Shift Work Guidance x 2
Humans have a 24-hour body clock called a circadian rhythm; controlled by the brain this regulates the times we sleep, wake and eat, our body temperature, pulse and blood pressure, and other important aspects of body function. Our circadian rhythms mean that we are active and do best in the day and sleep at night.
Shift work, particularly night work, can disrupt these rhythms – especially our ability to sleep – and can lead to health problems and fatigue.
The health and safety impacts of shift work are widely recognised. Long hours, fatigue and lack of rest breaks or time to recuperate between shifts increase the risk of errors, all of which can impact on patient safety. Health issues such as chronic sleep deficit, gastrointestinal problems, cardiovascular problems, depression, cancer and an increased susceptibility to minor illnesses such as colds and gastroenteritis are also linked to long-term exposure to shift work.
Some groups of workers may be more vulnerable to the health risks than others – for example, those with long-term conditions, pregnant workers and older workers who have worked shifts for several years.
In 2003, The Working Time Directive recognised the impact that working hours have on health and safety. In occupational health terms, this started the offering of health assessments to those that worked nights.
With the advent of the 24/7 services (think supermarkets and major road repairs) there are many more workers now expected to work at night.
The guidance from both HSE and RCN suggests that some shift systems have less impact on the health, safety and wellbeing of staff and organisations need to start optimal shift patterns – for example, a forward rotating shift pattern in which a worker moves from an early to a late to a night shift is better.
“Many of the people entering the nursing profession are aware that shift work is an essential part of providing a comprehensive 24/7 service for patients and some people will tolerate shift work better than others, “ said RCN UKSR Chair, Robert Moore. “The main risks are sleep deprivation and slower reactions due to fatigue, resulting in errors and the impact on general health as you get older. But I am also concerned about what preparation or advice we give staff who have not been involved in shift work before.”
Employers should supply policies and systems that promote healthy work hours and patterns. See guidance from the HSE on how to manage shift work.
See also the NHS response to reports of ‘Night Shifts double the chance of Breast Cancer – click here; with the suggestion that to combat these effects, those on night shift should quit smoking, keep up a healthy weight, eat a balanced diet, moderate alcohol and regular exercise