No Rest for the Weary Nurses

By Joan Spitrey, via Multibriefs

With the busy holiday season is upon us, many will be enjoying time off from work so they can visit with family. However, while holiday cheer is spreading, nurses and healthcare providers will continue to march along caring for those who are sick and in need of care.

While many enjoy ham dinners with apple pie, there will be nurses working through breaks to provide care to those vulnerable patients in need. Although the idea of skipping a meal break is unheard of in most professions, it sadly is more the norm than not in nursing.

Unfortunately, there is little research to determine how often nurses miss their meal breaks, but the problem certainly exists.

In an older anecdotal study from 2004, nurses reported that less than half of their shifts over a 28-day period came with meals breaks that were free of patient care responsibilities. While the study did not find any significant impact on patient care, the authors did recognize the effects it could have on the staff.

Although the body of research may be lacking data that truly represents the epidemic, the courts certainly are starting see a surge of lawsuits that speak to a far greater problem. And the good news is they are siding with the nurses. Over the past few years, multiple cases have been filed and ultimately settled in favor of better meal and break coverage for nurses.

Most recently, St. Joseph Medical Center in Tacoma, Washington, just agreed to a $5 million settlement regarding meal and rest breaks with its staff. According to reports, the staff was not afforded meal breaks that were free of patient care responsibilities. A key part of the settlement is to have relief staff scheduled for the nursing units to allow the staff proper meal breaks.

Seen as a huge victory in the nursing community, it also sheds light on a rarely talked about issue in nursing.

For most nurses to enjoy a meal break, they have to ask another nurse to cover their assignment. This is often referred to as the "buddy system," but it spreads the covering nurse very thin. Couple that with poor staffing ratios, and the idea of diligent patient care no longer exists.

Although the subject of meal breaks (or lack thereof) is not widely acknowledged, ask any nurse and she will freely share how often she is rushed for lunch or afraid to leave the floor because her peer who is covering her is already overworked. This sets up situations where nurses will put their patient first and just take a quick bite of food. But what patients really need is an energized and refreshed caregiver.

As more nurses continue to step forward, there will continue to be more discussion on how to better serve the patients while still caring for the caregiver. The traditional business models for break coverage clearly are not safe or effective, and the courts are starting to agree.

Joan Spitrey has been a registered nurse for more than 16 years, specializing in critical care and acute care services. She currently is a clinical nursing instructor, sharing her passion with the next generation of nurses. She can be found blogging at

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