The hospital is quiet in the middle of the night. Its linoleum hallways are hushed and darkened so that the patients can sleep. But in the critical-care unit, fluorescent lights blaze, as registered nurse Jill Coltrain and five other RNs work at a fevered pace. Surrounded by a bank of monitors that guard heartbeats, blood pressure and brain activity, the nurses move through a sea of I.V. poles. One checks the four intravenous tubes dripping fluids into a man recovering from open-heart surgery. Another nurse inspects a woman who’s hooked up to a ventilator. A third RN sponge-bathes her patient and dispenses medication, readying him for sleep.
The nurses have been on duty since 7 p.m. They’ll leave work at 7 a.m. That is, unless something goes wrong. In a critical-care unit, a nurse’s life rarely is predictable. For any of a number of reasons—a patient goes into cardiac arrest, the unit is short-staffed, or there’s a death—Coltrain may not leave work on time. She might not get home and into bed until 10:30 a.m. Frequently, she needs to be back on the job the next evening.
Coltrain has worked nights for 11 years in the intensive-care unit at Bethany Medical Center in Kansas City, Kansas. She works six 12-hour shifts in each two-week period. She’s unaware that she has anything in common with air-traffic controllers, oil-refinery workers, textile manufacturers, truckers and power-plant operators. Like more than 20 million U.S. workers, Coltrain works at night in a society that runs around the clock. Like many of these workers, she has a demanding, high-stress job that requires her to be alert and sharp-witted.
We live in a 24-hour world. Exquisitely designed machines and electronics allow communication, transportation, manufacturing and other services to continue without regard to time. This nonstop universe means that we can increase productivity because manufacturing plants run continuously. We can keep pace in the global marketplace because the time zones no longer restrict commerce and communications. We have all-night restaurants, overnight delivery and supermarkets, television and emergency services available all the time. But it has consequences, as well. People must work evening, night, and—worst of all—rotating shifts. Shift work runs contrary to our natural, circadian rhythm.
Human resources professionals must manage these 20 million night owls, and there’s plenty to manage. On-shift workers suffer from fatigue, health and safety problems. (Between 60% and 80% of night workers have trouble sleeping.) They have family and social difficulties. (Experts estimate their divorce rates to be 20% to 60% higher than day-shift workers.) They present different supervisory and management issues. Surprisingly, HR managers approach these employees as if they had the same work environment as their daytime counterparts, although this clearly isn’t the case.
Tired workers are less-effective on the job.
Human beings are hard-wired to be awake during the day and to be asleep at night. Our internal clock governs our physical and mental wellbeing. Internal and external cues—light, exercise, food, work schedules and social activity—keep the clock on time. When we force the biological clock to tick at a different pace, without regard to its natural cadence, the human machine malfunctions. Tired people make errors on the job. Fatigue undermines intellectual and emotional functioning. It also causes severe health and family problems.
“As we’ve converted our economy and our business to 24-hour operations, we increasingly have expected people to operate in circumstances for which their bodies weren’t designed,” says Martin Moore-Ede, who’s president of Circadian Technologies in Cambridge, Massachusetts, and author of The Twenty-Four-Hour Society. “By asking people to be equally competent at all hours of the day and night, we’re putting demands on their bodies that are beyond their natural design specs.”
People don’t operate as well at night. After several nights, they can become progressively sleep-deprived. An out-of-sync biological clock, as well as the sleep deprivation, causes problems. What’s frightening is that because of technological advances, when people make mistakes, they can cost businesses large sums of money. For example:
- The Exxon Valdez oil spill cost $3 billion (plus more than $50 billion in legal claims)
- The Chernobyl disaster cost more than $300 billion (plus 300 human lives and 1.5 million others contaminated with radiation)
- Sleepy truck drivers who cause high-way accidents cost approximately $5 billion per year in the U.S.
“The basis of the problem is that you get people raised in a culture in which traditional things get done at a specific time,” says Marty Klein, a psychologist who’s president of SynchroTech, a shift-work consulting firm in Lincoln, Nebraska. “We have traditional cultural mealtimes, bedtimes and family-gathering times,” says Klein. When you change that one factor—make a person work at night or on a rotating schedule—he or she is left without any guide to use to adapt these other areas of life that still are healthy and reasonable. Without guidelines, only a few are successful, according to Klein.
For professionals like Coltrain, whose jobs demand making life-and-death decisions, sloppy mistakes from less-than-peak performance can have devastating results. Coltrain chose her lifestyle. Fortunately, she’s a night person. Wisely, she’s vigilant about scheduling her life so that she gets enough sleep and has time with her family.
