Poor self-care is a safety issue
Nurse fatigue can jeopardize patient safety
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EDITOR'S NOTE: Nancy J. Brent, MS, JD, RN, Nurse.com's legal information columnist, received her Juris Doctor from Loyola University Chicago School of Law and concentrates her solo law practice in health law and legal representation, consultation and education for healthcare professionals, school of nursing faculty and healthcare delivery facilities. Brent has conducted many seminars on legal issues in nursing and healthcare delivery across the country and has published extensively in the area of law and nursing practice. She brings more than 30 years of experience to her role of legal information columnist.
As a nurse, you are very good at taking care of others. But you are not as good at taking care of yourself. Combating your own fatigue is an example of where you need more help. Doing so not only benefits you as a nurse, it can help reduce risks to patients for whom you provide care.
Ann Rogers, in her chapter “The Effects of Fatigue and Sleepiness on Nurse Performance and Safety” in the text “Patient Safety and Quality: An Evidence-Based Handbook for Nurses,” writes that those who work nights and those who rotate shifts rarely obtain optimal amounts of sleep, citing one study that indicated night shift workers get 1 to 4 hours less sleep than normal when working nights.

Nurses who work shifts also have acknowledged falling asleep when working. Another study indicated almost one-fifth of nurses working the permanent night shift indicated they struggled to stay awake while taking care of a patient at least once during the previous month. Sleeping longer on weekends and when not working is common. In one study cited in Rogers’ chapter, American nurses who were studied slept an average of 84 more minutes on days off than on workdays.
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By Nancy J. Brent
MS, JD, RN
Moreover, Rodgers continues, several studies indicate that failure to obtain adequate sleep is “an important contributor to medical error.” And, not surprising, the failure to get enough sleep results in a risk to the nurse’s own health and safety. Those risks include sleep disorders, obesity, cardiovascular disorders and gastrointestinal problems. The American Nurses Association recently published a position statement, “Addressing Nurse Fatigue to Promote Safety and Health: Joint Responsibilities of Registered Nurses and Employers to Reduce Risks (2014).” In it, the ANA clearly states the responsibility to reduce fatigue rests with both the RN and the employer.

The need for rest and sleep must be considered by both parties when additional work assignments are offered or accepted, including on-call assignments, mandatory overtime or voluntary overtime. It is essential that you, along with your employer, acknowledge the problems associated with nurse fatigue and sleep deprivation and together devise solutions to this continuing problem, not only to benefit patients, but to benefit you as well. As Homer said: “There is a time for many words and there is also a time for sleep.”
… the failure to get enough sleep results in a risk to the nurse’s own health and safety.”
— Nancy Brent, RN
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