Although the words “fatigue” and “sleepiness” are often used interchangeably, they are distinct phenomena. Sleepiness refers to a tendency to fall asleep, whereas fatigue refers to an overwhelming sense of tiredness, lack of energy, and a feeling of exhaustion associated with impaired physical and/or cognitive functioning. Sleepiness and fatigue often coexist as a consequence of sleep deprivation.
Even though fatigue can be due to a variety of causes (e.g., illness, a vigorous workout, or a period of prolonged concentration), this chapter will focus on the effects of fatigue associated with insufficient sleep (see Key Terms and Definitions). The impact of extended work shifts and the relationship of these work schedules to nurse and patient safety will also be explored. Several practices that show demonstrable potential for reducing the adverse effects of fatigue on patient safety will be reviewed at the end of the chapter.
The evidence is overwhelming that nurses who work longer than 12 consecutive hours or work when they have not obtained sufficient sleep are putting their patients’ health at risk; risk damaging their own health; and if they drive home when they are drowsy, also put the health of the general public at risk. Nurses, nurse managers, nursing administrators, and policymakers need to work together to change the culture that not only allows, but often encourages nurses to work long hours without obtaining sufficient sleep.