Friday, 5 February 2010

A window closes; a door opens. A window closes.

Here I am sitting alone in the ferry terminal to the mainland. Listening to CBC Radio 2 Drive, a song called "where are you now among the world?" Hardcore life changes in store here for me.

I'm moving to Halifax for upwards of a year, which is fairly huge for me considering I've pretty well always lived in Newfoundland less 10 weeks or so spent in Montreal a few years ago. As exciting as it is, it comes with a lot of anxiety and apprehension as well, which I guess is to be expected but that doesn't mean it makes me feel better.

This move is for school/work, I'll be finishing up my last nursing workterm there for school, and then am hoping to work there. It's a bigger place with nicer facilities and fantastic experiences with respect to nursing. However, with bigger cities come faceless people, unfriendly passerbys and higher crime rates. It also means giving up, or putting on hold, many relationships which I've spent years cultivating into the flourishing, trusting relationships they've become.

It seems every time I make a major life decision, it means giving up people I love. I know I said that rather rashly and made it sound like forever. I realize it's not forever, but it is for a long time, longer than ever before, and there has to be some worry there that things are going to change between us all. It also means that I have to start new again. Granted, the last time I did this would have been four years ago when I entered University and this proved to be an all around positive experience. I learned a lot about myself, and met so many marvelous people along the way. I'm just not quite convinced that I'm ready to put these people on hiatus to meet new ones. Aside from that, I have my oldest friends at home whom I'm also leaving to start a new life in Halifax. Sam is apparently moving up later on, which would be amazing, but we're still going to go months without seeing one another. We haven't done that before, and honestly a life without Steadfast Sam kind of disturbs me. And then, aside from my oldest friends, I'm leaving all my closest family. And my god daughter and her moms. At the cusp of her new world, learning to walk, learning to talk, learning to use a fork, learning to change the channel... all these things are things I'm likely going to miss on account of moving.

On the other hand, a set of whole new beginnings is exciting. I do have some relationships started in my new world, which is great and gives me something to look forward to. As well, no matter where I've gone I've met wonderful people. I moved to Montreal, stayed with some of the nicest people ever, abolished the stereotype that French people are terrible, and made friendships that have impacted my life tremendously. I moved to Goose Bay, met more wonderful and marvelous people. I moved to Corner Brook and met so many people - great friends, and learned more about myself than ever before. I also learned a lot, given it was the place where I completed my degree. I became involved with more than I'd ever dreamed of, volunteered and really accomplished so many goals on the road to becoming the person I want to become. I've also made many, many mistakes along the way. I've shed lakes of tears. However, I believe I've learned from them all.

So, I guess what I'm trying to say is that it appears I've come upon another new beginning. It's terrifying and amazing all at the same time. I'm excited to meet new people, make new mistakes, and turn another page in my book of life. I'm ready to fulfill new life goals, start over but yet continue down this same path which is my twisting and turning life. I'm looking to the future. I'm decidedly not doing away with old relationships, but rather continuing them despite difficulty. I'm ready to make some new friends, invite some more people into my circle and into my family. I expect it won't by any means be an easy road, but nothing good ever comes easy. If life has taught me anything thus far, it's probably that. When things are tough, something good is just around the corner.

I'm accepting these new tears with a new attitude. Looking at them more positively and recognizing that while everything seems horrifyingly new, in a few months I'll be rewriting this blog and talking about another new experience. Life is exciting. Another important lesson I've learned, especially from nursing, is that life is too short and too precious to harp over the small stuff. In 10 years will this matter? Probably. But I'm confident that those relationships which truly matter in my life will still be there. Those people which are most important will still be there for me, and I for them. And that there will be a whole gamut of new and important people, exciting changes and decisions.

I've always been afraid of rollercoasters.

I think I just conquered my fears.

I love you.

Nurse Adam


Wednesday, 23 September 2009

Day 2

Hello friends,

Sorry I'm a little late. I was up late doing homework and the blog got put to the wayside. Anyway, I realized yesterday that I was actually doing the P90X+ program and not the regular P90X program, which might be why I was ready to die at the end. So yesterday, Angela and I picked up where we left off, but this time using the correct, regular stream, product.

Tuesday is Plyometrics, so that meant a lot of hopping and jumping and most of all squatting. Needless to say after jogging earlier on in the day, by the end of the video I was ready to collapse.

Interestingly enough, I find that I actually have MORE energy after working out than before. I was worried that starting this regime would mean I wouldn't have time to get important schoolish things done, but I find that knowing I have to do P90X means that I make sure to find time either before or after the workout for school. And thus far it's working fine. Granted, it's only day 2, but I figure if it was going to present a major problem it would have done so yesterday since I had 4 meetings and a bunch of articles to read and a survey to amend and a cover to finish. But it all got done. And I was still able to exercise. And jog, as an added bonus. Angela likes to jog, so to appease her for agreeing to P90x with me, I am jogging with her when she wants to. Today it's raining so I don't need to. Thank god. My legs feel like gelatinous piles of lard.

