Inadequate Sleep And Resulting Fatigue

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

West, Ahern, Byrnes and Kwanten (2007) indicate that the new graduate nurses may have not worked full-time in the past; given that graduate nurses begin their career with a full-time job can lead to exhaustion. It was discovered that shift work leads to desynchronisation of physiologically determined circadian rhythms which has a major psychobiology effect and it is commonly perceived the effects of shift work contribute to graduate nurses attrition rate. The NGNs often have a high level of stress due to disturbed sleeping patterns, as they find to adaption to shift work or rotating work hours difficult. Eventually, it leads to feelings of lack of job satisfaction, exhaustion and spending of less time with their friends and family, which can eventually could lead to burnout (West et al., 2007).

Another cause of nurse fatigue is lack of adequate sleep. First, working 12 hour shifts means that nurses only have 12 hours to sleep and also conduct other activities of life outside the workplace, while other professionals have 16 or more hours for rest and social activities. This is the reason for the few hours of sleep recorded by nurses with some opting to not sleep at all but take short naps. These are

Purpose: The purpose of this speech is to inform my audience about the importance of safe nurse staffing that can help improve patient satisfaction, decrease patient complications, reduce nurse fatigue, improve nurse retention, decrease patient mortality, and reduce medical and medication error.

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.

Pamela F. Cipriano, President of American Nurses Association was in disbelief to see how she has tried to enforce the Nightingale pledge of keeping patients free from harm was failed because medical errors are the third leading cause of death in the United States. As of now ANA has conducted yearlong campaign named “Safety 360 It Starts with You” in order to reduce and take measurable advances to protect the welfare of nurses and workers. It is one of campaign that the ANA comes with that is in support to both the nurses and patients. However, in the real-world nurses are stress and fatigue due to patient ratio. In my workplace, which is a state hospital, they have full time nurses on call where nurses work more than 70 hours a week. The nurses

A fatigued nurse can lead to many errors and compromise the care given to a patient. Nurse fatigue has been found to increase depression. If a nurse has an altered mindset to begin with, they will not be able to take care of anyone else adequately. Nurse fatigue can also increase irritability. A nurse with increased irritability could lead the nurse to make irrational decisions. The nurse with sleep deprivation has an increased risk for error. A nurse is responsible for administering drugs. When a nurse is extremely tired, it could lead them to mess up the medications prescribed for the patient or to overlook reactions that the patient may experience from the medications. The nurse is also responsible for focusing on the care provided to the patient. A fatigued nurse could be too tired to notice crucial changes in the patient. The fatigued nurse will be affected in his or her performance. Nurse fatigue could also result in the nurses injuring themselves. Nurse fatigue could influence a nurse to make shortcuts and that can also endanger the nurse. For example, if a nurse has to lift a patient using a hoyer lift, but misjudges the situation because of lack of energy, the nurse could end up lifting the patient by herself and hurting her back. This is how nurse fatigue relates to the safety of the practicing nurse and patient

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)

Does one ever think about the words “required” or “extended work shifts”? To countless nurses these terminologies or jargons mean mandatory overtime. In today’s healthcare, “required” overtime has sky rocketed, attributable to, the nursing shortages throughout the United States. Studies have revealed that working “extended work shifts or additional shifts” have a negative impact on both patient and nurse safety. The purpose of this paper is to inform and advocate for the Registered Nurse Safe Staffing Act. This author will discuss the key points, provide a critique of empirical evidence, and demonstrate the importance and impact of this Act to the nursing profession.

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

The researcher assumes that shift work leads to nursing fatigue and multiple health issues. Shift work in nursing will eventually lead to an increase in medication errors and needle stick injuries. Researcher also assumes that lack of sleep will affect nurses’ well- being and decrease patient satisfaction. The researcher came to this assumptions based on the multiple research studies performed on shift work and the negative findings found related to shift work.

In addition, the lack of regulatory standards or mandated nurse to patient ratios will be detrimental to nurses. Nurses who experience heavy or excessive workloads tend to be afflicted with fatigue, this leads to nurse burnout, job dissatisfaction and a harmful working environment. According to Connie Garrett (2008), “the effects of extreme fatigue can be compared to being under the influence of alcohol”. Fatigue is known to slow or impede reaction time and alter attention to detail. These are major contributing factors related to errors of omission. Reaction time and attention to detail are important factors required for problem solving techniques, personal motivational skills and energy.

The broad research problem leading to this study is the belief that nursing shortage in facilities leads to patient safety issues. The review of available literature on this topic shows strong evidence that lower nurse staffing levels in hospitals are associated with worse patient outcomes. Some of these outcomes include very high patient to nurse ratio, fatigue for nurses leading to costly medical mistakes, social environment, nursing staff attrition from the most affected facilities. The study specifically attempts to find a way to understand how nurse

Stressful work environments, long work hours and inadequate sleep all contribute to an increase in physical and mental exhaustion amongst nurses. Typically, people choose nursing as a career to help others and to make a difference in their lives, without realizing the number of duties this career demands. Nurses may suffer in silence when they are experiencing stress. The effects can impact safe and reliable care by decreasing job satisfaction, decreasing productivity, causing poor personal health, and compromising patient care. Many facilities would benefit from implementing evidence-based strategies to address nurse fatigue and burnout.

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)