Research into the quality of life of nurses working at night has received scant attention to date. Apart from studies relating to changes in circadian rhythms of night nurses, very few other aspects of the complex adaptive process have been given serious consideration. Yet, knowledge of that adaptive process is a prerequisite for the selection of staff, and for the design of an appropriate educational programme and staff development strategy. This study looks first at methods of describing the quality of life in general, in order to aim at criteria for evaluation which do not impose the conventional position that day work is proper work. In the light of these criteria, preconceptions and limitations which surround shift work in general are identified and discussed. Night nurses as a group are then subjected to a more intensive examination, including a theoretical review; a survey of a population of one-hundred and sixty-one night nurses and selected interviews; and an account of a pilot study of a potential curriculum. Results of the survey indicate that nurses who show a preference for night work and who selfselect these hours on a permanent basis are more likely to derive challenge from and express greater satisfaction with their work, than those on alternative day and night shifts. Further, there is a stable population of workers who choose night work above all other options as a source of personal satisfaction, freedom and challenge. In the light of these findings, recommendations are made as to the selection, education and development of hospital night staff.

Nurses are largely unaware of the problems of night-shift-nurse sleepiness and available strategies to manage night-shift sleepiness. The purpose of this project was to examine nurses' self-perception, awareness of sleepiness, and current strategies to manage this problem in the emergency medicine department of a major academic hospital in the western United States. The validated de-identified Karolinska Sleepiness Scale (KSS) was used to measure the prevalence and intensity of night shift nurses' sleepiness prior to the development of an educational program on strategies to manage sleepiness. Of the 164 registered nurses surveyed, 72 (43.9%) reported sleepiness greater than 7 on the KSS. An educational program was developed and evaluated by a panel of 6 experts who were selected on their clinical, educational, quality improvement, and research in sleep studies. Expert reviews indicated that the education program was 100% relevant, appropriate, and understandable, and provided adequate information on the topic with no recommended changes. The education program was presented to 16 night shift nurses with a pre/posttest survey completed by 14 nurses. Results indicated that participating nurses increased their knowledge of managing strategies for sleepiness from 69% (agree or strongly agree) preintervention to 92% postintervention. Postintervention, there was a 50% increase in the number of nurses who reported benefits from the education intervention. The findings of this project contribute to positive social change by improving nurses' health and quality patient care by advancing nurses' awareness of night shift sleepiness and countermeasure management strategies.