Anyway folks, I have to get to the library to meet up with some classmates regarding group seminar. So, I will update hopefully again tonight post-workout, but it might end up being tomorrow morning again because I'm awesome.

Take care,
A

Monday, 21 September 2009

Adam vs. P90x - Day 1

So, I woke up yesterday morning and brushed my teeth. I once had quite a bit of weight on, but with a combo of good eats and an adrenal gland, I managed to succumb to a lanky/nerdy physique. Yesterday, though, while brushing my teeth I noticed that I have a lot of excess flab in places Id rather not. I'm getting a stomach pouch, and I'm not a fan.

Like every problem in my life, I used Google to search for an answer. I noticed a lot of talk about this P90x workout program. It seemed intense, but pretty alright. So I youtubed some videos to see what people were really saying (because seriously, why browse forums when you can youtube people and have them read to you instead?), and the results were astonishing. I decided at this moment that I would enroll in the P90X program. But I had a problem. I was alone. So, my good friend Angela enrolled with me. Together, we plan to stay motivated. So I picked up the program and read through the manual, and that brought me to tonight...

I decided to get right on it, as I feared leaving it too long would just result in me giving up on it. Angela came to my room and we started it up. As soon as we finished the obligatory stretching, it was INTENSE. The most intense 40 or so minutes of my life thus far, from an exercise perspective. I loved it though, and love how I feel after doing it. I miss working out, I've done it scantly throughout my life but have never kept up with it.

So here goes nothing.

To help me stay motivated, I'm using my blog. To feel like I have something that I have to do once I'm done. Forgive me if I miss a couple updates here and there, I'm a University student and my priorities, unfortunately, do not always lie with blogger.com.

Tonight was Upper Body PLUS. We were supposed to do Abs PLUS too, but decided to start with that the next time it rolls around as it's 11:30 already. Tonight was a bit rushed, but now that we've committed, we've also promised to start earlier so that we can finish the assigned workouts for that day. I did do a back load of crunches earlier today though, so hopefully that accounts for something.

Oh, and I figure I should give you some stats about myself. I may post pictures later, but today you get stats. I'm 6'0", about 160lbs, and have the body type of a 12 year old girl. I'm thin, but as I said earlier, am developing a tiny pouch (which I hope in 90 days will be 6 pouches of HARD MUSCLE GRRRRR). I'm a fourth year nursing student.

So, come join me for the ride. Ask questions. Keep me motivated.

Perhaps with my blog, I can convince others to join in. If I can motivate just one other person to make a difference in their lifestyle as well, I will feel great. In saying that, if you've made any dramatic lifestyle changes lately, tell me about them! It doesn't have to be P90X or even exercise related. Just let me know you're here. Help me shake the feeling of being alone on the Internet.

That's all for now, see you again tomorrow evening.
- Adam.

Sunday, 31 May 2009

Blog shift

Dear everyone,
I've moved my blog over to wordpress. I don't know how long I'll stay there, but for now, I'm going to. Only becuase I like the layout more.

Please change your bookmarks (because I just know that sooo many of you have my blog bookmarked haha) to:
http://nurseadam.wordpress.com/

Thanks! Have a good one :)
-Adam

Also, I got facebook once again, so add me there too.

twitter | flikr | deviantart | facebook | myspace

Sunday, 24 May 2009

New car!

Tonight I confirmed the purchase deal with my parents for my new car. Stella's replacement.

We had some good times, Stella and I, but she's met her maker. It was going to cost more to fix her than she was worth. Rather than get a new beater, my parents and I discussed for a while and came to the conclusion that it would be better for me to get a new car as I was going to get one upon graduating anyway. That said, after much deliberation, together we settled on a Honda Civic. Excellent mileage, good(ish) price, sleek, sporty. Everything you need for your midlife crisis. ...which I missed when I went from 8 to 80 on my 9th birthday. So I'm reliving my 30's now I guess.

Anyway, I figured I'd give you some photos so you can chew it over and picture me driving it. I can't find a photo of the exact colour that mine will be... but it will be that dark grey/pewter colour on the outside with black grey and silver details on the interior. Oh, and it has a sunroof. I win.

Here are pictures:

Interior:

Exterior:

I'm so pumped right now. I feel like a real adult. It's scary, but I'll take it.

Love,
Adam

Wednesday, 29 April 2009

Halifax is a sex knight.

Halifax is going well thus far. I'm staying with my good friend Christina and her parents in Cole Harbour. It's nice.

