The Impact of Night and Shiftwork On The Health of Nurses In Six Khartoum Teaching and Private Hospitals

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Shift and night work are well recognized risk factors for health and wellbeing. Rotating shifts are blamed for disturbance of circadian rhythm which can result in an increased risk of accidents and injuries. Night work and extended work schedules are common in nursing. This may present challenges to the well-being of nurses, their families, and their patients. Female nurses also suffer problems related to their physical nature and domestic responsibilities. In Sudan, the working conditions are aggravated by familial and social obligations and hot uncomfortable environmental conditions. Long commutes may also add to the stress. The general objective of this study is to assess the impact of night and shift-work on the health and well-being of female nurses in selected Khartoum hospitals. This cross-sectional study was conducted in four teaching hospitals in addition to two private hospitals. A total of 310 nurses filled the Standard Shiftwork Index (SSI) questionnaire developed by the International Shiftwork Research Team. The nurses’ working environment was assessed for heat, noise and light levels using instrument availed by the Occupational Health Department. The results of light measurements showed that all values did not reach the minimum limit value of the international standards (IES and WBG). Results of heat measurements in some units especially the Nurseries were found to be high which may lead to heat stress. Heat Stress Index (HSI) values in the selected hospitals were affected by the ventilation system. All noise measurements were found to be ranging between 45 and 74dB (A) while the standard, according to the World Bank Group for hospitals, is 30 to 40 dB (A). Results of questionnaire analysis showed that more than half (56.8 %) of the study participants work morning shifts (M) only, 28 % work afternoon night (AN) shift (16 hrs) and 10.8 % work both shifts (M+AN). About 40 % of the participants work in night shifts. However, results showed that 20% were night-active individuals according to the questionnaire. About 76 % of the participants were in the age group (18 -30 yrs). The mood and performance of this age group is more prone to the adverse effect of insufficient sleep. Some nurses spend up to 6 hours in transportation to and from work. The results strongly support what has been found in previous studies that shift work, especially night work and long working hours, have pronounced effects on the sleep quality and amount. Shift work caused health disturbance which can be explained by the use of many drugs for prolonged periods. The medications taken may include antacids, laxatives, vitamins and pain killers. The percentage of participants having regular menstruation dropped to almost half after shiftwork. Shiftwork had badly affected 50% of the participants in their performance, and over 80% in their sleep, social life and domestic life. This study clearly indicates that nursing managers, administrators, and policymakers should guarantee sufficient sleep for the nurses in order not to put their health and their patients’ health at risk. Also, there is great need for further studies so as to improve the working conditions and performance of health workers, especially nurses
Work Environment, Khartoum, Circadian rhythm, Ergonomics, Chronobiology, Heat Stress, Noise, Light.