A Rational Approach To Shift Work

A Rational Approach To Shift WorkAnn Emerg Med. October 1992;21:1250-1258

summarized by sun yaichenghttp://decode-medicine.blogspot.com/

The best strategy is to work the same shift all the time and keep the same sleep pattern.

Consider additional compensation for those willing to work night shifts for extended period.

For those unable to maintain consistent sleep patterns, use compromise strategies such as anchor sleep, split sleep periods, and napping to mitigate circadian disruptions.

Rotate all shifts in the clockwise direction, with at least one-month minimum time per rotation.

Isolated night shifts may be the best option for larger groups, or in groups in which one or more physicians are working nights permanently or for an extended period.

This concept is gaining more acceptance among emergency physicians, mainly because of the obvious appeal of fewer clustered night shifts.

The brevity of the isolated night shift rotation should not disrupt circadian rhythms.

Sleep in a quiet, darkened room, minimizing disruptions.

Give the work schedule to likely daytime callers when on nights.

Start the awake period with a high-protein meal, switching to complex carbohydrates toward bedtime.

Avoid caffeine and high-calorie/high-fat snack food before sleep.

Eat meals regularly.

Use bright light more than 10.000 lux for two hours after rising) as an adjunct for adjusting to new shifts.

Get regular exercise. Vigorous aerobic exercise after rising may diminish

the time needed to adjust to new shifts. Avoid heavy exertion before attempting to sleep.

Work with family and friends to plan regular quality time together.

Do not try to live a day shift lifestyle while working night shifts.

Hold administrative meetings early in the morning or late in the afternoon when working night shifts.

Respect the circadian rights of those working nights by excusing them from meetings held during the day.