Generally I like Halifax. It's very beautiful, very artsy. Just my type. I don't really like how far away everything is, but the bus system is pretty awesome at taking care of that problem so it's all good as long as you aren't in a rush or late for work.

Working in Halifax is lovely. The nurses are quite nice, the workload seems smaller than that in Newfoundland. Thoracic Surgery isn't nearly as scary as it sounds, my eyes don't widen anymore once I hear it... but I can make other people's eyes widen when I say it so it's all good :) I'm learning so much. I can almost feel myself learning it's so hardcore. Everyday I learn like 18 new things at least. Last night was my first nightshift thus far and it was absolutely fantastic.

Aside from that nothing's really new. I haven't decided yet if I want to live in Halifax. Right now I'm leaning toward staying in St. John's for a while, but I'm not discounting Halifax just yet.

Dawn is pregnant and due soon. Very exciting.

Ya'll keep asking me to put up a recent picture of me so here you are:

Aside from all of that, Christina has a dog and cat so Im in love. I have all the Starbucks I can drink, new shoes, Chapters, public transit and epic walks and new adventures. Life is good right now.

Now I need to get to evaluating myself.

I meet my preceptor Friday.

-Adam

Monday, 6 April 2009

I washed out my old man sweater.

Then I dried it.

It now is so soft and smells SO good.

I am in love with a ragged, old, ugly sweater.


....mmmm....

Also, I blog when I'm home. Notice that?

Fast | Slow

Love songs fast and slow. Awesome playlists for your favourite lover.

Slow:
  1. I'm Yours - Jason Mraz
  2. Take me Anywhere - Tegan and Sara
  3. Feeling Good - Muse
  4. Such Great Heights - The Postal Service
  5. Danger, Danger - Colleen Power
  6. Banana Pancakes - Jack Johnson
  7. Sometimes (I Wish) - City and Colour/Dallas Green (whichever you like best)
  8. Run - Snow Patrol
  9. I'll be on the Water - Akron/Family
  10. All my Loving - Jim Sturgess (Beatles cover)
  11. Thirteen - Garbage (Elliott Smith cover)
  12. Sea of Love - Cat Power
  13. Soco Amaretto Lime - Brand New
  14. Soda Shop - Jay Brannan
  15. Be Back Soon - Justin Nozuka
  16. Refugee - Melissa Etheridge (Tom Petty cover)
  17. Hide and Seek - Imogen Heap
  18. Samson - Regina Spektor
  19. Transatlantacism - Detah Cab for Cutie
Fast:
  1. Here (In Your Arms) - Hellogoodbye
  2. Toxic - Britney Spears
  3. Infatuation - Prozzak
  4. Forever - Chris Brown (Irony~*~*~*~)
  5. Lucky - Jason Mraz feat. Colbie Caillat
  6. Take a Chance on Me - ABBA / Mamma Mia OST
  7. Feel Good Inc. - Gorillaz
  8. Cupid's Chokehold - Gym Class Heroes
  9. The Mixed Tape - Jack's Mannequin
  10. My Baby - Jesse McCartney
  11. My Love - Justin Timberlake
  12. Float On - Modest Mouse
  13. You're So Damn Hot - OK Go
  14. Dangerous - Kardinal Offishall feat. Akon
  15. Baby, It's Fact - Hellogoodbye
  16. This Ain't Sex - Usher
  17. She Wants it (Ayo Technology) - 50 Cent feat. Justin Timberlake and Timberland
  18. Lovegame - Lady Gaga


Can't lose.

Love,
-Adam

Sunday, 5 April 2009

11:39

I am home for a little while and am going to study today. My parents are feeding me very well. I am spending time with Sammi. Life is good.

And by the way:

Equality by =novenarik on deviantART

I really liked this picture and fav'd it on DA and thought I'd share it with all of you.

Last night, my father made a really, really rude and ignorant (in that it was not full of knowledge) comment about "the gays." I obviously stood up and argued his point but then I was deemed "too uppity" but I don't remember exactly how he called me uppity, but he didn't use that word. But that's what he meant. Anyway, it kind of shocked me because, well, I guess I just hadn't heard much like that since highschool. It's funny, when I moved out I kind of created a little bubble for myself and I guess forgot that the world still functions on ignorance. I think Eminem said it best when he said "Snap back to reality | Whoop there goes gravity."

Anyway, I just needed to put that out there somewhere because it really bothered me, made me rant and roar, and is still bothering me. Groos, mang.

In other news I'm fairly convinced I'm going to buy a Nissan Cube when I graduate. Y/N? They're pretty hilarious and lovely. And the environment doesn't hate them, of course it doesn't love them either, but it doesn't hate them as much as say... my current car... or a Hummer.

