Sleep management experiences of shift-working nurses: A grounded theory study

Abstract

Background: Sleep management is considered as the most challenging issue for shift-working nurses. However, there is little knowledge on how they deal with the problem of insomnia caused by the shift work in the real context. Methods: We used one-to-one, in-depth interviews for data collection and constant comparative analysis approach and memo writing for data analysis based on grounded theory that exploring 18 shift-working nurses' experiences of sleep management. Finding: The data revealed that mental tensions of a caring environment, inappropriate scheduling of shifts, inappropriate environmental conditions, and inadequate support and companionship of managers, as contextual factors, cause a sense of sleep adequacy dissatisfaction in nurses, which is the main concern about shift work. Nurses used compensatory sleeping, gradual coping, medication use, adjustment to and preparation of environmental conditions, and use of stimulant drinks as coping strategies to deal with the main concern. Despite the use of these strategies and due to their inefficiency, psychological burden, gradual physical burnout, clinical inefficiency, and unresolved sleep adequacy dissatisfaction remain as the most important negative consequences (as injury) for shift-working nurses. Therefore, shift-working nurses manage their sleep in a gradual and passive coping along with the injury . Conclusion: Shift-working nurses need to actively manage and adapt to their condition (shift work without injury); however, they try to cope with this condition passively by trial and error. Both nurses and their managers need to learn and develop strategies to help nurses effectively encounter and deal with insomnia caused by shift work.