Most on-shift workers aren’t so fortunate. According to Klein, most of them never adapt. “Shift workers are in a constant conflict between taking care of their own biological needs and their family and social lives,” he says. “They’re constantly trading sleep for other things.”
Experts can help people optimize their performance during shift work. According to Moore-Ede, management most often simply ignores this information. Human resources managers hire people and tell them to turn up for the midnight shift. Managers don’t help them adjust to their lifestyles, however. Supervisors aren’t attuned specifically to the special needs of shift workers. Often the environment in which these employees work contributes to the problem or even induces sleep.
For example, many high-tech workplaces provide perfect dozing conditions. The room may be darkened so that people can view a computer monitor easily. Workers sit in comfortable chairs, listening to the soft whirring sound of the computers. It’s an insomniac’s dream. It virtually lulls people to sleep.
With on-shift scheduling help, employees can adapt to shift work.
Some businesses are taking note of the research and helping employees adapt to shift work. These firms find that the benefits can be great.
Shelbyville, Indiana-based Libby-Owens-Ford is one such company. A large automotive and architectural glass manufacturer, its plant near Indianapolis opened in May 1990 and changed to continuous operation in April 1991. All shifts were 12 hours long on a rotating schedule. Each person worked 14 shifts a month—two or three days from 7:00 a.m. to 7:00 p.m., two days off, then two or three days on the night shift from 7:00 p.m. to 7:00 a.m. People could have every other weekend off. The attraction to employees initially was the short number of hours required per month.
Research has shown that rotating shift schedules are the most difficult. Employees having such work schedules have the highest levels of sleepiness and the worst safety and job performance. On the other hand, the best shift schedules have no shift rotation and provide time off after five days of work. The situation at Libby-Owens-Ford bore this out.
“Businesses don’t always need dramatic restructuring to obtain results with shift workers. Education and awareness can go a long way.”
Steve Bartz,
Schlumberger Well Services
After eight months on the rotating schedule, people were beginning to show signs of weariness. The time off in between the night shift and the day shift wasn’t long enough for the body to recover, according to David Barchick, the company’s manager of human resources. Company surveys identified the work schedule as a consistent problem in other ways as well. “People were tired,” Barchick says. “They weren’t able to be involved in family activities. It was becoming an emotional issue.”
What’s more, according to Barchick, is that the company promotes itself as a wellness facility. The company doesn’t allow smoking, for example. “I always felt that we were promoting wellness, but we were making people work this terrible schedule. It was hard to look people in the eye and justify it,” he says.
The company brought in Cambridge, Massachusetts-based Circadian Technologies Inc. to assess the workplace and schedules, and to teach employees about managing a life of shift work. The company covered such topics as:
- Sleep schedules and nutrition
- What to eat before going to bed
- How to sleep
- The impact that shift work has on family life.
After the presentation, the organization surveyed employees, asking them to identify the criteria they wanted in their schedules. More than 80% wanted to keep the 12-hour shifts and the time off. What they wanted, however, was a straight day or night shift. They didn’t want a day-and-night rotation.
The company responded by restructuring its scheduling policies. Knowing that some people function better at night than others, it first tried to fill nighttime positions with volunteers. Libby-Owens-Ford also committed to tackling the issue of night work head-on. For example:
- The organization reorganized its 52 work teams based on skill and shift
- The benefits coordinator changed her work hours to begin at 6 a.m. so that she would be available for night people
- HR support and training became available until 11:30 p.m.
“I think it’s the best thing we’ve done in the three years that we’ve been open,” Barchick says. “It’s our biggest change intervention and the biggest success. It really has paid off.”
During the changeover, the facility maintained overall factory productivity. What’s more important is that since the change, turnover has dropped dramatically, from 32% to about 9%. The accidents declined from 10 or 12 serious injuries a month to three or four.
“Employees won’t tell you they love working the night shift, but they will tell you they’re less fatigued,” Barchick says. “There’s more normalcy to their personal lives. They’re finding that they get a little bit more time to recover.”
As an added benefit, Barchick says that the firm already has saved money just from the decreased turnover. The HR staff also finds it easier to get people into continuing-education programs.
Businesses don’t always need dramatic restructuring to obtain results. Education and awareness go a long way. When Houston-based Schlumberger Ltd. was looking at ways to make its work force more productive and service-oriented, it was stumped. “We’re always looking for safe ways to make productivity gains,” says Steve Bartz, director of health, safety and environment, North America, for Schlumberger Well Services. “We do a good job of recruiting highly qualified people and offer a lot of training, but we still had some performance issues. We really didn’t know what was missing.”
