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Tips for combating fatigue on your unit

Nurse Leader Weekly, February 4, 2005

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On this day in 1964, the Beatles arrived in the U.S. for the first time, landing at New York's Kennedy Airport.

Tips for combating fatigue on your unit
Wake up! The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is considering creating a National Patient Safety Goal for 2006 to reduce healthcare worker fatigue.

Richard Croteau, MD, the JCAHO's executive director for strategic initiatives, dropped this hint at the first annual Betsy Lehman Center for Patient Safety and Medical Error Reduction Symposium on December 2, 2004, in Waltham, MA.

By now you know that nurses who work shifts of 17 hours or more can be just as debilitated as people who are intoxicated. But with the current nursing shortage, chances are that inadequate staffing makes long shifts necessary at some organizations.

Although nurses spend many hours a week providing care for patients, they often forget about their own care. "Nurses are notorious for neglecting themselves," says Adrianne Avillion, DEd, RN, president and owner of AEA Consulting in York, PA.

Nursing administrators should help create the best possible conditions for their staff to help keep them alert. They should provide ergonomically correct chairs, proper lighting, and proper lift equipment on the units. Administrators can also do the following to relieve some of the physical strain staff experience:

Use larger print for labels and instructions. The average age of nurses is growing, says Avillion. Make sure that the print on labels and instructions is large enough for them to read easily.

Take a break. Do staff members get breaks for meals? If staff cannot take breaks, find a way to bring cafeteria food up to the units, Avillion says. Provide a room on the unit where staff can sit quietly and eat. Although it's best to take breaks away from the unit, this allows staff to avoid the bustle of the unit but remain available in case of an emergency.

Offer classes. Does your hospital offer wellness programs, such as exercise and smoking cessation classes, for nurses? People who are overweight tire more easily, says Avillion. The hospital should not only provide such classes for its employees but should also ensure that these classes are held when nurses can attend. "They need to meet the needs of a 24-hour operation," she says.

Offer a discount. Try to work out a way to offer nurses a discount on appropriate and supportive shoes for work, says Avillion. This way, nurses are more likely to wear proper footwear that creates less of a physical strain.

Provide counseling. Fatigue affects emotional health as well as physical health, says Avillion. When people get tired, they tend to snap at each other more easily. This can happen among workers on the same shift or between shifts. Avillion recommends managers ensure that they have counselors or mediators to help in such a case.

Source: Adapted from Briefings on Patient Safety (February 2005), published by HCPro, Inc.

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