Caffeine and Napping as Coping Strategies Among Shift-Working Nurses

Abstract

The article under analysis dwells upon the use of caffeine and napping as coping strategies among shift-working nurses in Australian metropolitan hospitals. Although the sample of the study is rather limited (130 nurses), certain trends have been identified. It is found that the vast majority of nursing practitioners use caffeine and napping as ways to address the challenges of shift work. These methods, however, have adverse effects on practitioners’ health related to sleep patterns, psychological and mental health, as well as weight control. The study has multiple implications for nursing research and practice as it can improve the performance and retention, as well as health status, of nursing practitioners. It is important to develop sound training programs to equip nurses with effective coping strategies that are less harmful to their health than a combination of napping and caffeine use.

Introduction

The present critique dwells upon the article by Centofanti et al. (2018) entitled “Coping with shift work-related circadian disruption: A mixed-methods case study on napping and caffeine use in Australian nurses and midwives.” The article under consideration is concerned with the use of napping and caffeine as coping strategies to address work-related circadian disruption among nursing practitioners. The authors do not mention specific research questions they attempted to answer, but they identified the purpose of their study. Centofanti et al. (2018) explored the extent to which nurses and midwives used napping and caffeine as coping methods as well as their reasons for choosing such methods.

This topic is highly relevant to nursing research and practice as the adverse effects of shift working have been acknowledged. For instance, it is found that shift work negatively influences nursing professionals’ health, physiology, and safety, as well as their performance (Querstret et al., 2020). Such health effects as a higher risk of cardiovascular and cancer mortality are among the most pronounced long-term health outcomes. More immediate health effects are related to the development of inappropriate sleep patterns (Rhéaume & Mullen, 2017; Savic et al., 2019; Zion & Shochat, 2019). Nurses employ different strategies to improve their performance during their shifts (Olson et al., 2019). Napping and caffeine use proved to be related to improved vigilant attention and decreased sleep inertia during night shifts (Centofanti et al., 2020). However, this method still needs further research in terms of its long-term effects, potential alternatives, nurses’ attitudes, and other areas.

Main body

The study under analysis is set in several Australian metropolitan hospitals with shift-working nurses and midwives. The setting is appropriate for addressing the research objectives as Australian metropolitan hospitals can be characterised by a high level of the workload with thousands of patients who need high-quality care. Large metropolitan healthcare facilities are commonly used as the setting for such studies because the staff of such hospitals often has to perform multiple tasks that require a considerable amount of physical and mental capacity (Olson et al., 2019; Savic et al., 2019). It is also possible to note that the setting is generalizable to a wider population as large emergency and acute care hospitals are similar in terms of the working load and resources across the country. In simple terms, healthcare practitioners have to complete similar tasks, experience substantial workload, and work shifts to provide healthcare services.

The sample of the present study was confined to 130 shift working midwives and nurses with mean age 44 years, ranging from 22 to 67 years old. Twenty-two participants took part in in-depth interviews that were the basis of the qualitative part of the research. The sample was rather small, especially regarding the quantitative portion of the research, but it was sufficient for justifying the results of the study. The participants were also representative as the age and gender range is similar to other studies and is quite common for the clinical setting in the entire country. The sample was also appropriate to answer the research questions as the focus was on nursing practitioners working shifts. Convenience sampling method was utilized, and it was appropriate and effective, which is specifically true for the qualitative part of the study. This method is preferable for qualitative research design as it is important to recruit knowledgeable people who are willing to share their knowledge and attitudes.

As far as the methodology of the research under study is concerned, it was sound and appropriate to address the established goals. The researchers describe the instruments they used in detail, which enhances the article’s relevance and validity. Centofanti et al. (2018) conducted surveys with the use of questionnaires that took the participants approximately 30 minutes to complete and held 60-minute face-to-face interviews. The researchers utilized the Standard Shiftwork Index (SSI) to collect demographic data, information regarding the participants’ psychological and physical health conditions, sleep patterns, and caffeine use. The SSI tool is used in different studies related to shift workers, and its validity has been recognized (Centofanti et al., 2018). Interviews were facilitated by the use of the Critical Incident Technique that is instrumental in encouraging participants to describe and reflect on their work during shifts and the recovery strategies they employed. All these tools are appropriate to address the questions raised within the scope of the study under analysis.

