Date of Award

2013

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Advisor

Marlene Dufault

Abstract

Aim: The aim of this study was to obtain descriptions of nurses’ perceptions and experiences of falling asleep behind the wheel on the drive home after a worked night shift.

Background: While the evidence suggests that the problem of drowsy driving and fall asleep driving is a strong contributor to vehicular accidents, little is known about nursing perceptions of the issue.

Methods: The design of the study is qualitative and descriptive. Face-to-face interviews were conducted with 12 registered nurses who had experienced falling asleep behind the wheel on the drive home from work after a worked night shift. The interviews were transcribed verbatim and analyzed using content analysis.

Results: The eight themes which emerged from the data evolved from factors identified by the participants during the interviews. They were: (1.) night shifts better for new grads, (2.) auto-pilot, (3.) struggling to stay awake, (4.) it’s scary, (5.) just need to get home, (6.) not a night person, (7.) feeling awful, and (8.) don’t know how to fix it.

Conclusion:This study strongly suggests the need for additional research. Because we know that drowsy and fall asleep driving after a worked night shift is a ubiquitous phenomenon among night nurses, the need to develop interventions to mitigate the risks of the phenomenon was confirmed. The findings emphasize the importance of open dialogue and heightened awareness of the dangers faced by the nurses when they have finished their shift and are driving home. Understanding the context of nurses’ experiences with falling asleep behind the wheel may elicit stronger communications between nurses and their nursing leaders. Targeted education on sleep hygiene, drowsy driving, and fall asleep driving for nurses, nursing leaders, and hospital administrators may serve to open the dialogue. Negative physiologic and psychological influences of night shift centered around poor quality and quantity of sleep. These negative influences were consistently presented by all participants. The nurses’ beliefs that they are physically unable to adapt to shiftwork warrants further research into screening for physiological and psychological ability to engage in shiftwork. Further studies are needed to explore the efficacy of restorative napping, and other interventions to prevent drowsy and fall asleep driving. Many participants expressed the fact that they had little to no choice but to work the night shift as new graduates. We need to closely examine why the newest members of the nursing profession are placed on the shift with the least amount of resources. The phenomenon of fall asleep driving after a worked night shift environment in nursing is poorly understood. The goal of this qualitative descriptive study was to elicit a description of the experience of night shift nurses with the goal of obtaining information that would serve to find ways to eliminate the occurrence of drowsy/fall asleep driving in nurse shiftworkers. Nursing and hospital administrators may be able to utilize the information gleaned from this study to optimize the nurse scheduling, implement evidence based interventions, and subsequently, keep the nurses safe.

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