Schlumberger Well Services is a worldwide company that provides drilling and interpretation services to the oil and natural-gas industries. It’s a highly complex, exacting job in which conditions are unpredictable. Work schedules in some of the divisions are irregular, and workweeks can range from 60 to 90 hours. It isn’t unusual for people to clock from 24 to 30 hours in one stretch. It’s a five-day-on, two-day-off schedule. In remote locations, it can be a 10-day-on, five-day-off schedule.
The company learned of shift-work technology at a worldwide safety environment conference. It decided to start a pilot project to examine ways to increase productivity at its Mt. Pleasant, Michigan, site, a large district facility. Two consultants studied the employees. They went on jobs for several days and saw how people worked. They looked at hard data: hours of operation, types of service problems, accidents and injuries. They focused on the waking and sleep patterns of several workers, and then administered a survey to the Mt. Pleasant workers and their spouses. After this thorough assessment, the consultants discovered that alertness was a big problem.
To correct the problem, the consultants started by building awareness on the part of workers and their families. First, they educated Schlumberger Well Services people about the limitations of human abilities at night:
- The high-risk periods
- Circadian rhythms
- Sleep cycles
- The effects of the environment on physiology.
The consultants explained to the employees how to balance their lives so that workers could get enough sleep. They also addressed the disturbing impact of sleep deprivation.
The next question was what to do about it. Most of the workers said they liked the way they worked. They enjoyed the long periods of days off and the irregular lifestyle. The schedule, however, was taking its toll. Like most other shift workers, when Schlumberger Well Services employees had time off, they reverted to a normal (daytime) social and family life. Equally problematic were the days during which they put off going to sleep as soon as they got home so they could be with their spouses or children.
Better lifestyle management was the answer. Schlumberger Well Services included the family in the program to help them understand how the whole system works. The consultants talked about the compromises that were needed to live with a person who does this kind of work. “They explained why the employees came home irritable, and we talked about sleep strategies and lifestyle changes. Our business is a way of life, a culture,” Bartz says.
Bartz says that the consultants also discovered that many employees had bad eating habits, which led to chronic sleep problems and digestive disorders. The five cups of coffee wouldn’t help when the worker went home and tried to sleep. People also ate a lot of high-fat foods. Instead of having a meal with good nutritional value, a lot of employees would stop at a fast-food restaurant as they were driving down the road on the way to a well site.
The education is beginning to pay off. When workers are very busy and working long stretches (12 to 15 days at a time), they don’t have as many service problems or the high accident rate that they had before. “Now employees know they’re likely to be impaired [by the fatigue]. They watch what they eat more carefully, and they take a nap whenever they get a chance.”
Rotating schedules must fit business needs and employees’ needs.
It’s clear that these employees live quite a different existence from day workers. “Employers are realizing more and more that helping shift workers manage their lives can improve the bottom line,” Klein says. “Improving shift-work schedules, and training workers and their families to cope with the lifestyle, reduces absenteeism and can lower turnover dramatically.”
It’s only a matter of time before most businesses consider shift work to be a profitable option. It’s more cost-effective to use equipment around the clock than it is to invest capital in more equipment. The situation creates problems, and it’s up to HR managers to find the solutions.
According to Richard M. Coleman, who’s president of Coleman Consulting Group, a shift-work consulting firm located in Ross, California, and clinical assistant professor at the Sleep Disorders Center at Stanford University in Palo Alto, California, if you create a livable schedule, many shift workers actually prefer shift work to day work. The crucial element, though, is developing a schedule that fits business needs and employee needs.
After concerns about pay and benefits (and the additional overtime possibilities that entice shift workers), night employees are most interested in scheduling the best time off possible and having a flexible schedule. For example, Coleman has helped create schedules in which people receive 20 weeks off a year, or regular four-day breaks between work shifts. He contends that it’s the quality of the time off that counts.
“If you’re working nights and weekends—about 50 hours a week—and your schedule changes all the time, your family is going to hate it,” Coleman says. “Trying to be a nice guy and educate the family about sleep patterns and giving them a calendar to organize their lifestyle isn’t really addressing the problem. They may be a little more understanding, but they’re still going to hate it.”
An effective schedule is key. If it’s a decent on-shift schedule that has predictability, flexibility and time off, the family and employee will be more receptive when the trainers hold meetings to explain how to live with these shifts. This increased receptiveness gives the plan a greater chance to succeed.
“If the on-shift schedule fundamentally isn’t working, then that dominates the person’s experience,” Coleman says. “The question is, ‘How well does the schedule fit with the employee’s life and his family’s social life?’ The best you can do is coordinate schedules 75% of the time, but that’s a pretty good fit.”
