On this month's cover is A Maid Asleep (1656-57) by the Dutch master Johannes Vermeer. We chose this painting to call attention to the issue of sleepiness in nurses who work the night shift, which is explored in this month's Original Research article.
On-the-job sleepiness among nurses can be problematic in many ways: it raises the risk of patient care errors, job-related injuries, and long-term health problems. According to an American Nurses Association (ANA) position statement on nurse fatigue that is mentioned in the article: "Inadequate sleep and resulting fatigue has major implications on the health and safety of registered nurses and can compromise patient care. Fatigue can also be costly to employers, resulting in increases in health care and workers' compensation costs, early disability, recruitment and training costs, and legal fees."
For night-shift nurses, one way to combat the issue is being able to nap on the job, which the ANA recommends as an evidence-based countermeasure to fatigue. But nurses may face barriers in doing so, including a lack of formal breaks on the unit and concerns about impeding the quality of nursing care. To learn about a project that explored those barriers and attempted to implement night-shift naps, read "Napping on the Night Shift: A Two-Hospital Implementation Project."-Diane Szulecki, associate editor