Safety during night shifts: a cross-sectional survey of junior doctors' preparation and practice.
OBJECTIVE
We aimed to determine whether junior doctors and trusts in the region make use of published evidence relating to best practice during night shift work that can safeguard alertness, reduce fatigue and limit mistakes. We surveyed junior doctors' preparation for and practice during night shifts, and the working and living conditions offered by hospitals for junior doctors carrying out night duties.


METHODS
Cross-sectional survey.


METHODS
An anonymous online questionnaire was sent to junior doctors training within Health Education North West from 13 December 2012 to 14 February 2013.


METHODS
32% (16/42) of trusts within Health Education North West sent the survey to 2139 junior doctor email addresses; 24.5% (524/2139) entered data into the survey.


RESULTS
91.6% of surveyed junior doctors worked night shifts. Prior to starting night shifts, 65% do not have a 'prophylactic' afternoon nap. At work, half (49%) can access a room with a reclining chair while 24% have a room with a bed. 37% 'never' achieve a 'natural break' on night shift; 53% 'never' achieve the recommended 20-45 min nap. 91% of respondents were unaware of the duration of sleep inertia that can affect alertness upon waking. When converting between day/night shifts, 2% use light lamps and 6% use non-benzodiazepine sedatives. Principal themes from free text analysis were feeling lethargic or unwell during night shifts, concern for patient and personal safety and inability to rest or take breaks.


CONCLUSIONS
The trainees surveyed find night shifts difficult, yet do not/are unable to implement evidence-based recommendations to limit fatigue. Results suggest those surveyed experience a lack of rest facilities within their place of work and a demanding workload. The results may indicate the need to increase awareness of the potential benefits associated with different interventions that can help mitigate the fatigue associated with rotating shift work.
Junior Doctor Advisory Team, Health Education North West, Manchester, UK.
Emma J
EJ
Jackson
Adam
A
Moreton
Education & Training (see Medical Education & Training); Occupational & Industrial Medicine; Qualitative Research