Staying awake and asleep: the challenge of working nights and rotating shifts: managing shift work disorder for the clinical nurse specialist.

摘要

CNS CONSULT I am a clinical nurse specialist (CNS) in a busy family practice. Over the past month, I have had several patients who work night shift request prescriptions for armodafinil (Nuvigil) to "stay awake." Both patients on assessment had poor sleep hygiene practices that certainly contributed to the fatigue they were experiencing during their shifts. I would appreciate information on best practices related to caring for patients who work nights or rotate shifts and experience fatigue and insomnia. More than 6 million persons work night shift on a regular rotating basis and are at risk for shift work disorder (SWD). Workers include those in health care, transportation, protective services, food, and entertainment. Disruption of sleep/wake cycle is associated with sleepiness, fatigue, impaired work performance, significant risks for motor vehicle accidents, and work-related accidents. For persons experiencing SWD, there are serious medical, social, economic, and quality-of-life consequences.