Reducing Nurse Fatigue

Photo by: Jaula DeArdilla

The phrase “health care” is very important to nurses. We got into the health care industry because we “care”; it’s definitely the operative word in the phrase for us. So, why is it that people seem to think we don’t actually care? Well, we’re fatigued and overworked and, consequently, our patients suffer as a result. If there is any industry that shouldn’t be big business, it’s the medical industry. Nurses stretched beyond their capacity just to save money is wrong, plain and simple. Nursing fatigue is a real and avoidable problem, and all health care facilities should make it a point to reduce nurse fatigue.

What is Nursing Fatigue?

Let’s talk about what nursing fatigue actually is first. As human beings, anyone can only handle so much stress and pressure at one time. If there is one thing that nursing is, it’s stressful. But the reason nursing is stressful is why so many of us become nurses in the first place. We want to save lives and make a difference, and in emergency and critical care situations, there’s going to be a little stress involved.

Contributing Factors

The number of patients assigned per nurse is becoming increasingly greater; in other words, nurses are becoming singularly responsible for more and more people at one time. On top of that, nurses work long hours, and are often required to extend their already long hours further. This is the perfect recipe for tiredness and constant fatigue.

• Nurse Staffing - This Nursing World’s page provides facts and links about nursing fatigue.
• Mandatory Overtime/Consecutive Shifts - Read Texas Board of Nursing’s OT and consecutive shift laws.
• An Evidence-Based Handbook for Nurses - Chapter 40 of this nursing handbook discusses the effects of fatigue to nurses.
• Fatigue: Implications for Nursing Practice - Washington State Nurses Association also talks about the dangers of nursing fatigue.

It IS a Big Deal

You might think a little fatigue isn’t such a big deal; none of us get enough sleep and we’re all under too much stress; nothing a giant cup of Joe won’t fix. But not all of us are responsible for saving people’s lives. I’m quite certain stockbrokers experience stress and fatigue at levels no human should ever endure, for example. But, a tired stockbroker will not accidentally kill somebody else... okay, perhaps not the best example, as people have been known to commit suicide after being bankrupted, but you get what I’m saying. Fatigue works differently in the health care industry.

You see, when a nurse is fatigued and his or her thinking cloudy, critical mistakes might be made and a patient might suffer. Worse yet, a mistake might cost a patient his or her life. This is why this is such a critical concern. You are responsible for the care and well-being of another human being is incapable of caring for him or herself. You CANNOT make a mistake when you’re a nurse, like you might be able to in other industries. Mixing up medication could be fatal; mixing up a sales order is not.

• Fatigue, Sleepiness, and Medical Errors - Agency for Health Care Research and Quality talks about medical errors related to fatigue.
• Health Care Worker Fatigue and Patient Safety - Read the Joint Commission’s paper of health care worker fatigue and its impact on patient safety.
• Facts about Nurse Fatigue and Patient Safety - The Wisconsin Nurses Association gives the facts about this alarming issue.

What are We Going to do About it?

So, what can we do about the growing occurrence of nursing fatigue in the health care industry, and what is already being done? Well, one solution is implementing smart staffing solutions within a health care organization. Many clinics and hospitals are rethinking their nursing rotation, and the amount of nurses they have on rotation.

It’s really a no-brainer: If you have enough skilled nurses on staff at any given time, your patients will receive optimal care. Simple!

Another way to ensure clinics and hospitals are adequately staffed is by keeping a variety of specialized nurses on duty during the critical hours they are needed. You can’t have a floor full of only LVNs. You need to have a variety of nurses with different skill sets to ensure that any patient need is covered. I’m not taking anything away from LVNs or any level of nursing - we all play crucial, crucial roles in patient care - but a variety of skill sets ensures patient care is more than covered no matter the situation.

• Registered Nurse Safe Staffing Act of 2013 - Read the bill on GovTrack.us.
• RN Safe Staffing Bill Introduced in Congress - Infection Control Today gives its take on this important Bill.
• American Nurses Association’s Safe Staffing Page - Check out the links on the ANA’s safe staffing page to learn more about this important topic.
• The RN Safe Staffing Act and What It Means for You - Capitol Update explains what the RN Safe Staffing Act is and how it will impact patient care.

As a nurse, you know how fatigued you are; hopefully, you haven’t had a mishap with a patient as a result of your fatigue. You also know that adequately staffing and rotating nurses is not rocket science. It’s easy to understand that appropriate patient care requires enough nurses on duty with a variety of specialized skills to ensure all medical care needs are met. We’ve introduced legislation to put RNs in charge of nurse staffing decisions in hospitals, and that makes sense. After all, it takes nurses to understand nursing and how to best ensure all patient nursing needs are met.

• Federal Legislation: Registered Nurse Safe Staffing Act — Safe Staffing Saves Lives is an organization dedicated to the safe nursing staffing cause.