SHIFT WORK

It is time for your shift. 

What are you thinking?  What are you doing?  How are you switching on? 

The benefits of mentally switching on are well documented for athletes however there is little research into what strategies nurses can use before and after their shifts to switch and off.  

Shift work is often found to be associated with poor psychological outcomes and inadequate recovery between shifts. One study from Greece looked at the strategies used by nurses to mentally prepare before a shift and mentally disengage after a shift and their outcomes.

The strategies described by nurses fell into two categories and five themes. 

The categories were either used at work and those used outside of work. Strategies at work such as breaks during a shift were found to have little impact on improving negative impacts of work environments such as nursing. In addition to this, nurses were found to often forgo their breaks during busy shifts. 

The five themes identified were predominately used both pre and post shift to promote mental engagement and disengagement.

The first theme was pampering or grooming. Specific strategies included use of fragrance, facial make up and showering.  

Fragrance increased self perception of self confidence. For many nurses smelling a nice aroma was reported both as an energy booster as well as a stress reliever. Showering was found to wake up nurses both physically and mentally pre shift while post shift reduced stress and created a feeling of well being. 

The second theme was religious rituals such as prayer. These rituals were explained as providing them with a feeling of control and strength to deal with the unpredictable. This was found to support previous studies which describe religion as a stress buffer.

The third theme was nicotine and/or caffeine. The use of these stimulants helped to increased alertness pre shift and to heighten their pre work mood and ease them into the work environment. 

The fourth theme was social interaction. The majority of nurses interviewed used social interaction with their work colleagues as a strategy to connect with their work environment pre shift. Humour amongst work colleague was also often used at the end of shift to debrief and switch off. 

The fifth theme was listening to music, which was described as giving them an energy booster or a relaxing mechanism post shift. The music used was often very loud to distract the nurse’s attention from work related thoughts and stressors to inner thoughts and feelings.

All five themes were identified by the authors as what can form part of the ‘switch on switch off’ model. These themes can be used pre work to switch on and energise for a shift and also post work with the intention to create a state of relaxation and to direct attention away from the shift. 

If these themes can adequately ‘switch on’ a nurse for their shift then attention must be paid to ensure a nurse can ‘switch off’ from their shift. 

‘Switching on’ can assist with an increase in performance and professionalism at work. Failure to switch on may lead to increased levels of work stress, reduced performance and mistakes.

‘Switching off’ can help increase resilience in nursing staff and assist with their health and recovery to ensure adequate patient outcomes continue at subsequent shifts. Ineffective switching off can contribute to burn out, absenteeism and high stress levels. 

The success of switching on and off is of particular importance when nursing handover occurs as some staff begin their shift and some staff complete their shift. The use of the same techniques for differing outcomes could be used.

This theoretical models proposed by this study can be used to assist in reducing work stress at an individual and organisational level. 

Your shift has ended. 

What are you thinking?  What are you doing?  What are you doing to switch off?

Author: Beth Montano

To learn more about nurse’s mental preparation for shift work:

Manomenidis, Georgios, Efharis Panagopoulou, and Anthony Montgomery. “The ‘switch on–switch off model’: Strategies used by nurses to mentally prepare and disengage from work.” International journal of nursing practice 22.4 (2016): 356-363.