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Professional Nursing Practice

This research paper was carried out to explain the impacts of night sections on nurses in different units in John Hopkins hospital. A reasonable sample of Hopkins nurses working in different units were taken through a thorough study by use of a questionnaire that explains the impacts of late hours shift among nurses assisting in diverse units (Kelly & Joel 1999). It was found out that, lady nurses had a reasonable difference on enough sleep and interpersonal crisis. On top of that, the end result showed that, nurses face problems related to health and so their productivity is heavily impacted by night sections. Their well being was equally being put at stake by these night duties (Kelly & Joel 1999).


Working in shifts is a fact that we cannot deny. A study carried out indicates that, around 26% of American population attends night duties. There has been a growing interest on workers working in shifts because intellects have observed that, many accidents found in working places are as a result of shifts (Blais & Hayes 2006).

The ICN (International Council of Nursing) observes that, a number of health facilities are available at any given time automatically making it a must to work in shifts. The same organization has also pointed out negative effects on the health of nurses, productivity resulting to poor services (Blais & Hayes 2006).

Nurses in any given hospital have a responsibility to stay at place of work in the day and at night so as meet the need of the ailing people. Some hospital units like the intensive care unit is very straining because of the complicated nature of patient are which calls for an advanced technology (Schroeder 2004).

In addition to this, study carried out on forty nurses indicates that fifty percent of them, who left the intensive care unit in the last nine months, attributed their reasons to working at night (Schroeder 2004). The same study attempted to know the how effective it is working during day time, in the afternoon and at night on nurses. It was found out that, productivity and feeling satisfied was very little when working on shifts compared to fixed system (Cronin & Anderson 2003).

Research unravels that, there is an impact of working at night on employees, night section have a long lasting impact on human being due to health risk exposed and stresses emanating from work deteriorating health (Cronin & Anderson 2003). These impacts are closely linked with interruption of sleeping hours where a worker struggles to balance between sleeping, work and family (Cronin & Anderson 2003).

Night section can be said to be work done after 6pm and before 6am the following day. Due to that alteration, the temperature of the body is compromised alongside other rhythms (Kelly & Joel 1999). Given that the body gets used to only one shift either daytime or at night, any attempts to change that leads to health problems. Impact in this case, is transition experienced in health, psychological and social matters of health attendants working at night sections (Kelly & Joel 1999).

John Hopkins is a health institution situated in Baltimore, United States. It has over a thousand beds and over fifty units dealing with different cases related to health matters. The nurses work in three shifts in the morning, middle of the night and evening (Kelly & Joel 1999). The morning and evening sections carry seven hours each while the night section assumes ten hours. The nurses in this hospital work on rotation bases and so they are exposed to all the risks mentioned above (Kelly & Joel 1999).


The main objective of the research is to explain the impacts of night sections on health attendants and then evaluate the effects on health on nurses, having in mind to present a workable recommendation to reduce stress brought by working situations and improve good care on the sick.


Latest research can assist the nurses and those in management to know existing impacts of night sections on hospital attendants, effects on their life and productivity (Cronin & Anderson 2003). The research will aid the supervisor by offering way out on what actions to take to prevent health attendants from stress related to this career that when caused by working at night leads to many shifting career. On the side of the nurses, it acts as an eye opener so that they are in a position to deal with the situation in future. The knowledge gained after research can be used on yet another study which may be clinical related among others (Cronin & Anderson 2003).

Literature Review

Blais & Hayes observe that, much attention has been paid to impact of night section on the entire life of individuals, more so nursing as a career has had lot of studies to explain the impacts of their working on their life in many perspectives (Blais & Hayes 2006). In their book Professional nursing practice, he argues that, problem arise because human being is supposed to work during the day (Blais & Hayes 2006). If an individual works at night, it comes with a number of challenges arising. Due to this, the problems which affect workers in most cases also create an impact on the productivity and therefore the quality is compromised.

Research previously done indicate that, physically and socially, night duties can have impacts on nurses in terms of health and security. The most affected are the lady nurses who find it very difficult to balance attention on the work and families. It is difficult when they are pregnant and when the kid is still growing.

