Nurse Fatigue Megan Demos Marian University

Fatigue  Created by Megan Demos RN as a project through Marian University in Fond du Lac, Wisconsin. Do you ever find yourself feeling like this at work?

Or like this?

What about this?

 Many of you can probably relate to the feelings depicted  Many are also probably wondering, so what? I feel like that all the time at work. “Isn’t that just part of being a nurse?”  The images shown have become the norm instead of the exception…this needs to change!

So What is the Problem?

Nurse Fatigue  Fatigue is a feeling of exhaustion that interferes with the ability to fully perform physically or mentally.  Fatigued people have decreased energy and reaction time, mood alterations, and impaired judgment.  Fatigue in nursing has been a growing problem due to an overall shortage of nurses.  Nurses work longer hours, skip their breaks, and care for an ever increasing ill population of patients with complex plans of care.

Nurse Fatigue cont.  12-hour shifts have become a common practice in nursing. These shifts help with continuity of care over the course of a day but not over the week.  A study of 2000 people reported that within the last 4 weeks 14% of workers had worked 16 hours and 81% ran over what they were scheduled to work.  Rotating shifts are harder on nurses than those that just work one shift; 60-80% of these nurses suffer from chronic fatigue and sleep disturbances.  Many nurses feel that no matter how little sleep they get they will not fall asleep because their job is too important and they always stay busy. The reality is that often times they will go into an involuntary sleep known as microsleep.

Why talk about this now?

Does Anyone Recognize this young girl? o “It should have been my life, not her’s. Deep anguish and remorse are the sentences I will serve for all time. I would give my life to bring her back.”-Julie Thao o This is Jasmine Gant from Madison, WI. o She was only 16 when she died while in labor with her first child. o The nurse responsible was working overtime when the incident occurred and was said to be fatigued.

Have you ever done this? o A nurse in Minneapolis was like this on her way home from work on July 27, o Worked 3 consecutive twelve-hour night shifts o An 18 year old girl was working her summer job and was struck and killed by Brockhaus’s car. o “To bear the guilt that goes with being responsible for the loss of life is heavier than anything I will ever experience.”-Laura Ann Brockhaus wheel.jpg?w=200&h=160

It is cases like these that demand changes be made in regards to nurse and patient safety!!!

Facts About Sleep  The circadian rhythm is a 24 hour cycle controlled by the body that may be stimulated by factors outside of the body.  The average adult needs 7-9 hours of sleep per day in order to allow our body to recuperate, both physically and mentally.  As of 2002, the average amount of sleep people get on workdays is 6.9 hours.  Caffeine consumptions should not exceed 3 cups of coffee/day because it may make falling asleep more difficult.  Exercise (at least 30min 3x/week) improves sleep.  Sugar gives a short burst of energy but then creates a “crash”. 

Facts about Inadequate Sleep  <5hr of sleep in 24hrs causes a decline in cognitive abilities  Missing a night of sleep causes a 25% decline in cognitive performance, which increases to 40% if 2 nights are missed  An accumulated loss of 1 hour of sleep per night can decrease concentration  Being awake for 17 hours is equivalent to a BAC of 0.05%  If awake for 24 hours it is equivalent to having a BAC 0.10%  million people have undiagnosed sleep disorders

Consequences of Inadequate Sleep/Long Work Hours  Falling asleep at work  Medical errors  Fatigue-related errors cost about $100 million per year  Number of errors changes depending on shift worked and how many shifts/hours worked in a row.  Staff injuries  Higher rates of musculoskeletal injuries, cardiovascular disease, and poor perceived health  100,000 car crashes, 40,000 injuries, and 1,550 fatalities each year due to “drowsy driving” 

An Actual Road Sign in Utah hilKonstantin.jpg

Who’s Problem is it?  Hospitals  Nurses  Community

References Ashley, L. (2010). Report of fatigue recommends actions at many levels. Canadian Nurse, Caruso, C.C & Hitchcock, E.M. (2010). Strategies for nurses to prevent sleep-related injuries and errors. Rehabilitation Nursing. Retrieved from October Cunningham, J. (2008). Fitness for duty: Managing fatigue-related risk. Texas Nursing, 4-5. Dennik-Champion, G. (2010). Lessons learned from the perfect storm. STAT Bulletin. Retrieved from Graves, K & Simmons, D. (2009). Reexamining fatigue, implications for nursing practice. Critical Care Nursing Quarterly 32(2), Hildreth, K. (2007, June 6). Nurse faces lesser charge stemming from fatal accident in Farmington. This Week. Retrieved from Hospital Employee Health. (2010). Fighting fatigue requires more than caffeine, Maben, J. (2010). Long days come with a high price for staff and patients. Nursing Times 106(2), 25. Ross, J. (2008). Fatigue: Do you understand the risks to safety?. Journal of PeriAnesthesia Nursing 23(1), Scott, L. D., Hwang, W. T., Rogers, A. E., Nysse, T., Dean, G. E., & Dinges, D. F. (2007). The relationship between nurse work schedules, sleep duration, and drowsy driving. Sleep 30(12), Wisconsin’s Work Net (2011). Registered Nurses. Retrieved from