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Skipping meals or breaks may contribute to nurse burnout and jeopardize nurses' health

A new study suggests that nurses are regularly sacrificing their breaks and meal periods to provide patient care. The researchers found that nurses took a break or ate a meal free of patient care responsibilities in less than half (47 percent) of the shifts they worked over a 1-month period. During the remaining shifts, they either worked nonstop throughout the entire shift (10 percent of shifts) or were able to sit down for only a short period, while remaining responsible for patient care activities during their breaks or meals (43 percent of shifts).

Nurses who were unable to take a break made no more errors than those who were able to take a break. However, staffing levels so low that nurses feel they must work nonstop to meet the needs of their patients may contribute to burnout and nurses leaving the profession, and it may jeopardize their health, says Ann E. Rogers, Ph.D., R.N., F.A.A.N., of the University of Pennsylvania. In a study that was supported by the Agency for Healthcare Research and Quality (HS11963), Dr. Rogers and her colleagues analyzed the breaks of 393 registered nurses (RNs) who worked full time as hospital staff nurses. The nurses completed logbooks for 28 days on their work hours, errors or near-errors, episodes of drowsiness and actual sleep on duty, duration of breaks taken during each shift, and whether they were relieved of patient care responsibilities during their meals and/or breaks.

Although nearly 40 percent of the shifts exceeded 12 hours, nurses working longer shifts were no more likely to be able to take a break than nurses working shorter shifts. There were 189 errors (most of them medication errors) reported by 30 percent of the nurses during the 28-day period. Although the absence of a break did not increase the risk of making an error, longer breaks appear to offer some protection against making errors. Breaks averaged 23.8 minutes on shifts without errors, whereas breaks averaged only 16.2 minutes on shifts when errors occurred. Also, nurses had 10 percent less risk of making at least one error when they had an additional 10 minutes for their breaks and meals.

See "The effects of work breaks on staff nurse performance," by Dr. Rogers, Wei-Ting Hwang, Ph.D., and Linda D. Scott, Ph.D., R.N., in the November 2004 Journal of Nursing Administration 34(11), pp. 512-519.

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