Importance Of Care-Provider Fatigue In Nursing Care

Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.

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.

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

In this proposal the findings stated that the likelihood of making an error is three times higher when working more than 12.5 consecutive hours of nursing practice. Errors made in the healthcare profession can put the patient’s life in jeopardy so it is important for workplaces to take all of these statistics into consideration. The proposal also found that errors are increased with overtime or working over 40 hours per week and night shift workers may have difficulty staying awake due to disturbance in circadian rhythms. In today’s society nurses often work 12 hour shifts, and this evidence is concerning. Nurses are supposed to give their full attention to their patient and have love for what they are doing, but fatigue is getting in the way of that.

As a result, overtime can compromise patients ' health or safety. Medical residents cited fatigue as a cause for their serious mistakes in four out of 10 cases (Boodman 2001), and two studies linked infection outbreaks at hospitals to overtime work (Arnow et al. 1982; and Russell et al. 1983). Indeed, the California Nurses Association reports that more nurses are refusing to work in hospitals with unsafe conditions, in which they include being forced to work unplanned overtime. The American Nurses Association (ANA), in a national survey of 7,300 of its members, found, disturbingly, that 56% of nurses believe that the time they have available for care for each patient has decreased, and 75% feel that the quality of patient care at their own facility has decreased in the last two years. The cited inadequate staffing as the chief reason.

Patients in a hospital and/or healthcare facilities have to be cared for all day and all night, everyday of the week by nurses. The usual way to fulfill this need is to divide up the day into three 8-hour shifts. Different shifts have been put into place to help improve nurse satisfaction, decrease the nursing shortage and save the hospital money. The 24-hour day is made up of two 12-hour shifts; 12 hours in the day and 12 hours at night. There has been quite an ongoing debate over the years regarding this issue of nurses working over 8 hours in a single day. Many people, such as hospital nursing administrators, have reason to believe that working long hour shifts causes more errors in

Nurse staffing have an effect on a variety of areas within nursing. Quality of care is usually affected. Hospitals with low staffing tend to have higher incidence of poor patient outcomes. Martin, (2015) wrote an article on how insufficient nursing staff increases workload and job dissatisfaction, which in effect decreases total patient care over all. When nurse staffing is inadequate, the ability to practice ethically becomes questionable. Time worked, overtime, and total hours per week have significant effect on errors. When nurses works long hours, the more likely errors will be made. He also argued that inadequate staffing not only affects their patients but also their loved ones, future and current nursing staff, and the hospitals in which they are employed. An unrealistic workload may result in chronic fatigue, poor sleep patterns, and absenteeism thus affecting the patients they take care of.

A nurse’s typical day isn’t without stress; it is usually a lot of complex planning, critical thinking, time management, an abundance of communications with all departments of the hospital, and documenting events that have happened throughout the day on their entire patient assignment. “Nurses who are mandated following the completion of their regular shift are often ill-equipped to continue working. They have not planned for that situation with: proper advanced rest, arrangements for

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)

Limited attention has been paid to the hours worked by nurses, or the effects of these hours on patient safety (Rogers, 2008). Even though most nurses favor 12- hour shifts and overtime, it is associated with difficulties staying awake during times of duty, reduced sleep times, and triple the risk of making an error (Rogers, 2008). The most significant risk of making an error occurred when nurses were scheduled to work 12.5 hours or more.

For some nurses, mandatory overtime can be an advantage due to financial instability but mostly mandatory overtime can cause fatigue, burnout, injuries, errors, inadequate sleep and deficits in performance. According to research working long hours which consists more than 40 hours a week or over 12 hours a day leads to an increased medication errors and patient mortality. The probability of making medication errors increases tremendously when nurses work longer than 12.5 hours a day. During surveys regarding reasons of overtime, 60 % of nurses stated that overtime was obligatory as part of their job, 29 % of nurses stated that they volunteered and 41% of nurses stated that they were “on call hours” (Bae, 2012)

“Burnout has been widely studied in the health service profession, and nursing is recognized as one of the occupations with the highest burnout prevalence rates” (Harkin & Melby, 2014, p. 152). Nursing burnout affects many nurses in the profession in one way or another. In the nursing world, a typical shift length is now twelve hours or longer. This shift length has changed from the past in which nurses worked a normal shift of eight hours. While there are benefits and disadvantages to each of these shifts, there has to be a regulation of total hours worked in a week. Nurses who work at the bedside of critically ill patients witness marked human suffering (Sacco, Ciurzynski, Harvey, &

The reason for selecting this article is that excessive workload is a major factor inducing this serious clinical incident and can lead to both physical and mental exhaustion. Exhausted states can be negatively associated with nursing performance. Researching the relationship between exhaustion deriving from a heavy workload and the quality of performance of nursing staff can become a preventive step of clinical incidents.

The reality is that human’s make mistakes. Caregiver’s fatigue and stress plays a huge role in medication error. It is reported that fatigue and stress increased the risk of medication error. In a study comparing nurses who worked a 12 hour shift in different age groups, older nurse’s experienced sleeping trouble and were not able to focus on maintaining their performances during their shift (the average age of US registered nurses is 46.8). Fatigue is related to misreading labels, because somehow one is not fully conscious, a nurse who worked a 16 hour shift went into the medication