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Boosting wellness on the 'graveyard shift'
Hospital maps out walking program
There's a reason the night shift is dubbed "the graveyard shift." Working overnight has been linked to a greater risk of cancer, heart disease, depression, and automobile accidents. That is why Albemarle Hospital in Elizabeth City, NC, has focused wellness efforts on this often-forgotten group of employees.
"When I learned about the risks [specific to night shift workers], I thought at the very least we need to educate them," says Barbara McCarthy, RN, BSN, COHN, occupational health manager, who is scheduled to bring her message to the annual conference of the American Association of Occupational Health Nurses.
Night shift health tips
A wellness program geared toward night workers doesn't have to be expensive, she says. "There are little things that can be done that really contribute to their health," she says.
Albemarle currently offers regular health screenings (blood pressure, blood sugar, and body fat) from 8:30 a.m. to 9:30 a.m., which means night workers have to overstay their shift to participate. McCarthy is planning to add screening from 10 p.m. to 11 p.m., which will be conducted by night-shift nurses who are champions of wellness.
The hospital's fitness center, located in a nearby YMCA, isn't open at night, but McCarthy has measured and mapped out walking routes. During their breaks, night-shift employees can walk a loop on the first floor (one-eighth of a mile) or the perimeter of the hospital (one-quarter mile).
Night-shift teams also participate in the hospital's wellness competitions. "The Biggest Loser," modeled after the television reality show, rewards the team that loses the greatest percentage of its weight. "Maintain, Don't Gain" encourages employees to try nutritious recipes during the holidays from November to January. Winning recipes are collected into a cookbook.
The recipes also inspired further initiatives. Since the cafeteria has limited offerings during the middle of the night, McCarthy encourages night staff to bring nutritious potluck meals to share on their shift.
Night work raises health risks
Before you can expect night shift workers to take advantage of wellness programs, you need to educate them about the risks of their overnight duty, says McCarthy.
For example, the International Agency for Research on Cancer (IARC), a World Health Organization agency based in Lyon, France, has designated working the night shift as a "probable" carcinogen. An analysis of studies showed that women working the night shift may have a 30% to 80% increase in relative risk of breast cancer, which makes night shift work a potentially greater risk of cancer than secondhand smoke, according to a monograph published by the agency.1
Disruption of the circadian rhythm causes problems, notes McCarthy, but there are lifestyle issues as well. "They get less sleep. People who work traditional day shifts will get between five and eight hours. People who work the night shift get three to five hours a day because they try to live a daytime life," she says. "You can't catch up. Ultimately, you're going to have sleep deprivation."
Meanwhile, night workers aren't as likely to engage in fitness, she says. "Many people work shift work because they have other commitments during the day. They're working the shift because it's the only option open to them in their lives. It really makes it very challenging," she says.
McCarthy is developing wellness presentations for the night shift workers and provides recordings of the daytime wellness programs that the night workers can view in the lounge during their breaks.
The night shift also has been encouraged to participate in "Get Fit Now," which targets employees with at least two comorbidities: Obesity, smoking, high blood pressure, diabetes, and arthritis.
McCarthy and her wellness coordinator function as coaches to help employees reach goals such as smoking cessation. She also uses other in-house resources, such as the diabetes educator and nutritionists. The hospital purchased health risk assessment software as a part of the program.
"It doesn't have to be expensive [to conduct wellness programs]," she says. "You just have to be creative."
(Editor's note: The 2009 AAOHN Symposium & Expo will be held in Orlando April 17-23. More information is available at www.aaohn.org.)
1. Straif K, Baan R, Grosse Y, et al. Carcinogenicity of shift-work, painting and fire-fighting. Lancet Oncol 2007; 8:1,065-1,066. Available at www.thelancet.com/journals/lanonc.