Night shift nurses exposed to bright light made fewer errors, felt less tired: McGill study

Nurses who spent less than an hour exposed to bright light before they started their night shift at a hospital reported feeling less tired and making fewer mistakes on the job, according to a new study from McGill University. 

The researchers suggest this small intervention could make a significant difference in the lives of nurses and patients and perhaps among other shift workers since it's known that shift work can cause "sleep trouble" and "cognitive impairments."

"Nurses receive basically no training on practical fatigue management," said senior author Jay Olson, who completed his Ph.D. at McGill, but who is now at the University of Toronto.

The team wanted to come up with a feasible tool that could be used in a hospital setting -- in a breakroom, for example -- or by the nurses themselves at home before they head to work.

Nurses who took part and used the light therapy as directed reported that "they felt completely refreshed," and "like a new person and a better colleague," Olson said in an interview with CTV News.

"It was kind of surprising that the effects are so large."

And the study is especially pertinent now since nurses in Quebec's health-care network are being pressured and overworked like never before as they fill in for absent colleagues.

SHINE A LIGHT

Researchers enrolled nearly 60 nurses from the McGill University Health Centre (MUHC) in the randomized, controlled trial. They were all working rotating day/night shifts at the time.

For 40 minutes before their night shift they were asked to sit before a portable light box or lamp, similar to the type of light therapy lamp patients use as a treatment for seasonal affective disorder (SAD).

During an initial 10-day period before the light therapy began, nurses in the experimental group made 21 errors. Some mistakes were described as minor because they didn't have a large effect or they could be corrected.

Some errors however were more consequential: a patient received the wrong dose of medication, another who needed to be supervised wandered off, and one patient went into respiratory distress, according to Olson.

However, after being exposed to the bright light before starting their shift the same nurses made only seven errors, a reduction of 67 per cent.

In contrast, the nurses in the control group who tried to modify their alertness by changing their diet only reduced the number of medical errors by five per cent.

The researchers also learned from the nurses who used the evening light intervention that they had "larger improvements in fatigue." Likewise, nurses who expressed that they felt more tired made more mistakes at work.

This study, published on April 18 in the journal Sleep Health, replicates the findings of an earlier study conducted during the pandemic.

Olson said they hope to continue to study the effect on a broader scale but also want to get the word out that exposing oneself to light in the evening before a night shift might be a cost-effective and simple way to improve performance and reduce fatigue.

The researchers are also conducting workshops on practical fatigue management at hospitals and have launched a website called Night Shift Owl, with guidance that shift workers can adapt to their own schedules.