In the hospital business, we understand that–patients need care around the clock and the building needs to operate continuously. When you’re open 24 hours a day, 365 days a year, a circadian rhythm is about as useful as a bat at noon.

According to information gathered by the U.S. Bureau of Labor Statistics, between 1991 and 1997, there was a 17 percent increase in the total number of people working evenings or nights, representing all types of work environments, not just health care. Three million Americans work the graveyard shift (a period of work in which half or more of the hours worked are between midnight and 8 a.m.), and another four million work evening shifts (a period of work in which half or more of the hours worked are between 4 p.m. and midnight).

Barb Immermann, RN, staff nurse in the Medical Surgical I, Behavioral Health Services, Chemical Dependency, has worked nights at UI Hospitals and Clinics for 27 years.

"I met Sally Mathis Hartwig, the former director of nurses at Oakdale, at one of our neighborhood parties, and I told her that I was a nurse who enjoyed caring for patients with alcoholism," Immermann said. "She later interviewed me and asked if I would commit to working nights for one year. I said yes, and here I am, still working nights today."

For Immermann, as for many other people who work during the night, this shift allowed her to take care of her five children during the day. "I could attend all of my children’s school events held in the evenings and could go to all the teachers’ conferences. I could also go to classes myself, and finally got my degree in 1990," Immermann said.

During most of her tenure, the chemical dependency and tuberculosis inpatient units were housed at Oakdale. "It was a great place–you could see cows and occasionally deer out the windows. The patients could go outside and walk," Immermann said. "Some of the nurses said there were ghosts. I think it was because so many sad deaths occurred there with TB patients. But being an old building, there were definitely noises."

Night shift workers enjoy the benefit of less commotion in the hospital, but there are drawbacks. "The rest of the world has a different schedule," Immermann said. "And mandatory things are always occurring during my sleep time–never at 2 in the morning."

Sleep deprivation is a key issue. Some experts call it "shift lag"–a number of physical and emotional symptoms ranging from fatigue and irritability to constipation and forgetfulness that night workers may experience. For more information on techniques for minimizing shift lag, read the story on page 6 in this issue of Compass.

Approximate number of night shift employees