MILAN, Italy — A quick, power nap may help medical staff fight off fatigue and keep patients safe during overnight shifts, a new study contends.
Dr. Nancy Redfern of Newcastle Hospitals NHS Foundation Trust adds that because of the risks to both night shift hospital workers and their patients, “healthcare should have formal risk management systems like those required by law in every other safety-critical industry.”
During the annual meeting of the European Society of Anaesthesiology and Intensive Care (ESAIC), Dr. Redfern recommended that every doctor and nurse needs a 20-minute nap during night shifts and no healthcare professional should work more than three straight night shifts each week. This would both keep patients safe from human error by hospital staff and keep doctors and nurses from having accidents while driving home.
According to survey results, published in the journal Anaesthesia, half of trainee doctors, consultants, and nurses have had an accident or near-miss while driving home from a night shift. Previous studies have also found that driving after being awake for 20 hours or more is as dangerous as driving drunk.
Workers driving after a 12-hour shift were also twice as likely to crash in comparison to those working eight-hour shifts. Dr. Redfern says this “sleep debt” begins to accumulate after two nights of restricted sleep. Moreover, it takes at least two nights of “good” sleep for the body to recover from this fatigue.
Doctors have the same needs as other workers
Specifically, researchers say cognitive function declines after being awake for 16 to 18 hours straight. For medical workers, Redfern says this impairs their ability to effectively interact with patients and their co-workers.
“When fatigue sets in, we in the medical and nursing team are less empathic with patients and colleagues, vigilance becomes more variable, and logical reasoning is affected, making it hard to calculate, for example, the correct doses of drugs a patient needs,” Dr. Redfern explains.
“We find it hard to think flexibility, or to retain new information which make it difficult to manage quickly changing emergency situations. Our mood gets worse, so our teamwork suffers. Hence, everything that makes us and our patients safe is affected.”
“We hope in the end that regulators will recognize that healthcare workers have the same physiology as employees in every other safety-critical industry and require formal fatigue risk management as part of its overall approach to patient and staff safety,” Dr. Redfern concludes.
“We need to change the way we manage night shifts to mitigate the effects of fatigue. Those working shifts must ensure everyone gets a power nap, and that we support each other to remain safe and vigilant when we work through the night. Staffing schedules should allow sufficient time between shifts for proper rest, and no-one should do more than 3 night shifts in a row.”
The team presented their findings during Euroanaesthesia 2022.