If, when I take it out for a test drive, I end up not liking it, I'm thinking I'm going to get a Sentra or Venza. Both Nissan, btw. Other options include a corolla (idk why I like them but I do), a Civic or a Fit. I also really like the VWs but am not going to buy one as Dawn and Judi talked me out of it. The Cube is nicer. I think with the Cube, my biggest deal would be that it's not a car. I really, really enjoy driving cars. I think I will have issues with driving a box. But we'll see.

Now, I'm going to go study some Medsurg (exam on Saturday) and write some notes on Breast Cancer. WOO. Cancer is really depressing. I read some news the other day, however, on cancer-fighting nano technology that's apparently coming. Very exciting. Very very exciting.

Bye for now,
-Adam

Monday, 30 March 2009

Spring

The last time I opened my curtains there was snow up over my window.

Today, and probably weeks later (I usually keep my curtains closed... apparently I function better in unnatural light), I can see grass.

:)

Thursday, 12 March 2009

Sleep-wake cycle

My body doesn't remember how to sleep during the night. I've become nocturnal.

This is awesome when you have classes at 0830hrs.



Gah!

You are what you eat.

eeSo today I've had 8 cups of coffee, a cup of mint hot chocolate a poutine and a slice of pizza.

My body and I are in love.

Wednesday, 11 March 2009

Leadership Paper - Feel free to give me feedback. Due Friday :)

Running head: IMPLICATIONS OF SHIFTWORK


 


 


 


 


 


 


 


 

Shiftwork: Implications for Nurses and Management

Adam Elliott 200643104

Western Regional School of Nursing

Sir Wilfred Grenfell College

Memorial University of Newfoundland


 


 


 


 


 


 


 


 


 

Introduction

Shiftwork within the nursing profession is commonplace with both day and night shifts occurring regularly. Shiftwork affects about 25% of all healthcare professionals and is not an issue that should be looked upon lightly (Berger & Hobbs, 2005). Shiftwork is work that is performed outside the typical daytime hours of 0700hrs to 1800hrs. Within the healthcare system, nurses are often scheduled to work days, nights, a rotation of both or even on an on-call basis (Blachowicz & Letizia, 2006). Though this type of work is beneficial in that it allows for 24-hour functioning of the hospital, better scheduling opportunities and even salary benefits, there are many consequences and challenges the nurse must face both at a senior management level and a floor nurse level (Blachowicz & Letizia). Shiftwork affects the individual extensively in every aspect of life from the food one consumes to his or her familial situation at home. This paper will identify these challenges and offer implications and resolutions for nurses and management.

Literature Review

A literature review was conducted related to the subject of shiftwork. There is strong evidence revealed in the studies which were reviewed for this paper indicating that shiftwork has many negative consequences not only for those who are working these rotations, but also for their families, the organization as a whole and in some cases even the patient (Berger & Hobbs, 2005; Newey & Hood, 2004). Shiftwork, or work that falls outside of daylight hours, is shown to disrupt the normal circadian rhythm of the body which causes fluctuations in the body's internal clock. Problems sleeping, diet alterations, increased injury, immune system dysfunction and even social isolation are just a few of the physiological and psychological problems that this disruption can cause (Berger & Hobbs; Zhao & Turner, 2008). With regard to the effects on family life, several challenges were identified in the literature. Those individuals doing shiftwork are more likely to have work-family conflict which, in turn, puts them at risk for developing mood and anxiety disorders (Willis, O'Connor, & Smith, 2008). Additionally, nurses find difficulty balancing work and home life linking conflict with increased absenteeism and decreased psychological and physical well-being (Willis, O'Connor, & Smith).

Definition and Models of Shiftwork

    The literature is lacking with regards to a common definition of "shiftwork" but it is generally accepted as work that falls outside daytime hours, and can include eight, ten or twelve hour shifts (Admi, Tzischinsky, Epstien, Herer, & Lavie, 2008; Berger & Hobbs, 2005). There are several different types of shiftwork, however, that can be utilized within an organization. One can work morning (0800hrs – 2000hrs), evening (1600hrs – 2400hrs), night shifts (2000hrs – 0800hrs), or any rotation therein dependent upon the organization the individual is employed with. These shifts can be permanent, I.E. working only nights or only days or they can be rotating, I.E. working two days and two nights or some other combination of shifts (Berger & Hobbs). Additionally, there can be forward or backward rotations. Forward rotations switch from days to evenings to nights while backward rotations go from nights to days to evenings. These forward and backward rotations usually last a two week pay period. Studies show that nightshifts tend to be more harmful physiologically and psychologically, but that rotating shifts are even worse as one's body does not have time to adjust or get used to a new sleep-wake cycle (Berger & Hobbs; Kilpatrick & Lavoie-Tremblay, 2006; Peate, 2007; Willis, O'Connor, & Smith, 2008).

