Fatigue in Healthcare Professionals

Sleep loss and impairments related to fatigue are common among professionals working in healthcare settings. Long continuous duty hours, reduced opportunities for sleep with minimal recuperation time, and shift work all contribute significantly to impairments in physical, cognitive, and emotional functioning. Detrimental effects include those on personal health and well-being, patient health and safety, performance of job-related tasks, and professionalism. Many challenges exist to implementing effective personal and system-wide strategies to manage the impact of sleep loss. Therefore, adopting fatigue management strategies that have been successful in other occupational settings and developing specific interventions that are appropriate for the hospital setting are key in the causes and consequences of sleep loss and fatigue in healthcare.

Healthcare workers typically work off-shifts and long hours to provide vital services to society around the clock. These demanding schedules can lead to difficulties with sleep because of the need to sleep at irregular times and at times that are out of phase with normal rhythms. This misalignment of sleep with circadian rhythms leads to trouble with falling asleep, more arousals during sleep, and early awakenings leading to poorer sleep quality and shorter sleep duration. Furthermore, sleep duration may be shortened by insufficient time between work shifts and the competing demands of work and personal life. Economic pressures could force healthcare workers to seek second jobs, extra shifts, or longer hours, leaving even less time for them to sleep.

The Joint Commission also suggests that health care organizations encourage teamwork as a strategy to support staff who work extended work shifts or hours. For example, use a system of independent second checks for critical tasks or complex patients. Also, organizations should consider fatigue as a potentially contributing factor when reviewing all adverse events, and educate employees on the importance of good sleep habits, including ensuring their rest environment is conducive to sleeping. Previous alerts have addressed diagnostic imaging risks, violence in health care facilities, health care technology, anticoagulants, and medication mix-ups. The complete list and text of past issues of Sentinel Event Alert can be found at www.jointcommission.org.

The Joint Commission suggested examining processes related to hand-offs, which are high-risk and may not be carried out as well by fatigued staff, and creating teamwork strategies to double-check each other on critical tasks or complex patients. The accrediting body also recommended creating a fatigue-management plan, providing uninterrupted coverage of responsibilities and educating staff members about good sleep habits and the effects of fatigue on patient safety.The sleep environment should be dark and quiet, so the resting nurse can fall and stay asleep, without interruptions, And nurses who have difficulty sleeping should consult a sleep specialist. A hospital’s fatigue-management plan, according to The Joint Commission, may include strategies for fighting fatigue, such as engaging in conversation, physical activity, strategic caffeine consumption and short naps.

Although this is an alert directed at individuals working excessively long hours, it is a reminder, and maybe a warning, to take care of ourselves and get proper rest. But be warned that quick fixes will not solve the problem. Clinicians must go back to the basics and ensure they get a good night’s sleep. Lavender may help combat insomnia as can some herbs or melatonin. People need to make time for sleep by cutting out the things in life they least enjoy, “Make the time to give the body what it needs.”

MORE RESOURCES


Activity Bursts : //abeforfitness.com/browse-office-videos-1- date.html
Sleep Health Check : //www.webmd.com/sleep- disorders/sleep-disorders-health-check/default.htm
Sleep Quiz : //www.webmd.com/sleep-disorders/rm-quiz-sleep

Celeste Botonakis
 

On the Nursing Assistant Guides blog, certified medical assistant Celeste Botonakis explores the daily life of a CMA. She'll keep you up-to-date with the latest on what’s happening in the field, and provides tips for those who are interested in becoming a medical or nursing assistant. Celeste has served in the medical field for over six years, and is passionate about helping people. She currently works at CSR Primary Care in Skokie, Illinois. Click here to learn more about Celeste Botonakis and NursingAssistantGuides.com.