries

For starters, healthcare is not the only industry that employs individuals to work night shifts or extended hours. The mining, trucking, aeronautical, and railroad industries all have considerable populations of night shift workers. In fact, these industries have led the way in developing employee training sessions on ways to mitigate the effects of circadian rhythm disruption and fatigue due to sleep deprivation (Hauck, Avers, Banks, & Blackwell, 2011). In addition, they have been proactive in passing legislation to protect workers from unsafe practices (Federal Motor Carrier Safety Plan of 1987, 2012; Natural Resource Mining Safety Plan of 1990, 2010; Railroad Fatigue Mitigation Plan of 1991, 2011).

Interestingly, nurses make up a good proportion of employees who work a night shift position. So, let’s learn from other industries and find out what they suggest.

Naps Are Good!

Naps are Good! Photo by Alexandru Zdrobău on Unsplash.com

When I was researching this topic I was amused to find that naps were at the top of the list as a way to combat sleep deprivation. My family has a saying – “naps are good.” Many years ago I learned the benefits of a power nap from my father. He was a pharmacist and worked long days, so he often came home for dinner and took a 20-minute power nap before returning to work for the evening. Throughout my nursing career, I have found that when I work long hours on a project it helps to take a short 20-30 minute power nap. I set my cell phone alarm and literally pass out for 20-30 minutes. When I wake up I feel refreshed and ready to begin where I left off. 

Below are some other tips on naps and rest periods if you work an evening or night shift (Johnson, Brown, & Weaver, 2010; Oriyama, Miyakoshi, & Kobayashi, 2014; Smith & Eastman, 2012; Stokowski, 2012):

  • Take a two-hour nap before the start of your first shift
  • Take a 30-minute nap or two 15 minute naps during your shift break(s)
  • Go to sleep as soon as possible after your shift ends
  • Try to get at least six hours of sleep between consecutive shifts
  • Take all scheduled meal and rest breaks during work time
  • Avoid rapid shift rotation (e.g., working different shifts in the same work week)
  • Avoid scheduling appointments or other activities during your routine sleep hours. 
Limit Distractions

Over the last several years I have interviewed hundreds of student nurses on how they cope with a return to school. Many of these nurses also work full or part-time. A concern voiced by the majority of these nurses has been about getting enough sleep. Often they have additional responsibilities, such as the care of an elderly family member or infant, financial concerns, or marital issues which impact the quality of their sleep.

I have made a habit of asking what tips they would pass on to other nurses on how to get a good night’s sleep. A common theme has been to limit distractions. Here are some of their suggestions:

  • Use ear plugs or a sound machine to block out extraneous noises such as a snoring partner, barking dogs, or street noises.
  • Use room darkening shades or curtains.
  • Turn off any computer screens or other ambient light.
  • Wear an eye mask.
  • Limit distractions close to bedtime such as video games, political news, or crime watch.
Create a Comfortable Sleep Environment

The National Sleep Foundation (NSF) has a special section on how to make your bedroom a sleep sanctuary using all five senses (NSF, 2017). Among other things, they suggest you keep your bedroom temperature at 65 degrees, invest in a good mattress and pillow, and keep your bedroom free from clutter. Find comfortable sleep attire that won’t bind or cause you to sweat. If you are going through menopause and have night sweats, I have a few tips to pass along that helped me during that period. My husband bought microfiber sheets and blankets that helped to keep me cool. He also installed an overhead fan which we kept on all night.

Lavender helps you sleep. Photo by Annie Spratt on Unsplash.com

Using your sense of smell may also help you relax. A recent article in American Nurse Today (Greenberg & Narain, 2017) suggested that lavender products such as lavender infused oils or lotions, aromatherapy, or sachets may have a calming and restorative effect. I can attest to the benefits of lavender. This past winter I broke my wrist and ankle and had to sleep downstairs on the sofa. Suffice it to say, my quality of sleep was not good. It wasn’t until I purchased some lavender scented body wash and used this to wash up prior to bedtime that I finally was able to relax and get a good night’s sleep. Try it and see what you think!

Establish a Bedtime Ritual

Another tactic that is often suggested is to establish some kind of bedtime ritual. In this way, you prime your body to wind down for sleep. For example, several nurses described how they took a hot bath or shower prior to going to bed. Some liked to complete a mild exercise, yoga, or meditation routine close to bedtime. The July 11, 2017 blog post on mindfulness had some great apps you could use if you are interested. In addition, there are YouTube videos on chair yoga that would be easy to incorporate into your bedtime routine.

Other bedtime rituals could include brushing your teeth, taking your medicine, using lotion or face creme, praying, or stretching. Whatever you do, try to make it a routine so your body knows it is time to go to sleep.

One thing to keep in mind, follow a regular sleep schedule regardless of which shift you work. Constantly switching your bedtime can wreak havoc on your ability to fall asleep easily.

