Fatigue and Performance
People who are fatigued are more likely to make errors, fail to notice errors, and fail to correct those errors
Every healthcare worker has experienced pushing through the effects of mental and physical fatigue on the job. While personnel often try to power through, fatigue inevitably introduces unique risks to the overall healthcare system. Understanding how fatigue impacts human performance allows organizations to develop effective policies, procedures, and mitigation strategies to maximize the workforce performance.
Understanding the Science
The demands of 24-hour care and unpredictable workloads mean healthcare organizations regularly face the challenges of managing workforce fatigue. The combined impact of natural circadian rhythms, environmental effects, sleep efficacy and duration, individual differences, and task complexity all contribute to the fatigue level of your workforce. Understanding the causes and effects of fatigue is the first step towards reducing its impact on your organization.
Fatigue scientists generally recognize two primary types of fatigue:
Both types of fatigue may independently impact a person’s performance. Importantly, this disconnect between physiological fatigue and subjective fatigue means that even people who report feeling rested may be impaired from fatigue. Fatigue’s impacts can be wide-ranging, but the most common effects that impact an organization’s risk levels include:
- Difficulty concentrating
- Impaired Judgement
- Attention Lapses
- Emotional Impacts
- Decreased Motivation
- Forgetfulness
- Failure to Anticipate Events
- Increased Error Rates
Fatigue in Healthcare Operations
Typical Circadian Rhythm Graph
These fatigue effects in a healthcare setting can introduce significant risks. Healthcare providers who are fatigued will make mistakes on well-practiced tasks, have slowed response times, make poor decisions, and fail to communicate critical information. Emotional symptoms of fatigue will impact how a person approaches or deals with coworkers, patients, and patients’ family members. Increased irritability and inappropriate emotions such as anger from fatigue can compromise patient care by preventing open discussions.
Typical circadian rhythm effects result in ‘dips’ in alertness around 2:00 pm – 5:00 pm and 2:00 am – 5:00 am. During these times healthcare workers should rely on fatigue mitigation strategies to avoid errors and reduce the impact of fatigue on patient care; this is especially true in healthcare workers who may already be suffering from a lack of sleep.
Feeling tired, needing sleep, or even saying that one is fatigued is viewed in some organizations as a sign of personal weakness or laziness. These situations are often a direct result of the culture, policies, work environment, and staffing plan of that organization.