One last option for healthcare professionals is that of a casual or call-in basis wherein the individual is called to work when needed without having a general schedule or knowledge of when he or she will be working (Berger & Hobbs, 2005). Call-in shifts could include mandatory overtime or emergency coverage. Therein, employees do not gain the opportunity to adjust to new sleep cycles and, again, this presents negative impacts on the health and well-being of the worker, the organization, the family and the client (Hospital Employee Health, 2008).

Physiological Impact of Shiftwork on Healthcare Professionals

    While shiftwork does have its advantages such as increased communication between staff, extra pay and increased days off, it is not without consequences (Kilpatrick & Lavoie-Tremblay, 2006). Shiftwork is shown throughout the literature to present the employee with many health challenges. Shiftworkers tend to eat less healthily, be more overweight, sleep less, and are more likely to smoke tobacco. Nightshift workers in particular experience increased fatigue, more headaches, and are more tired throughout the day while dayshift workers complain of more broken sleep and snoring (Admi et al., 2008). Additionally, shiftwork has negative implications for one's cardiovascular health, increased incidence of type two diabetes mellitus, female reproductive health challenges such as altered ovarian functioning and menstrual cycle irregularities, as well as circadian rhythm changes such as changes in core temperature, blood pressure and alterations in alertness (Blachowicz & Letizia, 2006; Kilpatrick & Lavoie-Tremblay).

    Sleep disturbances. A reoccurring issue within the literature related to shiftwork was that of sleep disturbances. Nightshift workers as well as those on rotating shifts experience higher incidences of insomnia, fatigue and are forced to alter their sleep patterns thus changing their internal circadian rhythm (Kilpatrick & Lavoie-Tremblay, 2006). In fact, workers on rotating shifts report less sleep overall reporting up to 1.5 hours less sleep per day (Kilpatrick & Lavoie-Tremblay). In theory, permanent nightshifts would be successful for nurses in that one could adjust his or her circadian rhythm or sleep-wake cycle to accommodate sleeping during the day and being awake during the night. However, due to social or familial responsibilities, nightshift workers often sleep during the night on their days off thus resulting in maladjustment which can actually lead to more fatigue and constant feelings of jet lag (Hospital Employee Health, 2008). Call-in shifts are illustrated by the literature to be cause for concern as well. This would be in the case of mandatory overtime or emergency call-in for example. The literature states that being awake for more than 17 hours has similar consequences to that of being under the influence of alcohol (Hospital Employee Health, 2008).

Nutritional imbalances. Shiftwork is shown to have many effects on the nutritional intake of workers and may even enact disturbances within the gastrointestinal system. Often, during shiftwork nurses will eat and drink very little or nothing at all (Zhao & Turner, 2008). This change in dietary habits can cause abnormalities in one's digestive tract function (Muecke, 2005). Similar to the body's inherent circadian rhythm, digestive enzymes are produced in a cyclical fashion. Thus, eating at different times during the day, or fasting during nightshifts can cause disruptions and irregularities in this rhythm. These irregularities include increased rates of obesity, increased rates of constipation, diarrhea, indigestion and even peptic ulcers (Muecke).

Psychological Impact of Shiftwork on Nurses

    In addition to physiological challenges, nurses are faced with psychological problems related to shiftwork. The literature reveals that nurses doing shiftwork report higher levels of stress, increased incidence of mood and anxiety disorders and that females have higher complaints of health problems than males (Admi et al., 2008; Oddie & Ousley, 2007). One major factor identified was that of increased incidence of depression among shiftworkers (Kilpatrick & Lavoie-Tremblay, 2006). These factors combined all impact client safety and can affect a nurse's familial and social environments outside of work.

Impact of Shiftwork on Client Safety

    As mentioned previously, shiftwork leads to increased incidence of fatigue among workers. This, in turn, can mean increased risk and negative implications for the client who is the centre of a nurse's care and could be considered the most important factor. Nurses who have rotating shifts are shown to have higher incidence of accidents at work (Peate, 2007). These could include things like med errors, failure to respond, delayed reaction times, or impaired memory as well as psychomotor insufficiencies such as administration of injections or intravenous insertion (Peate).

    One challenge of utmost concern related to client safety as outlined in the literature is that of medication errors (Hughes & Stone, 2004; Peate, 2007). This is due largely to levels of alertness, fatigue and overall sleepiness. In fact, after working a twelve hour shift the incidence of making a mistake at work is twice as likely as that after working an eight hour shift (Hughes & Stone). Lastly, medication errors are reported to take place largely during the night shift specifically between 0400hrs and 0800hrs (Hughes & Stone).

    One last challenge related to patient safety is that of depersonalization related to fatigue. This largely affects mental health patients as much of their treatment relies on discussion with healthcare professionals (Oddie & Ousley, 2007). If nurses become depersonalized, patients are less likely to share with them their feelings and thus are more at risk for worsening conditions or even antisocial behaviours (Oddie & Ousley).

