Time lost: Factors influencing advanced practice provider's prioritization of sleep.
Beverly M Hittle, Gordon L Gillespie, Holly J Jones and 1 others
PMID 33612510WHAT IT FOUND
Nine emergency care providers described sacrificing sleep to maintain social connections and meet work demands.
They cited irregular shift rotations, family obligations, and a culture of invincibility as primary barriers. Napping policies existed but were often ignored due to personal guilt or lack of private space.
Key findings
01Providers prioritized sleep around irregular work hours, often sacrificing it to maintain connections with family and friends during daytime hours.
02Organizational policies allowed napping, but providers frequently did not use them due to a sense of duty, discomfort, or lack of suitable space.
03Providers were largely unaware of national guidelines or position statements regarding sleep and shift work, and did not view sleepiness as a factor in error analyses.
STILL TO COME
How it was doneWhat they found
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What it does not show
The sample size was very small (nine providers), limiting generalizability. All participants were female, and none reported Hispanic or Latino ethnicity, restricting the diversity of perspectives. Covert observations were limited by space and participant schedules, meaning some behaviors like napping may not have been observed. Self-reported data on errors and fatigue may be underreported due to fear of professional repercussions. Recruitment failed to include scheduling and human resources staff, who might have offered different perspectives on policy implementation.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret these themes as evidence that current sleep hygiene interventions fail. This study describes the cultural and structural barriers to sleep in one specific emergency care setting. It does not test any intervention, so it cannot tell you what will work to improve provider sleep or patient safety.