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Ask the expert: How can you help prevent worker fatigue when you're understaffed and scrambling just to cover the next shift?

Accreditation Connection, May 16, 2005

"Fatigue is one of the most serious threats to patient safety," says Kirsty Kerin, PhD, a consultant with Circadian Technologies, Inc., in Lexington, MA, who specializes in preventing fatigue-related hazards associated with long-shift work.

Kerin offers the following five tips to help staff stay awake and alert:

1. Take a power nap-Five minutes or less will do the trick and is by far the best way to counteract the harmful effects of fatigue, Kerin says. Go somewhere quiet during a break and wear sunglasses or a baseball hat over your eyes to block out the light. If you sit quietly and are tired enough, you'll likely fall asleep. And don't worry about waking up groggy. Your body isn't able to slip into a deep enough sleep in five minutes to cause you to wake up dazed and disoriented, she says.

2. Chew on ice or mint-flavored gum-The coolness of the ice stimulates your brain while mint naturally has properties that help keep you alert.

3. Eat citrus-Snack on an orange or put lemon in your tea if they agree with your palate. While it won't give you the jolt that caffeine does, it will help stimulate your brain and increase your alertness. Caffeine has its fans, but the stimulant prevents some people from sleeping restfully once they finally go to bed. This, in turn, may cause them to feel sleepy when they wake up to begin their next shifts.

4. Brush your hair-Brushing your hair helps stimulate your scalp and promotes blood flow to the brain. It won't work miracles, but every little bit helps.

5. Avoid sugar-Otherwise, you'll feel sleepier once your body hits that infamous sugar low, says Kerin. You should also avoid eating peanuts, milk, tuna, and turkey, since each of them has substances that promote sleep-just think of the aftermath of that turkey dinner each Thanksgiving. If you hanker for a vending machine treat, choose pretzels rather than chips or sugary food. If you like citrus fruit, bring that in to snack on, and consider drinking hot apple cider rather than coffee, since apples also help the body stay awake, Kerin says.

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