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 increase the risk of patient care errors, job-related injuries, and long-term health problems.

For night-shift nurses, one potential solution is being allowed to take brief naps during a shift, which the American Nurses Association recommends as an evidence-based countermeasure to fatigue. But nurses may face barriers to 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.”

Some other articles of note in the May issue:

CE Feature: “Intrathecal Pumps for Managing Cancer Pain.” Among patients with cancer, moderate to severe pain is prevalent and can be refractory even with the use of systemic opioids, which may cause adverse effects that are difficult to manage at the doses required to control pain. When delivered intrathecally, however, opioids and adjuvant analgesics may provide greater pain relief at dramatically lower doses and with fewer adverse effects. This article provides an overview of intrathecal pump therapy, including its benefits and potential risks and complications; the medications that can be delivered intrathecally; and the nursing care […]