Description of Nurse Fatigue
Nurse Fatigue refers to psychological or physical tiredness that can prevent a nursing officer from functioning normally. It constitutes more than just the feeling of tiredness and drowsiness. It can either be physical or psychological and in some cases a combination of both. As such, the individual nursing officer can have a limited decision-making ability, affect their ability to think critically and lower their reaction time in addition to critically influencing their general health (Drake, Luna, George, & Steege, 2012).
Steege, Pasupathy, & Drake (2014) point out that when a nursing officer suffers mental fatigue, it could be associated with anxiety and sleep which may have occurred from irregular sleep patterns. Additionally, they may suffer learning and recall deficits as well as neurobehavioral defects like errors of omission and commission. Physical fatigue on the other end may induce sleep and rest habits physically draining a person. Also, there is the adrenal fatigue that may result when a person’s adrenal glands end up functioning at a level below the ordinary.
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Nurse fatigue has been linked to many causes. The first being, insufficient sleep. When a person fails to have a sufficient sleep, it affects their overall health. Sleep plays a significant role in regulating an individual’s immune function. Therefore when a person is deprived of sleep, they tend to suffer low immunity subjecting them to opportunistic diseases which weaken their body making them prone to fatigue ( Dubeck, 2014) . The other cause of nursing fatigue is extended working hours. It was further established that about two-thirds of nurses struggles with staying awake while on duty while more than one-fifth frequently fall asleep while on duty. Also, a study by the National Institute for Occupational Safety and Health reports that individuals who work more than 40 hours every week or on extended shifts that exceed 8 hours, as well as those that work both extended hours and overtime often experience adverse effects on their health ( Dubeck, 2014) . Such effects may include cardiovascular symptoms, muscular skeletal injuries and other muscular skeletal discomfort.
The Reason Nurse Fatigue Is Important To Professional Nursing
Nurse fatigue is a threat to patient safety. Nurse fatigue has adverse effects in the health care sector affecting the patient outcome. Fatigue affects the professional performance of nurses, limits their daily lives, and hampers their ability to self-care as well as for coping with their daily demands. Nurse fatigue takes a toll on patient care and jeopardizes patient safety ( Dubeck, 2014) . For instance, when a nurse fails to obtain sufficient sleep, they are more likely to have an increased chance of medical error. Studies have indicated that accidents rates in hospitals increase during the extended working hours with accident rates rising after 9 hours of work. The accidents further double after 12 hours of consecutive work by a nursing officer ( Dubeck, 2014) . It is more than just the patient safety but also about the health of the nursing practitioners. Nurse fatigue also increases the medical error in nurses risking their health as they administer treatment on patients ( Dubeck, 2014 ). As such it also puts them at risk as much as it does for the patients.
Dubeck (2014 ) asserts that nursing fatigue is a significant problem because risk managers will give this issue the first preference. As such, they will be able to assess the risks related to fatigue issues like repeated shift of work, under staffing and policies that promote overtime ( Hopcia, et al., 2012) . The professional nursing will create a fatigue management plan which comprises education of the employees concerning the effects of good sleep hygiene and fatigue and making it a task for the employees to intercede if they notice a coworker suffering from fatigue effects. It is possible for the nursing professionals to reduce their level of fatigue by joining and support each other to extend the shifts and working out on how to get personal sleep habits. Once the nurses have discovered the issue of fatigue, they will consider working in extended or multiple shifts on their fatigue level to counter the adverse effects. Eventually, it is the responsibility of the nurse to decline a task if he or she is affected by fatigue.
History of Nurse Fatigue
Townsend & Anderson, (2013) detail that nurses have for a very long time functioned for long hours failing to give a second thought over their fatigue. They have worked12 hours on a shift and in some cases 16 hours before being allowed a shift especially in hospitals that have personnel shortfalls. Historically, the nurses have worked long hours including sleeping in the wards to spend time with their patients. In the 19th century there were efforts to reduce the nurse working hours. As such, in 1886, labor Unions organized a one-day strike to protest and demand 8hrs as the maximum working hour per day (Townsend & Anderson, 2013). It bored fruits albeit little with just a few organizations having their working hours reduced to 8hrs. More advancement in the quest to reduce the nurse working hours would follow in 1938. The U.S. Fair Labor Standards Act became the guiding document on number of hours allowable for an individual per week. Similarly, a backing from an industrial research conducted over the 20th century indicating that workers’ productivity declines after 8 hours of work worsening over the 12th hour came into place. Professional compassion fatigue was then adopted as a term in the 90s to describe the nurse fatigue. Owing to the long hours of work that Nurses were subjected to, 98,000 preventable deaths result from the nursing fatigue. As such, there has been a wider concern in the medical fields to reduce the working hours over the 21st century to 8 hours a day. Accreditation Council for Graduate Medical Education restricted the work hours to 80 hours per week in 2003 (Townsend & Anderson, 2013). That was based on the recommendations given by IOM also referred to as Institute of Medicine. Currently majority nurses work for 8 hours shift reducing the errors in the medical practice and increasing the patient outcome.
