Electronic Health Reporter

By Brooke Faulkner, freelance writer; @faulknercreek

Picture a long day — one that’s longer than most. Maybe you wake up early, have a checklist of morning tasks to do, then head off to catch a flight. Once you land, you have to change, make your way to a work conference, give a speech, and mingle for an hour. Back at the hotel, you unpack, shower, and work some more until 1 a.m., when you can finally sleep.

Exhausting, right? Now imagine that for that entire day, you’re on your feet and working. There’s no flight to relax on and no mingling with people for an hour. During that time, your main goal is to take care of others; you’re solely responsible for their health and well-being. How exhausted would you be then? This is what doctors and nurses go through, and for anyone outside of the healthcare industry, it’s nearly impossible to envision what a week, or even a shift, is like.

What is healthcare provider fatigue?

Healthcare providers work incredibly long hours. Nurses often work 12-hour night shifts — sometimes even longer if there’s a nursing shortage. Doctors may work for double that, especially when they’re new to the job. Indeed, medical residents in the United States can work up to 28 hours in one shift. Without proper rest and sleep, fatigue and burnout can set in. This can impact the individual’s health and well-being, and it can also have negative consequences for patients.

There’s another type of burnout, too: compassion fatigue, a central problem to balancing work and personal life as a nurse. This happens when healthcare providers are emotionally or physically distressed from forming emotional connections with their patients. This often happens when dealing with patients who are going through a serious medical event, like a trauma or a chronic illness. Creating a work-life balance is one of the best ways to combat compassion fatigue.

Consequences of healthcare provider fatigue

When healthcare providers don’t have enough time to rest and sleep, it can result in negative patient outcomes, such as inaccuracies when administering drugs, injuries from accidental needle sticks, surgical errors, and poor operation of medical equipment. Other signs of burnout include:

• Cynicism
• Impaired cognition and learning ability
• Low career engagement
• Negative feelings and moods
• Poor communication skills
• Poor sense of achievement
• Slow reaction time

The good news is that burnout is manageable. Healthcare organizations have to treat burnout before it becomes a problem. Once they do so, job performance and the number of errors in patient care will both be improved.

6 ways to improve healthcare provider fatigue

Fatigue isn’t a random occurrence; it’s the culmination of patterns related to scheduling disorganization and poor organizational policies. Since you can point to specific causes of fatigue, the problem can also be fixed with personal and organizational changes.

1. Support Groups: Healthcare organizations can create in-house support groups for their staff or help workers find outside support groups.
2. Monitor Moods: It’s important for individuals and supervisors to be mindful of changing moods during shifts, as emotional changes like cynicism are a sign of fatigue.
3. Take a Break: Whether the break is for an hour or for a week, taking a break can make the worker more efficient once they return to work. Breaks improve creativity and focus. During regular shifts, workers should try to take a short break (preferably outside) every two hours.
4. Take a Nap: One-hour naps should be allowed and even encouraged during long (12-hour) shifts, especially prior to night shifts, in order to make the worker more alert. Organizational changes may have to occur, such as adding napping into work policy, creating a process for waking napping workers, providing an environment for napping, and scheduling workers to cover when others are napping.
5. Set Performance Benchmarks: Performance benchmarks give management a way to see how employees are performing and also offer red flags when performance starts to dwindle. This may be a way to determine the employees who are fatigued and whose work is suffering because of it.
6. Strategic Scheduling: Healthcare providers should not work two night shifts in a row. They should also not switch from an evening shift to a day shift too quickly — this can impact their circadian rhythms and make it harder to sleep and to be alert at work. Shifts should only rotate after two or more weeks.

Healthcare provider fatigue is a multi-faceted problem that requires a lot of participation from staff and management in order to solve. When healthcare providers are fatigued, their happiness and physical health can be impacted. Patient care can also be negatively affected, which goes against why many doctors and nurses get into the profession in the first place — to help those who need it most. This isn’t something that will be fixed on its own. Doctors and nurses have to get more sleep, balance their life with their work schedule, and find time to recuperate in order to perform their jobs better.