ANA Position on Nurse Fatigue

classicdame, MSN, EdD · Dec 3, 2014

Texas has been making moves to assist nurses in this area for several years. Mandatory overtime is against the law. Even if our facility carefully watches how much time someone works in a week, or in a day, the nurse has the option to go down the street and pick up extra shifts. So it is not really up to the employer to make people sleep. No way I can think of to monitor that. I am glad the employer is held responsible for PLANNING poorly, but the individual nurse has responsibility as well.

NurseOnAMotorcycle, ASN, RN · Dec 3, 2014

I read the article about how administration needs to limit overtime hours and not make us work our full hours before or after training days. I also read about how it's my own responsibility to make sure I get breaks during a shift and sleep at least X hours a day.

I'm sorry but it's one of those things sounds good on paper, but my children would never agree to skipping meals and extra curricular activities so I could sleep. Certainly, administration would never agree to letting us off on days we've done training since that messes up their staffing matrices, and ambulances and patients will certainly not stop coming to the ER just because we need a pee break.

Honestly, I don't think Administrators care enough about us to do anything like that because we are completely expendable since there are 4-5 nursing schools right near our hospital.

For example, I have several weeks of vacation every year, but they only every let me use two or three days a year. Instead, they push my shifts to the ends of either week so that I have to still work my full hours. I have floating holidays I try to use but instead they push my weekly schedule around the day I ask for and scold me at the end of the year for having to pay for the holidays I never used.

In my opinion, nurse fatigue and nurse burnout is something only the nurses in the trenches care about because we are living it. Admin seems to think we are nothing but lazy for wanting breaks and time off. No wonder nurses take so many sick days. I don't know about other regions, but here it is the only way we get a break. I wish my guilty conscience would let me call in sick sometimes too.

MunoRN, RN · Dec 3, 2014

I fully support the goal of reducing fatigue, but I don't think the ANA put sufficient thought into some of their positions, if any at all.

Recommending that nurses not work more than 40 hours per 7 days is a good rule if used as an average, or restated as 80 hours/14 days. The problem is that many if not most nursing jobs need to be staffed 7 days/week, which often means alternating weekend work. To stay below 40 hours/7 days, nurses working 8 hours shifts for instance would be maxed out at a .75 FTE. The IOM on the other hand has actually thought this through (and used math) which is why their recommendation is for a max of 60 hours per 7 days and 80 hours per 14 days.

nurseprnRN, BSN, RN · Dec 3, 2014

I fully support the goal of reducing fatigue, but I don't think the ANA put sufficient thought into some of their positions, if any at all.
Recommending that nurses not work more than 40 hours per 7 days is a good rule if used as an average, or restated as 80 hours/14 days. The problem is that many if not most nursing jobs need to be staffed 7 days/week, which often means alternating weekend work. To stay below 40 hours/7 days, nurses working 8 hours shifts for instance would be maxed out at a .75 FTE. The IOM on the other hand has actually thought this through (and used math) which is why their recommendation is for a max of 60 hours per 7 days and 80 hours per 14 days.

This doesn't make sense to me. I worked 8-hour shifts for forty hours/week for years. How is that 3/4 time? :: waltzing away :: Help me out here.

MunoRN, RN · Dec 3, 2014

This doesn't make sense to me. I worked 8-hour shifts for forty hours/week for years. How is that 3/4 time? :: waltzing away :: Help me out here.

For FT 8 hr shift/every other weekend staffing, you've got a total of 4 days off every 2 weeks. 2 of those have to happen on your often weekend, and in order to minimize fatigue the other two also need to be consecutive. In order to keep those non-weekend days off consecutive, the other 12 non-weekend days will have to occur as a 3 day stretch and a 7 day stretch with 7 consecutive days of work being the shortest possible stretch, or 56 hours in 7 days. That cuts max hours over a 2 week cycle to 64, which is a 0.8 FTE, although typically to get a schedule full of 0.8's to mesh, it's actually going to have to use a large portion of 0.75 FTE's (alternating 3 and 4 day workweeks).

OCNRN63, RN · Dec 4, 2014

I don't think the ANA is the proper entity to fight for bedside nurses. Not anymore. They spent so many years focusing their efforts on advanced practice nurses, and now all of a sudden they're like, "ZOMG! Bedside nurses have been getting the shaft by hospital admin.! We should do something about that!"

No...sorry. There are others who have been fighting for bedside nurses, and have been doing so effectively. They are the ones I want to see fighting for the nurses in the trenches.