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January 2013, Volume 43 Number 1 , p 64 - 65


  • Kimra Reed BSN, RN


NURSE FATIGUE caused by working long hours can be dangerous for both nurses and patients. For instance, a tired nurse may mistakenly record a healthcare provider's phone orders to continue home medications on the wrong medical record, causing a patient with diabetes to fail to receive insulin in the hospital. Nursing fatigue also costs the United States billions of dollars each year.1 (See How does fatigue increase costs?)Nurses have a responsibility to ensure they're adequately rested to provide the highest quality care possible. Working long shifts, night shifts, and rotating shifts as well as mandatory or voluntary overtime contributes to nurse fatigue, accidents, and errors and a decrease in patient and nurse safety.2Besides the safety and ethical implications, fatigue can lead to legal consequences, such as loss of license. Although nurses are accountable for their individual practice, employers also have a responsibility to keep nurses, patients, the facility, and the public safe.3 This article outlines the problem of nurse fatigue and practical steps to prevent errors related to fatigue.In 2006, the American Nurses Association (ANA) issued two position statements to ensure patient safety. The first addresses RNs' responsibility to evaluate their level of fatigue when deciding to accept an assignment extending beyond the regularly scheduled work day or week. This includes mandatory or voluntary overtime assignments.4The second statement addresses the employer's role in promoting healthy nurse work hours in all roles and settings. The ANA encourages RNs' employers to establish policies and procedures that promote healthy work hours and patterns that don't go beyond the limits of nurse and patient safety.3 Evidence indicates that prolonged work hours, rotating shifts, and insufficient breaks slow reaction time, decrease attention to detail, promote errors, compromise problem-solving ability, and reduce motivation.1Worker fatigue and a "blame culture" are major factors

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