Circadian rhythm, shiftwork and you!

Chronobiological knowledge is increasing and the relationship between this knowledge and shiftwork is becoming clearer. This, in turn, is highlighting a need to facilitate a mix of permanent (day, evening and night) and rotational shift systems within individual wards or units. Is it perhaps time to allow greater flexibility in how individual nurses deal with the profession's need to care for patients throughout the 24 hour period? This review will focus on the 24 hour day-night or circadian rhythms and the consequences of the disruption of these rhythms as nurses undertake shiftwork and other activities which demand efficient functioning at times when an individual's circadian rhythms are expecting them to be at rest. As disruption of these rhythms is essentially unavoidable when 24 hour care is required, the choice becomes one of determining a preference for tolerable rhythm desynchrony and shorter more frequently occurring episodes of night work, or some degree of rhythm synchrony and adaptation during slightly longer but less frequent episodes of rhythm disruption.