Impact of Shiftwork on the Social and Familial Environment

    In addition to impacting the client, shiftwork adds stress to the relationship between the nurse and his or her partner as well as the family environment as w hole. Individuals who have conflict between family and work are three times more likely to develop mood and anxiety disorders, are more likely to feel job insecurity and to have decreased work satisfaction (Willis, O'Connor, & Smith, 2008). Additionally, partners are reported to experience stress related to feelings of incompatibility and neglect due to their partner's shiftwork responsibilities (Willis, O'Connor, & Smith).

Finally, shiftwork impacts one's social environment. Studies state that in order to be experience less adverse effects the worker should alter his or her sleep schedule to accommodate the nightshift responsibilities (Berger & Hobbs, 2005). This, however, is nearly impossible to achieve when social and familial responsibilities are considered as most needs take place during the day, therefore, workers often shift their sleep patterns to night sleeping on their days off (Hospital Employee Health, 2008).

Impact of Shiftwork on the Organization

    In addition to the challenges presented by shiftwork to the client and family there are also significant challenges presented to the organization and employers as well. The literature reveals that decreased worker satisfaction and absenteeism are two major factors affecting the organization (Willis, O'Connor, & Smith, 2008). The literature shows that the impact for the organization as well as for the family are closely linked. Increased work-family conflict is linked to a decreased drive to go to work and therefore is linked to absenteeism which can lead to significant staffing challenges for employers. In turn, increased absenteeism can lead to more mandatory overtime or emergency call-ins for nurses. This, again, will add to the stress and challenges of shiftwork thus further encouraging the physiological and psychological problems and therefore engaging an entire host of challenges for all parties involved. This could mean implications from sick leave to increased funding needed to pay for greater occurrences of overtime, call-in shifts and the potential for hiring more staff (Willis, O'Connor, & Smith).

Resolutions to Shiftwork Issues

Though shiftwork presents many challenges to nurses, there are ways to overcome them. The literature reveals several aids to help both employers and employees with the impacts of shiftwork. Two of the major concepts that arose were that of self-scheduling and power napping (Berger & Hobbs, 2005; Kilpatrick & Lavoie-Tremblay, 2006; Malliarou, Moustaka, & Konstantinidis, 2008). Other strategies outlined were the elimination of mandatory overtime and call-in shifts as well as doing all labour-intensive procedures on a night shift before 0400hrs after which most accidents are shown to occur (Berger & Hobbs; Blachowicz & Letizia, 2006). Finally, one last strategy that was mentioned in the literature was that of keeping the cafeteria open during nightshifts and stocking it with nutritious foods (Blachowicz & Letizia; Peate, 2007). This would encourage nightshift nurses to eat nutritiously and decrease many of the gastrointestinal and nutritional imbalances related to shiftwork.

Self-scheduling is a concept that arose in many of the reviewed studies. One of the classifications for higher worker satisfaction is a greater sense of self, and having flexibility within one's work schedule significantly enhances this feeling and thus would increase worker satisfaction (Kilpatrick & Lavoie-Tremblay, 2006; Malliarou et al., 2008). This strategy may also result in a more enjoyable work environment as well as a significant recruitment and retention factor to keep in mind for managers and employers (Kilpatrick & Lavoie-Tremblay).

Another major strategy outlined in the literature to help eliminate the negative impacts of shiftwork is that of power napping (Berger & Hobbs, 2005; Kilpatrick & Lavoie-Tremblay, 2006; Peate, 2007). Scheduled or planned napping at work can prevent accidents at work due to sleep deprivation and can help with physiological problems like headaches and fatigue (Kilpatrick & Lavoie-Tremblay, 2006). Napping, however, should not replace one's regular sleep pattern as broken sleep also has negative effects on the body. It is important that the worker get steady sleep to keep from disrupting the circadian rhythm and to benefit from the effects of each of the four stages of sleep and REM sleep (Blachowicz & Letizia, 2006).

Implications for Nurse Managers

The Nurse Manager can do much to combat the effects of shiftwork on the nurse, the family, and the organization as whole. One of the major implications for management would be the concept of scheduling. Nurse Managers need to recognize the challenges of shiftwork and the impact it can have on all levels of healthcare and thus realize that a well-designed, accommodating schedule may increase the quality of patient care as well as worker satisfaction and improve the organization as a whole (Kilpatrick & Lavoie-Tremblay, 2006)

Additionally, when scheduling, Nurse Managers should recognize the differences in forward and backward rotations and the effects that these rotations can have on a worker's sleep pattern (Berger & Hobbs, 2005). Forward rotations encourage sleep on the nurse's first day off or the morning following the last night shift, however, this day is then spent to rest and therefore may have social implications for the nurse (Berger & Hobbs). As well, providing a schedule well in advance can give the nurse opportunity to schedule social and familial events thus decreasing conflict between work and family (Blachowicz & Letizia, 2006). Backward rotations reduce the amount of sleep time overall between shift changes which consequently increases the chance of sleep disturbances and maladjustment (Berger & Hobbs). In the end, it is important for managers to consider the needs of the staff when scheduling and ask for their input. All of the reviewed literature points to the adjustment to shiftwork being far more effective if the nurse has a say in his or her own schedule (Berger & Hobbs; Blachowicz & Letizia; Choobineh, Rajaeefard, & Neghab, 2007; Hughes & Stone, 2004).

