Too Tired to Care: Fatigue in Nursing Has Ugly Outcomes

The best thing I have ever done for myself was to get a job that did not require shift work. I lost so much during the years that I was a sleep deprived mess: I actually thought that all those night shifts were necessary and would help me to advance my career. I was wrong and I lost more in life than the few extra dollars I earned.

This is so true. Drinking fluids at work can be difficult at times because no food or drink can be at the station.

I'm just thrilled that I'll have day shift hours at my new job beginning in January.

Here's an interesting article: Nurse Staffing and Patient Mortality .Not interesting, wrong word. Very, very sobering I didn't have a problem with not enough sleep, but I still had problems with 'fatigue' that was more mental/emotional than physical. That would be 'compassion fatigue' which is a whole 'nother story.But my guess is that fatigue in nursing includes lack of quality sleep, among other issues that need to be addressed, such as compassion fatigue.

Having just returned to night shift I am learning how to attempt to get adequate sleep. I have worked nights in the past, but being older, I have found this time to be more difficult. I know the sleep I get during the day is not the same quality that I would get at night. Daytime sleep must not be as deep and as far as I know the deep or REM sleep is when our body rejuvenates. Therefore, I am feeling the drain of working nights and working 12 hours is impossible!!! I truly do not understand the national wave of forcing hospitals to work nurses these very long shifts. Was it to eliminate the middle 3-11 shift? It certainly was not to create better patient outcomes with more consistent nurse-patient relationships!! And, if the nurses are working 12 hours, what about the rest of the ancillary staff, like respiratory or diagnostic staff? If we are truly operating on a 24 hour day then why cannot certain testing be done during the night etc?? Wouldn't that shorten the amount of time patients are in the hospital? Do the larger medical centers have 24 hour care including diagnostic testing available for patients?? Why is nursing the only ones to work 12 hours??

I have always said that 12 hr nursing shifts should be illegal. It is unsafe. What nurse really works just 12 hrs? They are probably working 12+ hrs due to charting, patient care, meetings......a code. And why is it that a patient is more likely to code at the end of our shifts? Right as our brains have had all it can take and we are probably not thinking very clearly anymore. When I started praying to have a "small" fender bender on the way in to work just so I could call out, go home and go back to sleep......I knew I had lost it. lol This is why I switched to school nursing for my full-time job.

firstinfamily, I have said the very thing... I wrote an article on 12 hour shifts once and the pushback was unbelieveable. Nurses feel like i gives them more time off and t does... I personally felt the quality of time was compromised. I see the lack of true 24 hr care the inability of healthcare to truly be innovative...

I would prefer 8 hour shifts, but I welcome 12 hours shifts because I worked two 16 hour weekend shifts for the past 2 years at a drug rehab center. It was draining, mentally more than physically. There were times when I had almost nothing to do because I was in charge of admissions, but just being there was grueling, and trying to squeeze in 7 hours of sleep between shifts was sometimes impossible, especially if I had a late admission. And then there was the day when the night shift nurse called out and no one else volunteered to work. I did a 24 hour shift. Patients were all asleep, so no errors were made. I don't ever want to have to do that again. Don't ever want to do 16-hour shifts again either.

I'm glad to hear that others wonder at the wisdom of having nurses work 12 hour shifts! I know that, in many cases, nurses prefer to work fewer, longer shifts, especially if they work full time. After all, 3 12 hour shifts per week, with 4 days off, sounds a lot more attractive than 5 8 hour shifts, with only 2 days off per week. In my ER job, I work 3 8 hour night shifts per week, whereas most (not all) of my coworkers work various 12 hour shifts. I've found that many of them are really dragging when it gets to be 4 am, whereas I'm still pretty energetic. It might be different if the 12 hour shift were being worked in a low stress situation, but 12 hours of constant activity, juggling tasks, remembering and documenting a million and one details, and being constantly under pressure, doesn't seem healthy to me. It's also a big problem to get coverage when a 12 hour employee calls in sick, or goes on vacation. Very, very few coworkers want to pick up an extra 12 hours on short notice, so they've got people coming and going, working 4, 6, or 8 hours of that shift.

So to get more sleep no one should work night shift? So what are all those sun-downing, newly admitted, short of breath, active labor, hip breaking, wandering, coding or other patients going to do while all of the life saving staff is just happily snoozing away with their 10 perfect hours of fatigue reducing rest? I've worked night shift jobs for 14 years, and all this feels like more complaining about something that isn't going to change in our continuously non-perfect world. Instead of saying "nurses don't sleep enough", I'd like to see someone trying to find practical and realistic ways to work with the world we have. So we are working nights and still being told we have to find time to sleep, work out, lose weight, find quality time for ourselves and family, and still take care of dishes, laundry, bills, appointments, classes, repairs, etc.I've never found a decent study on what actually works to help get more sleep. Thank you for this. Most of the studies all say "It's a problem" without offering one shred of practical advice I can use to solve it.

I haven't worked in the hospital for a hundred years but back when I did, the 12 hr shifts were nurse driven. I hated them and my request for 8hr shifts was granted but I was the odd man out. Back then, in addition to shift differentials there was also the OT that came with longer shifts. The acuity was also soooo much lower, though I remember just as much grumbling about patient ratios. I heard the same thing about paperwork in HH, when we were doing BID W-D dressing changes and we would have a day's worth of patients within a square mile of each other. Makes me wonder what nursing will look like 20 yrs from now.

Great article!