Fatigue In Nursing

A considerable amount of literature has been published on the impact of working hours (8 vs. 12 hour shifts) on fatigue among the nurses. These studies revealed that twelve-hour shifts increase the risk of fatigue, reduce the level of alertness and performance, and therefore reduce the safety aspect compared to eight-hour shifts (Mitchell and Williamson, 1997; Dorrian et al., 2006; Dembe et al., 2009; Tasto et al., 1978). Mills et al. (1982) found that the risk of fatigues and performance errors are associated with the 12-hour shifts. Beside this, Jostone et al. (2002) revealed that nurses who are working for long hours

It is essential as a Registered Nurse and nursing student to ensure that a comprehensive safe and quality of practice is achieved, resulting in goals and outcomes being met positively improving the nursing needs of people. This standard is important to my scope of practice, as being a nursing student it is for me to ensure goals and outcomes are being achieved to ensure the safety and wellness to those I am caring for.

12-Hour shifts have constantly been an argument in the field of nursing. This topic interests me because there is constant jitter around this topic, to whether if it’s safe, or not. This can be taken into view from the patients view and also the nurses. Nurses should not be allowed to work 12-hour shifts because, the physical and emotional impact on their bodies is too debilitating, and the length of the shifts could be a potentially hazard to the patients.

Nurses spend most of their time taking care of their patients that they forget to be mindful of their own wellbeing. It is very important for nurses to take care of themselves because it is reflected through the care they provide to their patients. Sleep deprivation can increase the chances of a nurse miscalculating a dosage, which can be fatal to a patient’s life or injure themselves by forgetting proper body mechanics. Not having enough sleep and overworking themselves can be the cause for this simple mistake that could have been avoided through self-care. Having at least 8 hours a sleep a night is just one of the few ways a nurse can manage healthy living. A nurse’s work schedule can consists of mainly over

When nurses experience fatigue due to excessive overtime, effects that can occur are reduced decision making ability, reduced communication skills, increased forgetfulness, increased tendency of risk taking, reduced ability to handle stress on the job, decreased ability to do complex planning, and inability to recall details which can all danger patients wellbeing. Unfortunately even with all the

The continued shortage of registered nurses will be a catalyst for the increasing stress placed upon practicing nurses now and in the future. Mandatory overtime has been an incessant problem within the nursing profession. When lives are at risk, alertness is a critical part of a nurse’s job performance. Fatigue impairs one’s judgement directly affecting patient and nursing safety or outcomes. This author’s typical six week work schedule consists of eighteen-twelve hour shifts, nine “required” twelve hour call shifts, and three-four hour back-up shifts. A nurse that accepts a patient assignment in the operating room cannot legally or ethically leave when their shift has ended without proper relief. Inevitably, without proper staffing departure is not an

Within the recent years, hospitals and medical facilities have been experiencing nursing shortages that necessitate more nurses to be present to compensate for the care needed to be given. This requires nurses to be dealt with imperative extended work hours along with their normal shifts with no denial or excuse accepted. Working extra hours are accompanied with negative effects that have an impact on the nurse, coworkers, and patients. A major concern that occurs with overtime is that nurses become fatigued or burnout. Fatigue that is experienced is a result of sleep deprivation from working overtime that is associated with arduousness neurobehavioral functioning

A good nurse is aware and knowledgeable of ethics in the field of medicine and strives to provide quality care to avoid negligence. Experienced nurses always remain well informed of changing trends and laws relating to health and safety and regulations of the Board and customs through continued education. Nurses should be prepared to defend themselves. If they know how to avoid mistakes and avoid litigation, they are almost home free. “It is believed that health

In addition to understaffing, health care professionals are also placed within a setting where they are overworked. According to a research study by Imai et, al. (2004), “Excessive work demands, particularly for emergency overtime work, and low job control for community psychiatric nurses appear to represent work environment factors contributing to burnout”. When institutions are understaffed, it often means that nurses are then over worked. When this occurs, they no longer have the ability to upkeep their self-emotional and physical health. According to an article by USA Today (2015), “A steady stream of studies link fatigue to errors, increased risk-taking, declines in short-term memory and a reduced ability to learn – with researchers likening the performance of someone awake for at least 17 hours to that of a drunk person”. A common work shift currently for nurses in these settings are at least 12 hours at a time. Fatigue can also increase if workers have 12 hour shifts, for multiple days in a row. When an individual reaches this level of fatigue, it can be difficult for them to then care for another individual to the best of their abilities.

I was surprising to me as well to learn that something as preventable as a medication error can cause so much harm and money. I believe as nurses we have to be mindful and pay close attention to our bodies and physical wellbeing, and know when it is time to take some days off work to recuperate from fatigue instead of compelling ourselves to work additional shifts which can have detrimental effects on patient safety.

Patterson, E., Wan, Yi, Wai, T., Sidani, S. (2013). Nonpharmacological nursing interventions for the management of patient fatigue: a literature review. Journal of Clinical Nursing, 22, 2668–2678. doi: 10.1111/jocn.12211

The risks of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week. (Trossman, 2009). Working longer hours in a high stress area will always increase the error rate. Designating an adequate number of RN positions to ensure nurses work an appropriate schedule without overtime and that their workload allows for breaks. Managerial staff must work to develop specific policies about the length of work times based on the setting, patient and provider needs. Those policies should limit nurses from working more than 12.5 consecutive hours. Provide education for all care providers on the hazards and causes of fatigue. Continue to document unsafe staffing conditions and work with others to change the current work culture so that it recognizes the effects of fatigue on patient safety, as well as the nurse. (Berger, et al. 2006)

I think the courts should have looked at the whole picture. I do not understand why the nurses where charged and the pharmacist was not charged. The nurse administering the medication made a medication error by not checking for the correct dosage, but the pharmacist also made medication error when he/she prepared the medication. There are always other circumstances to consider when a medication error is made, the nurse may have just worked a double shift, then came in the day for an additional shift. Fatigue and errors suggest may nurses should have limits set on the number of hours they work (Conroy, 2007). Nurses work to do no harm, so trying to prevent further pain to a newborn would be something any nurse would do. Nurse shaming and blaming for doing things we all are capable, never makes a system safer (Alexander, 2014).

Erin, P., Wan, Yi, Wan, T., Sidini, S. (2012). Nonpharmacological nursing interventions for the management of patient fatigue: a literature review. Journal of Clinical Nursing, 22, 2668–2678. doi: 10.1111/jocn.12211

Furthermore, the nurses learn from the error and makes changes to his/her practice that decreases the likelihood that the error will occur again. If the nurses receive very little support from management and co-workers, affects nurses’ work-life, health, and confidence towards profession and then leave nursing. I completely agree that his tone is effective in persuades me by his point of view that nurses should seek help without hesitation and having fear that this will affect career.