Silent practices becoming norms: planned napping for nurses during intensive care night shifts – a focus group study

Abstract

<h3>Background:</h3><p>Night shifts in intensive care units (ICUs) are associated with significant physical and cognitive fatigue among nurses, which may affect staff well-being and patient safety. Although short naps have been shown to reduce fatigue, their implementation in ICUs remains limited and poorly understood.</p><h3>Aim:</h3><p>This study explored ICU nurses’ and nurse managers’ perceptions of planned napping.</p><h3>Methods:</h3><p>A qualitative descriptive design was used, involving nine focus group interviews (<em>n</em> = 20) across three Finnish ICUs. Data were analysed using inductive content analysis.</p><h3>Results:</h3><p>Participants described severe fatigue during night shifts and acknowledged the benefits of planned napping, including improved alertness, reduced errors, and enhanced well-being. Informal napping was common, but formal structures were lacking. Barriers included unclear policies, cultural resistance, and logistical challenges; whereas facilitators involved organisational culture, environment, scheduling, and managerial support. Emphasis was placed on fairness, flexibility, and clear protocols.</p><h3>Conclusions:</h3><p>Planned napping was perceived as a valuable strategy for managing fatigue, but successful implementation requires institutional support and context-sensitive planning. This study provides practical insights into implementing planned napping in high-acuity environments and supports the development of structured, evidence-informed protocols to promote staff well-being, patient safety and sustainable nursing practices.</p>