It is possible to note that a myriad of other methods exists and could have been used to explore the experiences of nurses working shifts. For instance, in order to identify the level of fatigue and stress, it is possible to utilise the Multidimensional Fatigue Inventory and Perceived Stress Scale (Olson et al., 2019). However, the SSI is a more convenient tool that enables researchers to identify a number of physical and psychological, as well as demographic, factors that can be the most influential in the present case. Centofanti et al. (2018) employed sound methodology, and no issues related to the methods and instruments used have been detected.

Centofanti et al. (2018) reported that approximately 70% of participants napped. The analysis of qualitative data showed that the participants tried to have a nap, although no proper environments were available. The researchers did not track any meaningful differences in physical and mental conditions between nappers and those who do not nap. It was found that the participants consumed 4 ±2 cups of tea, coffee, or cola a day. The consumption of such beverages increased at the end of shifts, during the periods of increased alertness, and on the drive home. Caffeine use positively correlated with sleep disturbances, weight gain, gastrointestinal symptoms, and negative psychological symptoms.

The present study can have diverse implications for nursing research and practice. For example, this research can be the basis for further investigation into the strategies nurses employ to address the negative effects of working shifts. The focus should be on the reasons for choosing exact strategies, as well as the outcomes of such decisions. The relationship between caffeine / nap use and healthcare practitioners’ health conditions will be another aspect to analyse. Some steps in this direction have been undertaken by Centofanti et al. (2020), but more extensive research is needed. It is also critical to cover a larger population in diverse settings and pay attention to more factors that can influence the results. The development of proper strategies to mitigate the negative effects of shift working and the creation of the corresponding training projects can be another outcome of the present study.

Conclusion

As for the conclusions to be drawn from the article, it is well-developed and provides details of a valid and valuable study. This study displays some negative effects of the measures commonly used by nurses, so these professionals can try to change the methods they utilise to address the challenges of working shifts. The article will hardly change my current practice immediately as I still find the combination of napping and coffee drinking effective. I have to admit that I also resort to such models in my practice that helps me remain alert or functional in some cases. Nevertheless, I will start looking for alternatives because I have learned about diverse tools that can be effective. I will review the most recent literature on the strategies nurses working shifts use to be more productive. I will also discuss the matter with my colleagues and people who are employed in other fields to collect as much data as possible.

References

Centofanti, S., Banks, S., Colella, A., Dingle, C., Devine, L., & Galindo, H. et al. (2018). Coping with shift work-related circadian disruption: A mixed-methods case study on napping and caffeine use in Australian nurses and midwives. Chronobiology International, 35(6), 853-864. Web.

Centofanti, S., Banks, S., Coussens, S., Gray, D., Munro, E., Nielsen, J., & Dorrian, J. (2020). A pilot study investigating the impact of a caffeine-nap on alertness during a simulated night shift. Chronobiology International, 1-5. Web.

Olson, J. A., Artenie, D. Z., Cyr, M., Raz, A., & Lee, V. (2019). Developing a light-based intervention to reduce fatigue and improve sleep in rapidly rotating shift workers. Chronobiology International, 37(4), 573-591. Web.

Querstret, D., O’Brien, K., Skene, D. J., & Maben, J. (2020). Improving fatigue risk management in healthcare: A systematic scoping review of sleep-related/fatigue-management interventions for nurses and midwives. International Journal of Nursing Studies, 106, 1-16. Web.

Rhéaume, A., & Mullen, J. (2017). The impact of long work hours and shift work on cognitive errors in nurses. Journal of Nursing Management, 26(1), 26-32. Web.

Savic, M., Ogeil, R. P., Sechtig, M. J., Lee-Tobin, P., Ferguson, N., & Lubman, D. I. (2019). How do nurses cope with shift work? A qualitative analysis of open-ended responses from a survey of nurses. International Journal of Environmental Research and Public Health, 16(20), 3821-3838. Web.

Zion, N., & Shochat, T. (2019). Let them sleep: The effects of a scheduled nap during the night shift on sleepiness and cognition in hospital nurses. Journal of Advanced Nursing, 75(11), 2603-2615. Web.