In yet another observation made by Schroeder, he says that, those who attend night duties have been found more prone to accidents than those who work during the day (Schroeder 2004). In his book Public & community health nursing practice, he says that, the findings on this have been compromised given that the conditions of carrying out responsibilities are just the same and nothing changes at any given section (Schroeder 2004). The amount of work to be done and the support system in the offing is just the same and therefore no difference. However, studies previously done indicate that, relative performance based on the concentration of the mind comes between 2-4pm, total concentration lies between 1-7pm and very poor concentration towards morning (Schroeder 2004).

Ellis & Hartley, basing their argument on a study carried out in Japan on employees shows that, nurses who work on rotation basis had fatigue related problems and this was on the higher side on those who work at night, then evening and finally evening (Ellis & Hartley 2004). In their text Nursing in today's world they observe that, the night section workers showed signs of sadness, little concentration, sadness and problems in relationship (Ellis & Hartley 2004). In a separate study in Germany, it was indicated that, fatigue does not emanate from either working during the day or at night; it is attributed to quick change of responsibilities. They went ahead to unravel that, being exposed to light for quite some time especially at night can contribute to a lady nurse contracting breast cancer to estimates of 60%.

Finkelman and Kenner deduce that, the amount of sleep an individual gets has a very big impact on the overall health, delivery at place of work alongside concentration (Finkelman & Kenner 1998). In their text Critical care nursing, the two observes that ailments like hypertension, diabetes and depression are brought by lack of rest for prolonged period (Finkelman & Kenner 1998). Medical experts advise that, grown ups should ensure that they rest for eight hours every night so as not to put their health at stake.

Research methods

This study design is descriptive in that it explains the phenomenon as it is being seen at that particular time. The system applies practical ideas; it is affordable and easy to operate. It is meant to explain the impact of night section on nurses (Kelly & Joel 1999). The research population comprises of nurses in the different units at john Hopkins hospital. For the sample a total of 150 nurses were taken from different two from each unit. This is very convenient and quick compared to other samples (Kelly & Joel 1999).

Data Collection and Instrument

Taking part in the research is voluntary and depends on the nurse willingness to provide good information. All the information collected will be kept discreet and no access by unauthorized persons (Kelly & Joel 1999). Any nurse who wishes to discard the questionnaire can do it at will. To research the impacts of night section on hospital attendants a questionnaire was designed (Kelly & Joel 1999).

The information was collected for a period of four weeks; the nurses were divided into two groups. The questionnaire were given out in four shifts and later collected from the nurses after they had finished (Kelly & Joel 1999).

Results and findings

One hundred and fifty questionnaires were given out to the nurses in john Hopkins hospital. The response was 100%. The highest number of those who responded were not married (72%) and within the age bracket of 23 and 30 years (Maurer & Smith 2005). The lady nurses were the leading with 57% and men took 44%. Men in most cases preferred to work during the day whether they have families or not (Finkelman & Kenner 1998). This might be attributed to the fact that most of them wanted to be with people close to them night. Unlike their unmarried counterparts married men saw working at night as very tedious (Finkelman & Kenner 1998). Those not yet married said being on duty at night was not tedious as one had energy to carry out responsibilities although one still did not sleep. Although men were complaining, their health remained intact. They only cried foul about ailing feet. The studies showed this was brought about by to much standing in surgery chambers (Kelly & Joel 1999).

Challenges emanate from crisis in relationships. The status of a nurse in the society can make him or her prefer taking night duties. Working at night does not give somebody time to enjoy with the family (Kelly & Joel 1999). The results indicated that 95% complained that their life is affected socially while 5% had no issues. Most of the hospital attendants felt that, the ten hours allocated for night sections is very high and so the need for reduction of the same. On the same note, 80% felt that there is a lot of work at night compared with the day section (Kelly & Joel 1999).


Research indicates all persons regardless of age are exposed to health risks which come with night sections as shown above. The latest improvements in relation to shifts are geared toward development of employee’s health (Maurer & Smith 2005). This is being pushed by international labor office (ILO). Given there is no perfect arrangement, employer should promise their workers a safe working place with no health risks where one can work for long (Maurer & Smith 2005).


Going by the findings in the research, hospital attendants should be subjected to frequent medical check up. Another recommendation is that, employees must provide nurse with options when they feel comfortable to work (Maurer & Smith 2005). The changing from night to day time should be systematic. When a nurse is allowed to have a say when she or he deems suitable it will be a kind of motivation. The management should provide a comfortable place of work complete with good furniture to allow one to rest anytime one feels worn out. There should be a canteen for a soft drink and some soft music to relax the tired brain (Maurer & Smith 2005). 

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