Conclusion

Though there is no definitive solution to the challenges of shiftwork, there are many steps that can be taken at both a nursing and a management level to help decrease the negative impacts caused by this type of work. One important outcome that is seen throughout the literature is the workers' opportunity to choose what types of shifts they want to work (Choobineh et al., 2007). These workers show higher incidence of work satisfaction, fewer health problems, and less interference between the employee's social and work environments (Admi, et al., 2008). This is one implication in particular that management could look at in Newfoundland and Labrador as nurses here fall far below the national standard in being able to choose their work schedules. In NL, 25% of nurses report having flexibility in their schedules compared to 38% within the rest of Canada (Shields & Wilkins, 2006). Other strategies include getting adequate rest on days off, power napping and healthier eating (Berger & Hobbs, 2005; Blachowicz & Letizia, 2006). Perhaps the most significant barrier to improving shiftwork is that of impaired communication between management and nurses. If employers improve these lines of communication, analyze the literature associated with shiftwork, and implement measures to improve the overall health of the organization, shiftwork will be much better tolerated by all parties involved. As society shifts to a more twenty-four hour culture, the demands for shiftworkers will only increase. Therefore implementing these strategies will not only enhance tolerance to shiftwork bu will also increase client safety, the workers family environment and the overall stability of the organization as a whole.


 


 


 

References

Admi, H., Tzischinsky, O., Epstien, R., Herer, P., & Lavie, P. (2008). Shift Work in Nursing: Is it Really a Risk Factor for Nurses' Health and Patients' Safety? Nursing Economics
, 26 (4), 250-257.

Berger, A., & Hobbs, B. (2005). Impact of Shift Work on the Health and Safety of Nurses and Patients. Clinical Journal of Oncology Nursing
, 10 (4), 465-471.

Blachowicz, E., & Letizia, M. (2006). The Challenges of Shift Work. Medsurg Nursing
, 15 (5), 274-279.

Choobineh, A., Rajaeefard, A., & Neghab, M. (2007). Problems Related to Shiftwork for Health Care Workers at Shiraz University of Medical Science. Health Journal
, 12 (3&4), 1-5.

Hospital Employee Health. (2008). Shift Work: Sleepless in more than Seattle. Hospital Employee Health
, 27 (9), 105-107.

Hughes, R., & Stone, P. (2004). The Perils of Shift Work. American Journal of Nursing
, 104 (9), 60-63.

Kilpatrick, K., & Lavoie-Tremblay, M. (2006). Shiftwork What Health Care Managers Need to Know. The Health Care Manager
, 25 (2), 160-166.

Malliarou, M., Moustaka, E., & Konstantinidis, T. (2008). Burnout of Nursing Personnel in a Regional University Hospital. Health Science Journal
, 2 (3), 140-152.

Muecke, S. (2005). Effects of Rotating Night Shifts: Literature Review. Journal of Advanced Nursing
, 50 (4), 433-439.

Newey, C., & Hood, B. (2004). Determinants of Shift-Work Adjustment for Nursing Staff: The Critical Experience of Partners. Journal of Professional Nursing
, 20 (3), 187-195.

Oddie, S., & Ousley, L. (2007). Assessing Burn-Out and Occupational Stressors in a Medium Secure Service. British Journal of Forensic Practice, The
, 9 (2), 32-48.

Peate, I. (2007). Strategies for Coping with Shift Work . Nursing Standard , 22 (4), 42-45.

Shields, M., & Wilkins, K. (2006). National Survey of the Work and Health of Nurses 2005: Provincial Profiles. Health Statistics Division. Ottawa, ON: Statistics Canada.

Willis, T., O'Connor, D., & Smith, L. (2008). Investigating Effort-Reward Imbalance and Work-Family Conflict in Relation to Morningness-Eveningness and Shift Work. Work & Stress, 22 (2), 125-137.

Zhao, I., & Turner, C. (2008). The Impact of Shift Work on People's Daily Health Habits and Adverse Health Outcomes. Australian Journal of Advanced Nursing
, 25 (3), 8-22.

Sunday, 8 March 2009

Who needs Cora's when you have a kitchen?


Banana pancakes. Wake up slow.

