The Shift Worker’s Head Nod

Stories - Clock Carla Hamster Wheel JPEGImagine this:

You are coming off of your last of 4 insanely busy night shifts. You get in your car and start the long drive out of the city towards home. You replay a bit of your night (this is now your quadruple check that you haven’t forgotten to tell the on-coming shift anything important that they may not be able to figure out themselves). You get on the highway. Traffic’s not too bad at first, as you are going against the morning rush. You look over at the westbound traffic and you feel grateful to not be one of “those people” who have to get up every day and do the monotonous 9-5. You look forward to your 5 days off. As the sun starts to rise, traffic slows (nothing like that glare of the new day’s sun to impede your commute).

As you start to slow down you realize your body has just done the equivalent of saying “goodnight” and your eyes start to get even heavier than they were before you started your drive. You roll down your window (yup, even in minus 30 weather). The crisp air and the few deep breaths you take gives you a little more focus. You realize you need to keep moving – you look for the next off ramp and start a mental map of an alternate route – what might be your best bet for traffic that will keep moving? It doesn’t look too bad ahead. This is the fastest way home. And home, is where your bed is. So you stay the course. A few moments pass and you realize you don’t remember merging onto the connecting highway. You actually don’t remember the last few exits. Autopilot. You crank your radio up and reposition slightly in your seat. You find a song you know and give the saddest attempt to sit up right and sing along, tapping your fingers on the steering wheel. There’s that sun again. The brightness of the sun and your squinting to see past it makes your heavy eyelids feel that much heavier. A rumbling under the wheels of the car jolts you. Did they make that shoulder wider? You pull back into your lane and keep going. You reach in your bag and pull out an apple – fondly recalling the conversation with a friend at work who suggested you try this. They too have a lengthy drive home and an apple worked for them. Now, you don’t go into a night shift without your morning driving apple.

The 5 minutes you take to eat your apple takes you to the last stretch of your drive to bed – I mean home. Farm fields as far as you can see. Why is everyone in such a rush? That’s the 3rd car that has passed you on a single lane roadway. You look down and realize you’re driving well below the speed limit. Well, that won’t get us home any faster! As you attempt to depress the gas pedal you realize that your muscles have thrown in the towel as well. You must now focus intently on applying the needed pressure to keep a consistent and appropriate speed going. You perch your elbow on the opened window’s edge and rest your head on your hand – eyelids forced open by your fingertips. This can’t be safe. Does this happen to everyone coming off of nights you wonder? You get a little more energy as you near the finish line and turn down your street. You pull into your garage. Home. Family. Bed. The fear melts away. You sit back for the first time since your drive began. You are startled by someone knocking on your window. You look down at the clock. 2 hours have passed since you pulled in. It’s your significant other wanting to know why you didn’t come in and go to bed instead of sleeping in your car.

Sound familiar? As you read further, you’ll see that this scenario touches on almost all of the signs of driver’s fatigue. Shift work counted as one of the many reasons that people drive fatigued. Very dangerous both for the driver as well as other drivers and pedestrians – but a scary reality to many night shift workers.

The difference between driver’s fatigue and drowsy driving

Fatigued Driving: fatigued driving refers to a “disinclination to continue performing the driving task at hand”. It can occur as a result of the monotony or repetitiveness of either the driving task or the driving environment, or can occur after driving for extended periods without a rest or break.

Drowsy Driving: drowsy driving is a function of the human body’s natural circadian rhythm or “sleep-wake” cycle, meaning that most people feel sleepy twice a day – at night and in the afternoon. Drivers that operate a vehicle at these times are more likely to feel drowsy.

These definitions were taken from the Traffic Injury Research Foundation. (Traffic Injury Research Foundation). Using these definitions, shift workers can be affected by both fatigued and drowsy driving. Since a shift worker’s circadian rhythm is altered, the times of the day when shift workers feel their sleepiest are not the same as someone who doesn’t work shiftwork.

How often does this happen?

“Shift worker are more likely than those who work a regular day time schedule to drive to or from work drowsy at least a few days a month (36% vs. 25%)”. (Transport Canada).