Importance of Nurse Fatigue to My Personal Nursing Practice
The implication of nursing fatigue to the patient outcome is dire. For a robust health care, there is need to reduce medical errors so that the patient care can be safe. Safety is paramount in the health care, and one great area that contributes to errors in the care of patients is Nurse Fatigue. As a nurse practitioner, Nurse Fatigue is a critical aspect of my practice. My duty to ensure an improved patient outcome through ensuring the proper and accurate provision of primary care to patients. Nursing fatigue enables me to appreciate its implication on patient safety as well as its contribution to medical errors either due to omission or commission. Therefore, Nurse Fatigue requires me to think critically and develop strategies that will provide solutions towards mitigating Nurse Fatigue and overall improving the patient outcomes.
The Main Opposing View
According to Carlson, (2012), there are claims that Nurse Fatigue is just but a matter of Nurse not knowing how to care for the patients and their minds when dealing with patients. Carlson, (2012) suggest that fatigue perhaps is but the fatigue of doing things the way the nurses have always done them as well as thinking about things in the manner they have always done. Helping others can always make one happier. Nurses should always give themselves to the duty of helping others without feeling fatigued. The problem is not due to the care for patients but rather about nurses caring for themselves and their minds so that they can be compassionate and willfully dedicate their time and energy towards helping the sick.
Evidence Based Practice Research
In the research by Dubeck (2014 ), there is compelling proof that shows that inadequate sleep and fatigue has unfavorable effects on the mood and performance of nurses. Many other clinic trials and research using time series have acknowledge the same. Dubeck (2014 ), further adds that the adverse effect of fatigue has been documented in many settings ranging from field studies to tightly controlled labs as well as employed staffs. The researches signifying the link between unfavorable effects on healthcare and acquiring less than seven hours sleep in the night use less healthy plans, but they comprised a large number of participants. Hopcia, et al. (2012) a lso points out that based on a study by the National Institute for Occupational Safety and Health reports that individuals who work more than 40 hours every week or on extended shifts that exceed 8 hours, as well as those that work both extended hours and overtime often experience adverse effects on their health. Hopcia, et al. (2012)) further notes that working in jobs that have overtime (more than 8 hours) is associated with about 61% of injury. For those above 12 hours, the rate of injury is 37% while 60 hours a week is 27%.
Carlson, K. (2012). Jerome Stone and the Myth of Compassion Fatigue . Retrieved from http://rnfmradio.com/jerome-stone-myth-compassion-fatigue/. 26 Jan 2017.
Drake, D. A., Luna, M., Georges, J. M., & Steege, L. M. (2012). Hospital nurse force theory: A perspective of nurse fatigue and patient harm. Advances in Nursing Science, 35 (4), 305-314.
Dubeck, D. (2014). Healthcare Worker Fatigue: Current Strategies for Prevention. Reviews & Analyses: Pennsylvania Patient Safety Authority . Retrieved from http://patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/Documents/2014_prepub_fatigue.pdf.
Hopcia, K et al. (2012). A Case-Control Study of Occupational Injuries for Consecutive and Cumulative Shifts among Hospital Registered Nurses and Patient Care Associates. Workplace Health Saf., 60 (10), 437–444.
Steege, L. M.; Pasupathy, K. S. & Drake, D. (2014). Proceedings of the Human Factors and Ergonomics Society 58th Annual Meeting: Relationships between Wellness, Fatigue, and Intershift Recovery in Hospital Nurses. SAGE Journals 58 (1), 778-782.
Townsend, T. & Anderson, P. (2013). Are extended work hours worth the risk? American Nurses Association, 8(5), n.p. Retrieved from https://www.americannursetoday.com/are-extended-work-hours-worth-the-risk/.