Talk Health and Care

Why We Need To Talk About Fatigue

NHS staff must work to provide care 24 hours a day, 7 days a week, 365 days a year. They work long shifts, around the clock, including overnight.

Regular breaks are essential to maintain performance. Gatwick’s managers close runways rather than allow their air traffic control workers to work over 2 hours without a 30 minute break, because they know performance cannot be sustained beyond that. 12-13 hour shifts without a break - too common in today’s NHS - mean it is impossible for staff to sustain safe, efficient, effective performance. Regular breaks are essential for safe patient care. We must redesign our hospital systems to reflect that.

We’re not evolved to be awake at night, let alone function at our best in busy, stressful, complex healthcare environments. Working at night is, physiologically, the same as working when jet-lagged. We should support staff working at night better - train them in sleep and sleep deprivation strategies at induction, permit regular power naps on night-time breaks, ensure all staff can get safely home the next day. Driving tired is like driving drunk ... and doctors, nurses and other NHS staff still regularly die just trying to get home safely after a night shift. 

We need to reorient our NHS when it comes to sleen and fatigue. It is a patient safety issue, a staff safety issue, a cost issue and a physiological imperative.

More here: 

https://ep.bmj.com/content/102/3/127

https://m.youtube.com/watch?v=_SLWD9uXeNw#

https://onlinelibrary.wiley.com/doi/full/10.1111/anae.13982

Suzette Woodward 4 months ago

totally agree with this

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Rachel Macrow 4 months ago

Agree totally.
We re not robots, we do need rest periods and simple comfort breaks but forgot these to prop up the under staffed service we are working in. Morale is poor, health suffers for staff and poorer quality outcomes for care are a greater patient risk as a result.

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Chloe Gillum 4 months ago

Completely agree the reason I left full time ward work was because of bad shift patterns with no / little breaks when at work

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Matt Hancock 3 months ago

Hi Michael – good to hear from you again on this.

Whenever I visit a hospital or care setting, I’m always impressed by the incredible commitment and compassion in evidence 24 hours a day. I couldn’t agree more that staff getting the right rest is vital for the running of health and care services.

Improving the health and wellbeing of staff across the NHS is something we take extremely seriously, and we are working with NHS Improvement to talk to Trusts about this issue. Some of the problem is how we think of our breaks. I know several Trusts are changing their emphasis from “taking breaks” to “recharging”, which is an important acknowledgement that we need that down time to be working to the best of our ability.

I’d love to hear more from you, and everyone else, about your lived experience of working in health and care. Please keep it coming.

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