Oh, and all of you need to download the song Banana Pancakes by Jack Johnson in case you don't have it already. Best weekend song ever. It also inspired me to make banana pancakes which are fawkin hawesome.

You need them. In your belly. Now. So does Quinn.

Love!
-Adam

Friday, 6 March 2009

Jian!


JIAN AND I.

Look how surly he looks! Look how stoked I am! I promise you I got compliments on that outfit. I did not look like a cardboard box.

Best. Night. Ever.

Monday, 2 March 2009

ECMAs Recap

The ECMAs are officially done. What a weekend! Corner Brook is so exciting when it's alive with talent and funk! 

I'm far too exhausted (from volunteering nonstop the last three days and partying harder than I ever have) to make a real blog entry about it but I can tell you that:

  • There are many up and coming bands that I think are going to be huge. Keep an eye on MTQ from Nova Scotia. I don't think they'll hit it big, but they're definitely worth listening to. 
  • Ska is on the rise on the East Coast and we couldn't be more in love. 
  • Grand Theft Bus are as amazing live as they are recorded.
  • I can indeed party down. I have the capability.
  • Buses from NS are nicer than those of NL. The drivers are nicer too, or at least this one particular one was. 
  • Volunteering is incredibly rewarding. 
  • Jian Ghomeshi is as amazing in person as is on the radio. I have to elaborate a little. I have loved Jian since high school, and tonight he hosted the ECMAs. I met him at the afterparty, gushed my love, and we actually spoke for about 5 minutes. He even pretended to be genuinely interested in me. I was so impressed. Fantastic fellow. I have a photo, but it isn't uploaded yet. Will post later. 
  • I could never work for a taxi company and enjoy it. 
  • Bars are kind of fun when they're not full of techno and gross, but I still don't like going to them. The Bar room makes fries that taste like bologna. Do not want. 
  • I will stoop low to get into bars with great bands playing - Last night in order to get into Whelan's Gate we pretended we were official delegates from Australia brought by the ECMAs to check out music. It worked, we got in annnnddd we have an excellent story to tell. 
  • When I am intoxicated, I will tell you how great you are - I ran up to a girl last night to tell her that she was a fantastic singer. I told her I was first aid at her show, and she was great. Anyway, she really liked us and decided to chat for about an hour at the bar. We told her our Australian story and she died laughing. We're pretty much BFFs now. Her name is Kim Wempe. We ran into her again tonight at the afterparty, but this time SHE APPROACHED US (I know, we're famous)!  She asked us if we were Australian tonight and just chatted with us for a while. What a magnificent girl. 
Okay that's pretty much all I have to say for now. I will maybe say more later, but chances are I wont. 

Goodnight! 
-Adam 

Friday, 20 February 2009

Krysta...Snodden? Ryan...Rudofsky?

Also, it appears as though Ryan is staying with CBC... but they're also bringing back Krysta? Best of both worlds! I'm pumped. I love them both, I'm so glad CBC didn't make me choose or force me to send an email. 

Here's a link to his blog where I read he's staying. http://www.cbc.ca/nl/features/nlweather/2009/02/sticking_around.html#comments

Woot!

Sweet Dreams. 

I'm also pumped, by the way, that Krysta is coming back. I heard that she was going to give it all up, but sincerely hoped she'd be back after she delivered her child. She's coming back to CBC in June both on Here and Now and Living. I like Erin Sully too, though so maybe they can have a hosting duo like the weather? Iiiiiiiiiiiiiiiiiiiiidunno. We'll see. Exciting news, anyway. 

Death by Penguin.

I just dreamt I got shot in the heart (queue Bon Jovi) by a woman in a penguin suit while I was in the arctic searching for my parents who were at a party on ski-doo. I was really cold being in the arctic, so when I got shot in the heart by the penguin, all I could think was "mmm it feels so warm." Then I slowly died (my dream actually faded out as I fell to my icy demise), but it felt really nice... being shot in the heart by a tiny woman in a penguin suit.

What kind of screwed up brain do I have? srsly.

I am too tired to write anything of substance, but I totally could becuase a lot has happened lately. 

But it's almost 5am. I just needed  to tell someone about my dream because it was weird. 

Night, 
-Adam

Saturday, 14 February 2009

HVD!


Happy Venereal Disease Valentines Day!

I just thought I'd make a quick post to wish all of you all the best. 

Now, back to Medsurg. 


Tuesday, 10 February 2009

My second pair free


These are my other glasses. 

These are the freaky ones I told you about earlier. 

I don't really like them anymore. 

Penny for your thoughts. 



I also can't stop listening to The Littlest Birds. I think this is a sign I need to go to town. Just one more week. Just one. More. Week. 

WOO. 


Also, I passed my IV practical today. I can now give IV's to real people if need be. That's moderately exciting.