How to Address the Persistent Issue of Nurse Fatigue
By Jennifer Larson, contributor
Nurse fatigue in America is a growing issue for many. Long shifts, challenging schedules and not feeling well-rested on the job have all become warning signs that often go under addressed.
The American Academy of Nursing (AAN) recently released a position statement on the problem of nurse fatigue. In the statement, the Academy acknowledges the numerous problems related to sleep deficiency and emphasizes that safe nursing practice requires nurses to receive high quality sleep of adequate duration.
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Linda Scott, PhD, RN, NEA-BC, FAAN, Dean and Professor at the School of Nursing at the University of Wisconsin -Madison, is an AAN board member who co-authored the position statement. She has also conducted research in the past that has evaluated possible countermeasures to address the problem of fatigue in nurses.
“We have long been aware of the issue of fatigue in nursing and its impact on practice and patient care,” Scott said. “We know that fatigue has an adverse effect on patient care and an adverse effect on the health of nurses and also an adverse effect on public safety, when you have drowsy nurses on the road.”
With this statement, the Academy is urging everyone to pay attention to the issue and to take action.
“The time has come for us to do something about it,” said Scott.
A Joint Responsibility
The AAN statement does not put the onus squarely on the backs of individual nurses to address the problem. Rather, it also addresses the need for managers to share in the responsibility of “reducing the risks linked to poor sleep health and fatigue.” Nurse managers can be part of the solution by considering best practices for scheduling and other strategies for making a healthy practice environment for the providers and their patients.
“It really is a joint responsibility,” said Scott. “Yes, there is an individual accountability but there is also an organizational accountability.”
In 2014, the American Nurses Association (ANA) updated its own position statement on nurse fatigue, which was titled “Addressing Nurse Fatigue to Promote Safety and Health: Joint Responsibilities of Registered Nurses and Employers to Reduce Risks.” The ANA statement also acknowledges that the efforts to address the problem must be a joint effort between employers and individuals.
Megan Brunson, MSN, RN, CCRN-CSC, CNL, takes this aspect of her management responsibilities very seriously.
“As a supervisor, I will not hesitate to adjust a schedule within 24 hours out when a nurse confides in me she is struggling,” said Brunson, manager of the CVICU and night shift supervisor at Medical City Dallas Hospital and a former director on the board of the American Association of Critical-Care Nurses (AACN). “Being responsible for the night shift schedule, I will contact them after reviewing their requests, if I see they signed up for too many shifts or shifts every other night. This will bring the conversation forward and allow me to chat about their concerns and mine.”
Another example of a strategy that a manager could consider using: the strategic nap. Scott noted one of her own research projects found that the use of strategic naps--about 20 minutes in duration--was shown to decrease fatigue among nurses and improve alertness.
Your Responsibility as an Individual
As a night shift manager, Brunson is well acquainted with the challenges that shift work can present to nurses in their quest to sleep well. She’s developed a list of strategies to help herself stay on track, too.
“Map out your sleep each week,” she suggested. “Literally count the hours and give the ultimate respect to the amount of time you are sleeping. Sleep has to be the no. 1 priority in your schedule.”
While night shift work can disrupt a person’s natural sleep habits, working away from home for long stretches of time can also present some challenges. Some travel nurses find that they don’t sleep as well when they’re working and living away from home. The unfamiliar environment may not be conducive to getting a good night’s rest.
But as Scott noted, individuals have a responsibility to make sure they’re getting enough sleep so they can be alert on the job. They need to pay attention to their bodies’ need for adequate rest for their own sake--and for their patients’.
When you’re working away from home on a travel nurse assignment, do you look for ways to make sure you’re getting enough sleep? Are you making good sleep hygiene a priority? It may be time to take a closer look at your sleep habits to see what improvements you can make.
For more information on improving your own sleep habits, read How to Sleep Better: 10 Tips for Nurses.