Things to Avoid Close to Bedtime

While it may be common sense, the following are some things to avoid close to bedtime:

  • Avoid spicy, rich, and fatty meals within four hours of going to sleep.
  • Avoid alcohol or nicotine before going to sleep.
  • Unless absolutely necessary, avoid the use of sleep medication as many can be habit forming.
  • Avoid caffeinated beverages or foods except for early in your shift. This includes coffee, tea, chocolate, and soda.
Do Your Professional Duty – Get a Good Night’s Sleep!

The American Nurses Association recently updated its Code of Ethics for Nurses (2015) in which it provides direction for how nurses should conduct themselves as professionals.

Provision 5.2, Promotion of Personal Health, Safety, and Well-Being states, “As professionals who assess, intervene, evaluate, protect, promote, advocate, educate, and conduct research for the health and safety of others and society, nurses have a duty to take the same care for their own health and safety” (p. 19, emphasis added). The provision also notes, “nurses should eat a healthy diet, exercise, get sufficient rest, maintain family and personal relationships, engage in adequate leisure and recreational activities, and attend to spiritual or religious needs” (p. 19).

Use the tactics noted in this blog as well as other sources, such as the NSF website, to overcome any obstacles that stand in your way of getting quality sleep. In a nutshell, as a nurse, you owe it to yourself, your family, and your patients to get a good night’s sleep.

References

American Nurses Association. (2015). Code of ethics for nurses. Silver Spring, MD: Nursebooks.org.

Federal Motor Carrier Safety Plan of 1987, 49 U.S.C. §§ 385-395 (2012).

Greenberg, M. J., & Narain, A. (2017). Relax with lavender. American Nurse Today, 12(6), 39-41.

Hauck, E. L., Avers, K. B., Banks, J. O., & Blackwell, L. V. (2011). Evaluation of a fatigue countermeasures training program for flight attendants. [Report]. Oklahoma City, OK: Civil Aerospace Medical Institute, Federal Aviation Administration. Retrieved from https://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/2010s/media/201118.pdf

Johnson, A., Brown, K., & Weaver, M. (2010). Sleep deprivation and psychomotor performance among night-shift nurses. AAOHN Journal, 58(4), 147-154. doi:10.3928/08910162-20100316-02.

Oriyama, S., Miyakoshi, Y., & Kobayashi, T. (2014). Effects of two 15-min naps on the subjective sleepiness, fatigue, and heart rate variability of night shift nurses. Industrial Health, 52(1), 25-35.

National Sleep Foundation. (2017). Inside your bedroom. Use your senses. Retrieved from https://sleepfoundation.org/bedroom/

Natural Resource Mining Safety Plan of 1990, 20 U.S.C. §§ 242-261 (2010).

Railroad Fatigue Mitigation Plan of 1991, 49 U.S.C. §§ 228.407-228.413 (2011).

Smith, M., & Eastman, C. (2012). Shift work: Health, performance and safety problems, traditional countermeasures, and innovative management strategies to reduce circadian misalignment. Nature and Science of Sleep, 2012(4), 111-132. doi: 10.2147/NSS.S10372.

Stokowski, L. A. (2012). Help me make it through the night shift. Ohio Nurses Review, 87(2), 12-16.

Guest Author Bio:

Debra A. Wolff, DNS, PCNP, RN, is president/chief executive officer of NURSES-Ready for the Next Step, a business launched in 2013 to help prepare nurses for success in the next step of their education and career. She also teaches online at Empire State College. During her 38-year career in nursing, she has been a lifelong learner. Dr. Wolff earned a bachelor’s degree from the State University of New York, Plattsburgh; a master’s degree and a certificate as a nurse practitioner in community health from Binghamton University, and a doctoral degree in nursing science from The Sage Colleges, where she was inducted into the Phi Kappa Phi Society.

From 2011 to 2013, Dr. Wolff was the project coordinator for the newly established Future of Nursing and New York State Action Coalition, as well as the coauthor and data analyst for the New York State Nursing Schools and Faculty Report: 2010–2011. Before 2010, she was the project director for a cancer research project that enrolled 115 sites nationwide and collected data on over 4,500 patients receiving chemotherapy. She had the privilege of being the only nurse working with this interdisciplinary, multicultural team. She has published extensively in Cancer, Journal of Clinical Oncology, Journal of the National Comprehensive Cancer Network, Annals of Oncology, American Journal of Managed Care, Academic Medicine, Journal of Rural Health, and Clinical Orthopaedics and Related Research.

You can email Dr. Wolff at dwolff@nycap.rr.com 

Dr. Wolff’s new book is available on AMAZON.COM and at Springer Publishing. If you go to the Springer site, don’t forget to use the discount code SS10CJT for 10% off your order. 

Going back to school? I’ll let you know more about this book in August. Stay tuned!