Nurses Association Urges Limiting Work Hours to Combat Fatigue

In new guidance, the American Nurses Association recommends limiting the number of hours the average nurse works to reduce the risk of mistakes that can endanger patients' lives.

The dangers of fatigue in various industries got a lot of fresh attention in 2014, particularly after the late-night crash that nearly took the life of comedic actor Tracy Morgan.

It’s a new year, but that drumbeat is continuing, with the American Nurses Association taking a lead role.

ANA, which represents the country’s 3.1 million registered nurses, recently released a policy statement recommending that employers limit the time that nurses work to just 12 hours in a 24-hour period and that nurses be kept to a 40-hour week.

What’s more, ANA advises that nurses have more flexibility when it comes to extra shifts.

“Promoting a culture of safety and a healthy work environment reduces the risk for job stress and the potential for negative outcomes associated with fatigue,” the policy statement explains [PDF]. “Registered nurses should be discouraged from working extra shifts or working overtime that may contribute to fatigue. Every registered nurse, if asked, should be able to decline working extra shifts or overtime without being penalized.”

Unlike some other professions where fatigue can lead to life-and-death mistakes, nursing isn’t subject to federal regulations regarding work hours. (Current labor laws focus mainly on breaks.) Hospitals and medical facilities use a variety of voluntary solutions to combat the fatigue problem—including a “buddy system” where nurses check each other’s work—but these strategies go only so far, nurses say.

“With truck drivers and airline pilots, they’ll pull the driver out of the truck or the pilot out of the plane,” operating-room nurse John Kauchick told The Courier-Journal. “If you’re a nurse, [long hours] are what you sign up for.”

ANA President Pam Cipriano said the new recommendations are meant to draw greater attention to the issue and to the risks that go along with nurses working long hours.

“If a nurse is fatigued, it is possible that a mistake could be made or someone could forget to pass along an important fact, or the person could be more on edge,” Cipriano told The Courier-Journal.

A 2013 survey conducted by Kronos, Inc., found that fatigue and long shifts were common in medical facilities. In the “Nurse Staffing Strategy” survey, 77 percent of respondents said their facility had 12-hour shifts, and 96 percent reported being tired at the beginning of their shifts.


Ernie Smith

By Ernie Smith

Ernie Smith is a former senior editor for Associations Now. MORE

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