Nurse Fatigue
Nursing is hard work. It tires the mind, the body and the emotions. Nurses are with patients twenty-four hours a day, seven days a week. Some nurses work with well, acutely ill, chronically ill, rehabilitative and/or dying patients. Some nurses work eight hour shifts; some twelve hour shifts; and then there are those that work a shift plus overtime. Some nurses work permanent shifts, some rotating shifts and some work shifts in no particular pattern. All of these factors make nursing a very physically and emotionally draining profession.
Other industries have been aware for many years of the links between fatigue and accidents, mistakes, errors and near errors. For instance, the airline and trucking industries limit the number of hours pilots and truck drivers can fly/drive. They also require a certain number of hours between "flights" or "runs" Why? They do this because empirical research has demonstrated that one’s decision making skills decline with fatigue; reaction times lengthen with fatigue; and problem solving is impaired. All of these outcomes of fatigue contribute to decreased safety in the air and on the highway.
Although medicine limited intern and resident work hours several years ago, nursing did not become concerned about fatigue until nurses being forced to work overtime began to worry about how safe they were during the overtime hours. About the same time, the health care system was deeply involved with determining the causes of adverse patient outcomes. In addition, the United States Pharmacopeia (USP) met with professional organizations to discuss the findings of their adverse incident reporting system. Of no surprise to most nurses, the data show that most reported medication errors were “made by nurses”. However, the USP and people familiar with the health care system know there is much more to the findings than the raw numbers indicate; thus, the exploration into factors affecting adverse nursing-sensitive patient outcomes.