March 9, 2018

Daylight Saving Time 2018 - Tips For Night Shift Nurses

Daylight Saving Time 2018 - Tips For Night Shift Nurses

Ahh, Daylight Saving Time (DST). That time of year when sleep-deprived nurses get one more wrench thrown into their already busy lives.

Often incorrectly referred to as Daylight Savings Time, this seemingly minor adjustment can interrupt our circadian rhythms, confuse our charting, complicate our medication administration, and just mess with our workdays.

It’s amazing really, what a difference an hour makes.

When is Daylight Saving Time?

DST in the United States begins at 2:00 am on the second Sunday of March and ends on the first Sunday of November at 2:00 am. 

That means that Daylight Saving Time 2018 begins on March 11 and ends on November 4th.

Here’s the DST schedule for the next five years: 

Year Start End
2017 March 12 November 5
2018 March 11 November 4
2019 March 10 November 3
2020 March 8 November 1
2021 March 14 November 7
2022 March 13 November 6

DST is controversial though, and several states have pending legislation to eliminate it or do not observe it all. Arizona (except for the Navajo Nation) and Hawaii do not observe DST and California, Nevada, and Washington all have pending legislation to either adopt it year long or eliminate it.

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Night Shift Nurses And The Time Change

Interestingly, although we’ve had DST for decades, there still doesn’t seem to be a consensus on exactly how to handle it at hospitals.  And for night shift nurses, the change can be very disruptive to their lives and patient care.

Shifts and Pay

Private hospitals, especially for-profit hospitals tend to err on the side of whatever’s most convenient for them. The schedules stay the same, so a NOC shift nurse normally scheduled for 7 pm - 7 am would simply be paid one hour less during the spring and one hour more in the fall with the administration claiming ‘it all evens out.’

And it does even out. As long as you work both those nights.

Other hospitals take a more reasonable approach and pay nurses for the actual number of hours worked, so 11 hours in the spring and 13 hours in the fall. Another popular option is to keep the pay the same but allow the nurses to leave an hour early or ask them to stay for an extra hour. 

If you’re part of a nursing labor union, you may be paid the full 12 hours in the spring and then 13 hours in the fall.

Charting and Rounds

Charting is an interesting subject when it comes to DST.  The problem is not so much with the nurses being confused, it’s the computer system’s inability to understand what it means. 

Most modern charting systems have DST built in, but some older systems simply shut down during that time period while the system is reset with the ‘new’ time. One user on a popular nursing forum describes what happens at their hospital:

From 145 “old” time to 3 “old” time - the computer charting system just went down completely. Couldn’t chart meds, enter vitals, put in new orders - nothing. Then at 0300 “old time,” it came back on and you could only chart starting then, saying it was “0200” “new time”.

One of our rooms had a patient that was crashing and burning HARD and the system just crippled everything. Such a mess!

Another user offers a simple way of dealing with the actual documentation:

This is not nearly as complicated as it might seem.

From 0100 (pre-DST switch) to 0300 (post-DST switch) I simply chart as follows:

“documentation verbiage” 11/6/2011 0130 EST

“documentation verbiage” 11/6/2011 0110 DST

For nurses using 15-minute rounding sheets, documenting can become messy as well with 4 additional entries needing to be added to the margin.

There are other considerations as well. IV fluids aren’t such an issue since it’s okay for a patient to have an extra hour of fluids, but NICU nurses must adjust feeding times because frankly, babies don’t care about Daylight Saving Time.

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Tips for Making a Smooth Transition

While it seems that night-shift nurses wouldn’t struggle with the normal sleep issues surrounding DST, that extra hour still interrupts your circadian rhythm or internal clock, leaving you feeling groggy and irritable. 

To ease this transition for the upcoming ‘fall back’, you may want to try going to 10-15 minutes later every day or two leading up to the change. Adjusting your eating schedule slowly can also help along with minor, incremental adjustments to your other routine activities.  

Most sleep experts agree that you should stay out of your bedroom until bedtime.

Why We Have DST

You can thank Ben Franklin for coming up with the concept way back in 1784 as a money-saving measure when candle use was the only lighting option and an expensive one at that.  He argued that rising with the sun and going to bed earlier at night would allow everyone to make use of free morning daylight. 

Since then DST has gone through several iterations resulting in a colorful history that affects international relations, creates nested time zones, and influences your health. National Geographic has covered this subject extensively and the articles are worth a read.

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