Monday, June 06, 2005

Lunch? What Lunch?

Skipping meals or breaks may contribute to nurse burnout and jeopardize nurses' health

A new study suggests that nurses are regularly sacrificing their breaks and meal periods to provide patient care. The researchers found that nurses took a break or ate a meal free of patient care responsibilities in less than half (47 percent) of the shifts they worked over a 1-month period. During the remaining shifts, they either worked nonstop throughout the entire shift (10 percent of shifts) or were able to sit down for only a short period, while remaining responsible for patient care activities during their breaks or meals (43 percent of shifts).

Nurses who were unable to take a break made no more errors than those who were able to take a break. However, staffing levels so low that nurses feel they must work nonstop to meet the needs of their patients may contribute to burnout and nurses leaving the profession, and it may jeopardize their health, says Ann E. Rogers, Ph.D., R.N., F.A.A.N., of the University of Pennsylvania. In a study that was supported by the Agency for Healthcare Research and Quality (HS11963), Dr. Rogers and her colleagues analyzed the breaks of 393 registered nurses (RNs) who worked full time as hospital staff nurses. The nurses completed logbooks for 28 days on their work hours, errors or near-errors, episodes of drowsiness and actual sleep on duty, duration of breaks taken during each shift, and whether they were relieved of patient care responsibilities during their meals and/or breaks.

Although nearly 40 percent of the shifts exceeded 12 hours, nurses working longer shifts were no more likely to be able to take a break than nurses working shorter shifts. There were 189 errors (most of them medication errors) reported by 30 percent of the nurses during the 28-day period. Although the absence of a break did not increase the risk of making an error, longer breaks appear to offer some protection against making errors. Breaks averaged 23.8 minutes on shifts without errors, whereas breaks averaged only 16.2 minutes on shifts when errors occurred. Also, nurses had 10 percent less risk of making at least one error when they had an additional 10 minutes for their breaks and meals.

See "The effects of work breaks on staff nurse performance," by Dr. Rogers, Wei-Ting Hwang, Ph.D., and Linda D. Scott, Ph.D., R.N., in the November 2004 Journal of Nursing Administration 34(11), pp. 512-519.
Posted by HypnoKitten at 1:06 PM

Blogger may, at 2:10 PM  

i used to work a 12 hour AM shift. lunch is always between 3-5 pm, sometimes taken in the unit while catching up with charting. i guess the adrenalin just keeps pumping, you don't notice the time.
wow...pinning time!

Blogger Desiree, at 3:22 PM  

We do have a job where meal breaks are not on a scheduled time, are rushed and then too we do work long hours. I have known many nurses over the years with various bowel problems - that I have no doubt come from our erratic and often rushed eating habits.

Blogger mamalife, at 6:00 PM  

Interesting... as a nurse I've never known a true meal break... when I worked in the hospital (11p-7a) our supervisor told us we were NOT allowed to leave the unit for a meal break, if we ate we were to remain on the unit to answer call lights/take care of patients (and this supervisor could be found WHERE most of the shift... outside smoking, thank-you-very-much ... she was finally fired) ... in on office setting we always manage to eat, but it is often that patients run over into or sometimes even straight through lunch. Just the nature of it all I suppose!

Blogger Student Nurse, at 6:04 PM  

Thanks for the frequent, thoughtfull comments to my site, they really make blogging worthwhile. You had written about my brother with CP:

"Aren't you able to have medicaid pay for a caregiver to come once or twice a week so you can get a break? I thought they did that. I really don't know and have no experience, though. There must be some help for you guys."

Actually yes, the state does offer a goodly number of relief hours. However, my mother is a bit old fashioned and somewhat private- she wants to keep things "in the family" and feels like a failure as a mother if she can't provide all of the care for my brother. Maybe if he grows bigger she will be forced to hire someone to lift him.

Happy Blogging!

Student Nurse

Blogger Third Degree Nurse, at 6:55 PM  

Thanks for the terrific nursing school links. If you ever drop this blog, please let me know so I can copy your quiz/disease links. Right now I'd rather get to your site to use them than copy them to mine.

Blogger Andrea Prados, at 11:14 AM  

Thanks for your comments on my blog; I'm new to blogging, so I can use the encouragement. Interesting study about the lack of meal breaks for nurses. When I first started in the ED, nobody took breaks; we have changed that now and it's rare that we don't. Much more civilized and conducive to working 12 hours.

Blogger HypnoKitten, at 11:50 PM  

May: Some days I've noticed that things are just zooming along and I have no need for a defined break - others, definately gotta have it. And coffee. Lotsa coffee.

Desiree: Bowel problems! OMG I'll have to watch out for that. Lovely - and I thought the worst I could get was a UTI from not getting to go to the restroom often enough. :P Yuk.

Mamalife: As I keep saying, I'm new to this - but isn't that illegal? Dang, I'm glad she's out of there. It's one thing to miss lunch, but having a policy that you can't leave on your break is like being in prison.

Student Nurse: You're welcome - thats what community is all about. Make sure you share the love and comment on other blogs to give them encouragement too! :) And you can feel free to answer me over in your blog's comments, because I'll usually go to a blog a few times a week to see if there is a new posting or some response to my comment, so I'll get it there too.

Third Degree Nurse: I don't think I'll stop blogging anytime soon... heh heh. I'm going to add more as soon as I get some time. Thanks for the encouragement.

Andrea: Yeah, I'd have a real hard time working regular 12s without breaks. When I was working in the ER, they made sure everyone got one (There is a sign up sheet, and they follow it pretty closely). But I work in a pretty cool place. Keep on posting and visiting others and you'll see your blog grow! :)

Blogger beajerry, at 9:12 AM  

Interesting info!
I work 12hr shifts myself and usually never take a break, though I know I should.
I eat on the run.

Blogger mamalife, at 6:27 PM  

Illegal, yes, definitely illegal... but... to complain would mean to suffer/lose job, whatever... one nurse did complain... the supervisor made her suffer... sometimes we put up with shit because we need the paycheck. Like I said, this supervisor was fired. A bit after this I decided I was tired of the shit and left... I am now very lucky to have a job I truly, truly love.

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