To accomplish this, human resources managers must be sensitive to the situation. They must be aware of whether the shift schedule is or isn’t working for the employees. If the schedule works, then it makes sense to offer employees and their families what’s available to make life better: tips on child care, on sleeping and on keeping alert. “However, if the schedule is fundamentally broken and employees hate it,” Coleman explains, “no amount of education will fix it. You have to change the schedule.”
There’s only one way to know if the schedule works, and that’s to ask people. There’s only one way for a manager to understand what it’s like to be a shift worker, and that’s to live it—at least for a while. You can’t expect a supervisor who doesn’t have to cope with the whole raft of problems inherent in shift work to manage it well. “The HR manager can talk to all the employees, go on the night shifts, come out on weekends, nights and holidays, and find out what people think,” Coleman says. You also can survey the employees.
That’s what SEH America Inc. did. The Vancouver, Washington-based company manufactures silicon wafers for computers and other electronic devices. In 1986, one division went to a seven-day, 24-hour workweek. However, the schedule was imposed without consulting the workers and without taking into consideration the problems it might create with child care, church attendance and other traditional, weekend family activities.
The experiment initially failed. “Our productivity was lower working seven days a week, 24 hours a day, than it was working five days a week. We were making less product,” says Michael Loggins, the company’s director of human resources and administration.
SEH abandoned the continuous on-shift schedule for that division. However, three years later, when the company faced the same economic situation, the entire company decided to reimplement a 24-hour schedule. To use its machinery more effectively, senior management decided that it must operate the plant around the clock. This time, however, several employees voiced their concerns early in the implementation process. Loggins was able to bring in consultants to survey the workers about their preferences. “We needed to address basic economic issues, which meant that we needed to operate 24 hours a day. However, that left a tremendous amount of latitude to the employees to decide what they wanted,” Loggins says.
Coleman Consulting Group held meetings for six weeks. During these meetings, the company educated the workers, surveyed their needs and met with families. In the end, the consulting firm asked shift workers to look at a lot of different schedules and include their families’ needs in their evaluations. SEH employees opted for two 12-hour (6:00 a.m. to 6:00 p.m. and 6:00 p.m. to 6:00 a.m.), nonrotating schedules that included long weekends.
HR must address family and lifestyle considerations.
According to Klein, the next step to developing successful shift-work schedules is to offer lifestyle training and support. “The key to successful shift-work training is to train the spouses, not only the employees,” says Klein. Although company trainers aren’t accustomed to training spouses, one of the main reasons that shift workers leave their positions for day jobs is the conflict with family life.
SEH turned its attention to the whole family. After the SEH workers chose their schedules, Coleman began a regular series of meetings. Several of the meetings addressed family concerns. Initially, Coleman held four meetings to talk about lifestyle choices and difficulties. The most important issue raised by workers who had families was child care. They were worried about finding weekend and around-the-clock child care. It was especially difficult for married couples who both worked at the company.
SEH went to work on the problem. The company contacted the Southwest Washington Child Care Consortium, a service that helps locate and arrange child care. From the consortium, Loggins and his staff discovered that there was a child-care center close to the plant. The center was able to extend its hours so that it would be open from 5:30 a.m. to 7:30 p.m., which would meet the needs of SEH’s day workers.
Eventually, SEH partnered with two other groups and built a child-care center. The center houses 90 children and is able to accommodate dinner and sleeping arrangements (although they haven’t needed to do so, yet). The center also offers weekend care.
SEH isn’t alone. Other businesses also realize that child care can be a major problem for shift workers. St. John’s Hospital in Springfield, Illinois, for instance, offers around-the-clock child care, seven days a week. Step-by-Step Learning Center is located across the street from the hospital. It provides care for children who are from 6 weeks to 12 years old, which allows the health-care staff to be available for emergencies and extended hours.
Although HR managers focus on family and lifestyle considerations, it’s also important to help employees understand that if they’re to stay healthy and productive, they have to adopt new patterns of sleeping, eating, exercising and social interaction.
The on-shift schedule information that’s crucial for HR managers to understand includes:
- How the employee’s body works
- What normal sleep patterns are and how to adapt sleep strategies so that em-ployees can live and work around the clock
- When the common dips in alertness occur
- What the roles of nutrition, coffee and stimulants are
- What family and social dilemmas may result, particularly how family communication can break down.
