Becker's Hospital Review

42 Chuck Lauer A recent study about the effect of sleep de- privation on our decision-making has hit home for me. You see, I am an avid hockey fan, and my team, the Chicago Blackhawks, is in the playoffs. Let me explain. For much of my life, I have been used to getting up at 4:45 a.m. each day, getting in a workout, having breakfast and getting to work bright and early. This dates to my days in the Army, where an early rise is drilled into you. In order to get enough sleep, I am usually in bed by 9 p.m. Lately, however, I have been staying up all hours watch- ing my beloved Blackhawks in an exciting and tense playoff series. As with most sports these days, the games go on until 11 p.m. or later, and I am so wound up afterward I have been getting to bed past midnight. The problem is that my inner alarm clock still gets me up before 5 a.m., and I am a wreck. By now, non-sports fans are wondering why I just don't turn off the TV. When you have suffered what Chicago sports fans have endured over the decades, a winning team is something to stay up late for. In my foggy state, I have just read about a study in the Journal of Applied Psychology, which found workers who are sleep-deprived are more likely to cave in to unethical behavior, particularly when bosses or managers are pushing them in that di- rection. Another study, by the National Sleep Foundation, found the percentage of Americans who sleep fewer than six hours a night increased from 13 percent to 20 percent from 1999 to 2009. We are working longer hours and sleeping less. Michael Christian, assistant professor of orga- nizational behavior at the University of North Carolina's Kenan-Flagler Business School in Cha- pel Hill and co-author of the Journal of Applied Psychology study, said: "A lot of organizations and industries are enmeshed in this macho culture, where it's actually cool to be sleep-deprived. I've heard stories of stock traders who show up in the same clothes they wore the previous night, even though they slept. They wore the same clothes to make it look like they haven't slept. As a manager, you don't want the really tired person making the important ethical decision that day." Healthcare is an example of an industry where ethical behavior is essential. People's lives are at stake in healthcare decision-making, and yet we see exhausted docs and nurses on the job all the time. Last year, the public relations firm Edelman based in Chicago reported that in a global study only 19 percent of people trusted business leaders to make ethical and moral decisions. Prof. Christian says the variation in behavior he and lead researcher David Welsh of the University of Washington in Seattle observed between well- rested and sleep deprived people wasn't necessar- ily huge. But he went on to say: "I think it's sig- nificant in that it's meaningful any time you can predict when someone is going to be more sus- ceptible to unethical influences or when they are going to do something that could have significant impact on other people or on the organization's well being. In business we are operating in groups with colleagues and peers, typically in hierarchi- cal structures. Figuring out what can help people resist or what makes people succumb to unethical influences is, I think, critical." One thing Prof. Christian thinks might help any organization that is willing to do something about sleep deprivation is to simply be aware of what it can do to employees. Plus he suggests they might even encourage employees to employ prop- er "sleep hygiene," which would involve things like not watching late night TV, exercising, going to bed at the same time each night and not staring at your iPhone for messages right before you go to bed. Finally, Prof. Christian suggests "those organiza- tions that have made strong attempts to change their culture…probably have a lower incidence rate of unethical behavior. I can't say for sure that it's because of well-rested employees, but I think holistically it's the whole package. If I think my organization thinks about me and encourages work-life balance that allows me to be a well-rest- ed individual who's happy and healthy, then I am going to want to do things that ultimately help that organization." The way I feel right now, I wouldn't want to be making key business decisions. Soon, the playoffs will end, and I will get back to my schedule and regular sleep. For many people, what I am feeling now is routine. I have witnessed among many senior leaders in healthcare a pride in needing only a few hours of shuteye a night. It is not a good example for oth- ers. It would do well for any of us who are con- cerned about our people to understand the possi- ble consequences of sleep deprivation. Sleep isn't treated with the seriousness it deserves, a result of a suspicion that you aren't enough of a go-getter if you sleep enough. Given that it may affect our moral and ethical decision-making, maybe it is time we woke up to this problem. n The Ethics of a Good Night's Sleep By Chuck Lauer, Former Publisher of Modern Healthcare and Author, Public Speaker and Career Coach SUBSCRIBE TODAY! Becker's Hospital Review CEO Report E-Weekly Guidance, analysis and best practice information on hospital leadership, operations and management issues for top hospital and health system executives. Each E-Weekly, sent every Tuesday, contains the most popular feature articles covering business and legal issues, CEO profiles and bench- marking and statistical data to immediately inform your decision-making. 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