Unfortunately, statistics in North America are inconsistent between states and provinces. There is no way to quantify fatigue the way we can for blood alcohol level. As well, drivers are not willing to admit their fault in an accident when driving fatigued or drowsy. The National Highway TSA, in America, conservatively estimates that driving fatigued causes approximately 100, 000 crashes, 1,550 deaths and 71, 000 injuries a year. Australia, England, Finland and Europe collect more consistent data and among them have determined that between 10%-30% of crashes are due to drowsy driving.

“It is estimated that about 20% of fatal collisions involve driver fatigue (CCMTA, 2010)

A 2007 survey found that about 60% of Canadian drivers admitted that they occasionally drove while fatigued and 15% of respondents admitted that they had fallen asleep while driving during the past year (Vanlaar et al., 2008)”. (Transport Canada).

Another survey shows:

An alarming 20 percent of Canadians admit to falling asleep at the wheel at least once over the last year. Studies also suggest fatigue is a factor in about 15 percent of motor vehicle collisions, resulting in about 400 deaths and 2,100 serious injuries every year. (Canada Safety council).

Decreased sleep correlates with increased accidents

The same people who would never drive impaired by a substance; will not think twice about getting into a vehicle while fatigued. Police cannot lay charges for fatigue impairment (Canada Safety Council). TIRF indicates that charges laid against fatigued drivers include dangerous driving; criminal negligence or impaired driving. The State of New Jersey is the only place in North America that has law for fatigued driving. It is called Maggie’s law and was instituted after a teenager was killed by a driver who had been awake for over 24 hours. A driver causing a fatality in an MVC after not sleeping for 24 hours in the state of New Jersey, can be charged with vehicular homicide.

Warning signs of fatigue include:

  • Blinking or yawning frequently;
  • Closing eyes for a moment or going out of focus;
  • Having wandering or disconnected thoughts;
  • Realizing that you have slowed down unintentionally;
  • Braking too late;
  • Not being able to remember driving the last few kilometers
  • Drifting over the center line onto the other side of the road

(Transportation Canada)

What’s being done?

So, we know fatigued driving is a problem, and working shift works makes it more likely that you may drive fatigued and/or drowsy. So what is being done? In Canada there are signs reminding drivers that “Drowsy Driving Causes Crashes” or “Drowsy Drivers Next Exit 5 Kilometers”. There are devices that measure eyelid closures, head nodding, and lane deviations and attempt to warn the driver – however, these have not been proven effective yet. Sadly, these are the only things that could be found prior to publishing this article (Transportation Canada).

Driving safely after night shift

So, what do we do? Give up shift-work? Don’t work nights? Advocate for sleeping areas in all shift working jobs?

To manage fatigue, drivers can consider doing the following:

  • Sleep well prior to long road trips;
  • Share the driving with other passengers;
  • Take regular rest stops every couple of hours and do some exercise;
  • Eat light meals or fruit throughout the journey and drink water;
  • If one feels tired during the trip, a nap of twenty to forty minutes is an effective way of reducing sleepiness (Transportation Canada).

I particularly find the first suggestion unobtainable by certain professions. Whether it is back to back traumas, that 3rd alarm fire, the unexpected rave gone wrong or the last stretch of your long haul as a truck driver, there are a plethora of situations that ensure you will not get a break or sleep well prior to your drive home; especially if you have to get home to start your other shift as a parent. There is no easy answer. Some people I know will stay back and rest a few moments with their head on a table. Carpooling may help, however, if you are all on the same schedule you may be playing hot potato with who’s going to be the fatigued driver. Public transit is an option – but don’t be surprised if you miss your stop.

We would love to hear and share your tips and suggestions on what you do to safety make it home after night-shifts.

“The Shift Worker’s Head Nod” is a guest post written by Catharine Johnson RN and originally published in The Shift Worker’s Guide . Catharine and her partner, Seonaid Lennox are Shift Workers who have created a site to help workers survive when they don’t work 9-5. A special thank- you to Adrian Howell (also a Shift Worker) of Adrian Howell Photography for supplying our title image. Follow us on Facebook to keep up to date with helpful posts all focused on shift work.

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