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Fighting the effects of nurse fatigue


Have you ever gotten home from a shift and forgotten the journey from the hospital to your house? Are you ever irritable and cranky, but can’t figure out why? Almost all of us have encountered these situations, often the effects of nurse fatigue, during our nursing careers.

What is nurse fatigue?

Nurse fatigue is described as feeling emotionally, mentally, or physically tired or weary as a result of the demands of nursing. An overwhelming amount of literature discusses the causes of nurse fatigue, showing its relationship to lack of sleep or low-quality sleep as a result of work demands, personal responsibilities, and other lifestyle factors. The literature also cites long work hours, not enough recovery time between shifts, night shifts, rotating shifts, excessive workload and job demands, staffing shortages, and dangerous work environments as main causes of nurse fatigue.

The dangers of nurse fatigue

The mental impairments and physical tiredness caused by nurse fatigue can lead to decreased work performance, which can compromise patient safety and satisfaction. Being tired all the time also can decrease our own job satisfaction.

Fatigue is linked to various health problems, such as cardiovascular disease. Work related injuries, such as needlestickes, are more likely to occur when you’re not paying attention. And falling asleep at the wheel can easily happen when you’re tired.

The 12-hour shift

The 12-hour shift can be a hot-button topic. These shifts make it possible for nurses with family and other personal responsibilities to have a full-time job without working 5 days a week. But the evidence is clear that 12-hour shifts can lead to fatigue that may result in errors and impact patient and staff safety. Research has shown that the most patient errors occur in the last 4 hours of a 12-hour shift. However, eliminating 12-hour shifts entirely may lower nurse satisfaction rates.

Minimizing nurse fatigue

While staffing shortages and insufficient resources are common causes of nurse fatigue, they’re often out of your control. So focus on changing what you can control, such as scheduling, sleep, and self-care.

Develop good scheduling practices. If you’re fortunate enough to make your own work schedules, avoid the temptation of clumping your days together so that you have a week off between pay periods. Although that week off is nice, working several shifts in a row will leave you exhausted and can increase your chances of making an error. If you’re responsible for making schedules for others, heed this same advice and try not to schedule too many consecutive days for individual employees.

Rest when you can. If you have a spare hour or  two, don’t be afraid to kick your feet up and relax or take a nap. The dishes and laundry aren’t going anywhere, so be selfish and take some time to rest. Those small moments can add up and truly make a difference in combating fatigue. If you benefit from napping during your work breaks, then go ahead and take a short snooze, if permitted by your organization’s policy.

Sleep. Try to sleep 7 to 9 hours in a 24-hour period. Be sure your environment is dark, cool, and quiet to promote sleep. Remove distractions such as televisions, tablets, and cell phones.

Take care of yourself. Don’t expect others to know how you’re feeling, so make yourself a priority. Your emotional health is just as important as your physical health, so take care of your mind and spirit the same way you take care of your body. Get a massage, take 20 minutes in the morning to read the newspaper while you sip on your coffee, or enjoy time with your family or friends at the park. And don’t forget to exercise and eat right. These activities can reset your frame of mind and brighten your spirit.

Your responsibility

The effects of nurse fatigue can be devastating and life-threatening, so work to minimize it. It’s your professional responsibility to avoid working when fatigued—it could save a life, including your own.

Kelsey Wong is an RN II at Children’s Hospital Los Angeles and adjunct faculty at Mount Saint Mary’s University in Los Angeles.

For more information about nurse fatigue visit the ANA website.

Selected references

American Nurses Association. Addressing nurse fatigue to promote safety and health: Joint responsibilities of registered nurses and employers to reduce risks. September 10, 2014.

Griffiths P, Dall’Ora C, Simon M, et al. Nurses’ shift length and overtime working in 12 European countries: The association with perceived quality of care and patient safety. Med Care. 2014;52(11):975-81.

Joint Commission, The. Sentinel Event Alert Issue 48: Health care worker fatigue and patient safety. December 15, 2016.

Rogers AE. The effects of fatigue and sleepiness on nurse performance and patient safety. In: Hughes RG, ed. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality;2008:509-45.

Steege LM, Pinekenstein B. Addressing occupational fatigue in nurses: A risk management model for nurse executives. J Nurs Adm. 2016;46(4):193-200.

Stimpfel AW, Aiken LH. Hospital staff nurses’ shift length associated with safety and quality of care. J Nurs Care Qual. 2013;28(2):122-9.

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