Taking a Look at Nurse Fatigue

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).

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

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

According to Jansen, van Amelsvoort, Kistensen, van den Brandt & Kant (2003) and Ruggiero (2005), fatigue is viewed as a critical issue for nurses because it leads to potential undesirable outcomes such as medication errors, degradation in performance, decreased mental acuity, personal problems, job dissatisfaction, and frequent requests to move off of night shifts (as cited in Kunert, King, & Kolhorst, 2007). “Work related fatigue is a complex, multidimensional condition with emotional, physiologic, cognitive or mental, and sensory components that occur as a consequence of excessive work demands and insufficient energy

Nurse’s sleep was evaluated using wrist-worn actigraph with the support of a sleep log; Karolinska Sleepiness Scale (KSS) and Occupational Fatigue Exhaustion Recovery scale (OFER) were used to evaluate fatigue levels baseline and intershift. Performance level was assessed using the Walter Reed Psychomotor Vigilance Test (PVT). Consecutive shifts where found to increase the levels of ongoing fatigue and sleepiness (sleep debt); with increasing performance issues (lapsing) on the PVT test on the second and third consecutive shifts worked. This research study includes a respectable data size (80 nurses) with respected and strong data collection tests (actigraph, KSS, OFER, and PVT). Limitations of the study include a short duration of data collection cycle, no measure of the effect of shift rotation preceding the shifts worked, and possible data variance due to nurses who could have worked multiple jobs.

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.

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).

Today the big debate in nursing career is weather nurses working at hospitals in the United States should be working 8 or 12-hour long shifts. The reason this debate is still ongoing is because they are finding advantages to both of these shifts. Researchers are finding nurses who are working 12-hour shifts to be more fatigued. Whereas, when a nurse works 8-hours they are more involved and energetic through their shift. Even though 12 hour shifts in a way can be beneficial to the nurses they also need to think about the patient stratification. Studies have shown that nurses who work 8-hour shifts provide better patient satisfaction. If all hospitals across the United States mandated 12-hour shifts nurses will be more prepared and focused

Hospitals work around the clock. There is someone handing out medicine, doing paper work, or checking on their patient. The average work week is forty hours a week. Most hospitals require nurses to work mandatory overtime. Nurses shifts are twelve-hour shift, including lunch breaks. Hospitals are understaffed with nurses to fill the hours that are in a week. Nurses usually work up to one extra shift a week if not more. Long exhausting hours can cause more mistakes, fatigue, and resentment towards your job. Over worked nurses will experience one if not more of these and it will affect their work ethic. Overtime has caused most if not all of these symptoms to nurses at least once in their career.

When given no choice but to provide an overwhelming care to a ratio of patients not recommended, this will cause nurses to feel unsatisfied with their career. Because nurses are to render care with unrealistic workload, this may result in “chronic fatigue, poor sleep patterns, absenteeism, and job dissatisfaction” (Martin, 2011). It is but peace of mind that nurses acquire up arriving home. If they are disturbed during rest, or have to think about the hard work awaiting to be placed upon them, staying awake and alert during a shift, will result in an increase of incidents and unsatisfactory care; the evidence of the malpractice of nonmalificence and

I have been a staff nurse in the emergency room for fourteen years. I have worked a variety of 8, 10, 12, and even 16 hour shifts. I currently am working 8 and 12-hour shifts on nights. Previously, I also worked some 12-hour day shifts. I personally have been struggling with working the 12-hour shifts. My commute to work is 1 hour one way and I have fallen asleep several times driving home from work. The last four hours of my shift I experience great fatigue and even have had trouble staying awake. I have come close to having medication errors and feel that my quality of care is less during the last four hours. When working 12-hour shifts I average around 5-6 hours of sleep before

Research studies and surveys have identified many factors contributing to nurse fatigue which tend to intersect with one another to cause a more significant effect than any one factor would alone. A common theme in the literature is the issue of nurses caring for too many patients for an extended period of time (Tabone, 2004). This often comes as a result of inadequate staffing of registered nurses (Registered Nurses’ Association of Ontario, 2011) which is another contributing factor to nurse fatigue. Nurses report working long shifts of more than 12 hours, not having sufficient time to rest prior to their next shift, and changing shifts within the week as factors contributing to their fatigue (Registered Nurses’ Association of Ontario, 2011). All of these things result in a

High levels of fatigue affect the ability to think clearly and that includes being able to judge your own level of impairment. Fatigue is a reality of nursing. Every day and every shift nurses experience fatigue in mind, body, and spirit. And fatigue, over time, takes its toll (para.10).

Nursing Fatigue is a subjective feeling that creates an exhaustion that interferes with a nurses cognitive and physical capabilities (CNA & RNAO, 2010). It is influenced by psychological, physiological, behavioral and environmental factors including work stress, increased workload, understaffing, patient and family expectations, unexpected emergencies and a disorganized workplace (CNA & RNAO, 2010). The well-known fact that nursing fatigue creates many health care issues and the sought out vision of an improved

The work environment may exacerbate fatigue in nursing causing them to leave because they cannot provide good care to patients (Purdy, N., Spence, K., Finegan, J., Kerr, M., & Olivera, F., 2010). Gellasch conducted a study (2015) which concluded increased shift lengths put nurses at risk for exacerbating fatigue, causing them to make errors, and forcing them to leave the clinical care setting due to lack of support from colleagues and employers, and inadequate staffing. Chan, Tam, Lung, Wong, & Chau’s (2013) study showed that there is differences between the nurse’s ideal and the actual reality of nursing practice, leading to job dissatisfaction because nursing is stressful with the most common stressor being heavy patient workload. According