Nursing Fatigue and Patient Safety
Fatigue, is the state of one being energy deprived to carry out proper activities of daily life (Rogers, 2008). It certainly is evident within the health care system in regards to nursing and how it affects a nurse physically, mentally, and emotionally (Canadian Nurses Association, 2012). This can negatively impact the quality of patient care, as judgment is impaired, increasing risk of injuries to the patient (Scott, Arslanian-Engoren, & Engoren, 2014). This paper will discuss the impact of nursing fatigue on patient care, level of power, policy cycle, barriers to resolution to the issue, potential strategies that can be implemented to promote patient safety, and nursing stance on the topic discussed throughout.
Health Impact Patient safety is among one of the top priorities associated with nursing as a profession. One of the common factors that contribute to fatigue is sleep (Rogers, 2008). According to Rogers (2008), it is shown that nurses have the inability to be efficiently productive with inadequate sleeping habits. This ultimately results in an inability to provide safe, competent care, as nurses are over worked, thus triples the chance of making an error (Rogers, 2008). Greater chances of making errors are most likely to occur when a nurse works past 8.5 hours (Rogers, Hwang, Scott, Aiken, & Dinges, 2004). With inadequate rest and risk of burning out, medication errors and needle stick injuries are most likely to occur,
A major issue in the medical career field is the demand for nurses and this, of course, means that these nurses will be working strenuous hours to meet the high demands. While this may satisfy some issues it also creates others. Longer hours results in exhausted nurses and this leads to negative patient outcomes.
In the recent past, nursing has come to the forefront as a popular career amongst students across the globe. The demand for nurses has kept increasing gradually over the years. In fact, the number of registered nurses does not meet the demand of the private and public health sector. This phenomenon has resulted in a situation where the available registered nurses have to work extra hours in order to meet the patients’ needs. With this in mind, the issue of nurse fatigue has come up as a common problem in nursing. According to the Canadian Nurses Association (CNA), nurse fatigue is “a feeling of tiredness” that penetrates a persons physical, mental and emotional realms limiting their ability to function normally. Fatigue does
Significance: Because nursing is the largest health care profession and nurses provide most of the patient care, and as an acute nurse, I can relate to how unsafe nurse staffing/low nurse-to-patient ratios can have negative impact on patient satisfaction and outcome, can lead to medical and/or medication errors and nurse burnout. It can also bring about anxiety and frustration, which can also clouds the nurses’ critical thinking. Most patients might not know the work load on a particular nurse and can assume that her nurse is just not efficient. Doctors also can become very impatient with their nurses because orders are not being followed through that can delay treatments to their patients. There is also delays in attending to call lights resulting in very unhappy patients who needed help.
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.
Nurses spend most of their time taking care of their patients that they forget to be mindful of their own wellbeing. It is very important for nurses to take care of themselves because it is reflected through the care they provide to their patients. Sleep deprivation can increase the chances of a nurse miscalculating a dosage, which can be fatal to a patient’s life or injure themselves by forgetting proper body mechanics. Not having enough sleep and overworking themselves can be the cause for this simple mistake that could have been avoided through self-care. Having at least 8 hours a sleep a night is just one of the few ways a nurse can manage healthy living. A nurse’s work schedule can consists of mainly over
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
When nurses experience fatigue due to excessive overtime, effects that can occur are reduced decision making ability, reduced communication skills, increased forgetfulness, increased tendency of risk taking, reduced ability to handle stress on the job, decreased ability to do complex planning, and inability to recall details which can all danger patients wellbeing. Unfortunately even with all the
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.
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
“Sleep Quality in Nurses: A Randomized Clinical Trial of Day and Night Shift Workers” is a quantitative study by Nui, Chu Chung, Lin, Chang, and Chou published in the journal of Biological Research for Nursing (2012). The article aims to compare the amount of recovery time needed by nurses that work the night shift in relation to nurses that work the day shift. In order to determine if a study is eligible to use for developing evidence based practice it is important to critique research articles (Lobiondo-Wood & Haber, 2014) for their quality and applicability. This will determine if the study is relevant and can be applied to nursing practice. That is the purpose of this paper.
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
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
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)