Ways Nurses – And Their Employers – Can Fight Nurse Fatigue

ANA’s Senior Policy Advisor Ruth Francis, MPH, MCHES, explains why nurse fatigue is a dangerous issue for nurses and what we can do about it. 
 
When nurses don’t get adequate rest, their exhaustion can lead to safety issues for themselves and their patients. According to the American Nurses Association’s 2016 Health Risk Appraisal, most nurses get about seven hours of sleep per night. That’s on the low end of the National Sleep Foundation’s recommendation for adults, which is seven to nine hours. But lack of sleep isn’t the only issue contributing to the problem of nurse fatigue.
 
“It’s also the emotional toll of caring for up to 12 different patients during one shift, in addition to managing your own issues, caring for your family, commuting, and trying to maintain a life outside of work,” says Ruth Francis, MPH, MCHES, and ANA’s Senior Policy Advisor.
 
Fatigue causes problems for nurses and patients
Obviously, nurses’ health and wellness will be compromised if they’re exhausted. But, patients’ health may be in jeopardy, too. Being physically and emotionally drained may cause nurses to:
  • Be unable to focus
  • Have a slower reaction time
  • Be confused
 All of this can cause a nurse to make a medication error that could have serious consequences for a patient.
 
Long hours contribute to exhaustion
Nurses’ own safety is at stake, too. ANA’s 2016 Health Risk Appraisal reports that 12 percent of nurses have nodded off or fallen asleep while driving due to fatigue.
 
According to The Institute of Medicine, registered nurses should not exceed 12 hours of work in a 24-hour period, or 60 hours of work within seven days. ANA recommends that registered nurses not exceed 40 hours of professional nursing work in a seven-day period.
 
However, over 50 percent of nurses work shifts longer than 10 hours at a time. Even worse, 57 percent of nurses reported starting to work before their shift, staying late, or working straight through their break. And 33 percent have said they’ve been assigned workloads that exceeded their comfort level.
 
Hospitals need to be held responsible
One of the reasons nurses work such long shifts and overextend themselves is because employers require or allow it. Employers often give incentives like overtime pay when nurses work themselves past the point of exhaustion.
 
Hospital administrators should want to protect their nurses, not only because it’s the right thing to do, but also because nursing errors impact the bottom line.
 
Here are some actions employers can take to fight nurse fatigue:
  • Eliminate the use of mandatory overtime
  • Allow nurses to accept or reject work assignments (they know what they can handle)
  • Use a regular, predictable schedule so nurses can plan for work and personal responsibilities
  • Limit work weeks to 40 hours or less (and days to 12 hours, tops)
  • Provide adequate rest breaks
  • Disperse the workload fairly amongst staff members
  • Arrange transportation or places for nurses to sleep if they are too exhausted to drive home
  • Support a culture of safety
 
Nurses need to take responsibility, too
“As professionals, nurses also need to advocate for themselves,” says Francis. If you know you’re tired, speak up. Nurses go above and beyond often, but you need to remember that your health is important and it can affect the health of others around you (particularly your patients).
 
Here are some ways individual nurses can combat nurse fatigue:
  • Aim to sleep seven to nine hours within a 24-hour period
  • Take breaks. Make them as restful as possible. Nap if you need to.
  • Improve your own health and wellness through stress management, diet, and exercise.
  • Be aware of the side effects of over-the-counter or prescription medications and how they affect you
  • Support your peers when they say they need a break or can’t take a shift
For more recommendations for both nurses and employers, read ANA’s Addressing Nurse Fatigue to Promote Safety and Health: Joint Responsibilities of Registered Nurses and Employers to Reduce Risks.
 
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Posted by Healthy Nurse, Healthy Nation (HNHN) on Dec 22, 2017 12:55 PM CST

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