“It’s critically important that managers or supervisors understand the natural patterns of performance and alertness—the times of the night in which it’s most difficult to stay alert on the job,” Moore-Ede says. “They need to make special efforts to design work flow so as to keep people stimulated all the time.” (See “How HR Can Help Employees Stay Alert,”)
Moore-Ede suggests that supervisors should schedule important jobs for the times that are outside the danger-zone hours. For example, it’s common practice in nuclear-power plants to do rod adjustments at night. It’s detailed work that can cause immense problems—even plant shutdowns—if employees push the wrong buttons. It’s also tedious work. The most-effective shift supervisors, according to Moore-Ede, are the individuals who recognize the problem and make a special point to be out on the floor at 3:00 a.m., interacting with people, not retiring to their offices, drawing the blinds and snoozing for a while.
Shift workers can’t be managed as afterthoughts.
In addition, because we live in a daytime culture, companies have to stop treating shift workers as if they’re nighttime afterthoughts. A business may have 15% of its personnel working shifts. Shift employees, however, don’t have access to many of the services that daytime employees have. For example, the personnel office might not open until 9:00 a.m. and the night shift gets off at 7:30 a.m. It closes at 4:30 p.m. and the evening shift comes in at 5:00 p.m. The company cafeteria is open at noon but not at night. The food machine gets filled at 9:00 a.m. and is empty by the time the night shift comes in. The recreation area is open only during the day, and employees can use the gym during their lunch hour—but only if they’re on the day shift.
If you want workers to have healthy lifestyles, the company must reinforce this goal with activities and support. At the very least, management must include these workers actively as part of the labor force. Bring them into company activities.
The Pierre Hotel in New York City is an example of an organization that works to include night-shift workers. The hotel has 24-hour room service, night cleaners, bellmen, elevator operators and front-desk staff members who often take reservations from overseas in the middle of the night. It also has increased security during the night. Altogether, approximately 200 of the 650 employees work evenings and nights, and some of the shifts rotate.
One way that management is sure that the night shift keeps in touch with what’s happening in the hotel, according to Shelley Komitor, director of HR, is by having a buffet breakfast quarterly. The evening and night staffs, night managers and department heads join her and the general manager for an in-depth morning meeting.
It’s an opportunity for the staff to discuss any issues it has with the department heads and the general manager. (This meeting is held in addition to a monthly meeting with the general manager and representatives of each department, day and night shifts.)
Recently, night workers complained that the quality of the food in the cafeteria wasn’t adequate. Employees brought it to the attention of the food-and-beverage director during the breakfast. He sat down with the executive chef and came up with a better menu and food offerings for the employees at night. At the next meeting, the general manager will follow up on this problem to be sure that the employees are satisfied with the solution.
Employee safety is another concern. Like the Pierre Hotel, Bethany Medical Center has increased its security staff because it’s open all night.
“We’re in the inner city,” says Robert Fieger, director of personnel at Bethany Medical Center. “The security department is staffed to be more visible in the evenings and at night.” Guards escort people to and from the parking lots. The hospital stations guards at strategic locations during the prime periods during which staff members report in and check out. They also guard the entrances.
“We need to be sure that we provide reasonable protection for our employees,” Fieger says. “It isn’t impossible to have an incident in the daytime, but it’s more likely to happen—and much more on the minds of our employees—when it’s dark. We have to be concerned about employee safety.”
Furthermore, it’s important to understand the specific training needs of night workers. Do job requirements change? Are workers handling more-difficult customers at night? Are their jobs more challenging than those of day workers?
On-shift workers do their jobs without as much supervision as day workers. Therefore, training is a key issue. They have to have maintenance skills because if something goes wrong on the line, there may not be a maintenance person around during the night. To do their jobs effectively, night workers must be able to look beyond their own tasks. They must think like a plant manager. They tend to be working with expensive technology, or they wouldn’t be working around the clock. Therefore, they have to be trained to maintain the equipment and to recognize problems. They must know enough to understand what they can handle and when to call a manager, or how to know when there’s a danger factor.
“How do you train someone on the night shift?” Coleman asks. “Not very well.” People aren’t as alert. Trainers aren’t as effective at night. He says it’s important to create dedicated training time. “Put employees on the day shift and bring in a trainer,” Coleman says. “Do it at a time when someone else is covering the equipment.”
In the best of all possible worlds, only people who do better on night shifts would work them, but that isn’t likely to happen. So HR professionals must help all employees stay awake at work and satisfied at home. On-shift workers who maintain their health and avoid chronic tiredness, who spend time with family and friends, and who participate in the free-time activities they enjoy, may actually begin to prefer night work.
Coltrain loves it. “I like the hospital at night. You get different crises,” she says, adding that when you have questions at night, there aren’t as many people you can ask. “You have to be more assertive; more willing to take the ball and run with it,” says Coltrain. “I would have a hard time working regular day shifts.”
Personnel Journal, August 1993, Vol. 72, No.8, pp. 36-48.
