Too Tired to Care: Fatigue in Nursing Has Ugly Outcomes

Do you shave off an hour of sleep to get just one more thing done? Are you tired most of the time? Have you ever stopped to wonder what fatigue is costing you in terms of lost moments with your children, spouse or relationships? This article talks about a problem that is epidemic in nursing, fatigue, and presents simple solutions to get your energy back naturally. Nurses Announcements Archive Article

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Too Tired to Care: Fatigue in Nursing Has Ugly Outcomes

"Nursing workload a key factor in rising patient deaths" is a headline in an online news blog and cites the work by researcher Linda Aiken. Professor Aiken has published numerous studies linking nurse workload to increased patient deaths.

More and more nurses report they get less than 6 hours sleep per night. As we head into the holiday season that number may even be less.

Do you compromise on your sleep? If you have a hard time saying no, you may head up shorting yourself on sleep just to get more done. Sleep is actually the time when your body does the repair needed to keep all other systems running well.

Did you know that sleep deprivation contributes to weight gain:

  • carbohydrates are not metabolized well and your body stores fat.
  • cortisol is secreted which increases hunger.
  • growth hormone is decreased. Growth hormone helps regulate the ratio of fat and muscle keeping your metabolism optimal and burning fat.

Sleep doesn't always seem so important or necessary when you are artificially energized by caffeine, sugar and the adrenaline during sympathetic overdrive. Unfortunately this is short lived and the crash will come. When this happens getting quality sleep is actually more difficult making the matter worse.

One of the risks of chronic stress is adrenal fatigue. This is when your body no longer compensates with the flight or fight syndrome energizing your body to handle what is in front of you. Cortisol actually shifts from being secreted in the early part of the day, around 5-6a and is secreted at night giving people a "second wind" when they come home from work. This usually interferes with going to bed at a decent time and getting the sleep they need.

A diet high in caffeine, simple carbs and sugars, usually eaten to compensate for fatigue further leads to sleep problems due to the blood sugar instability that can happen with a diet high in sugars and low in fiber and protein.

I know that many nurses "know" that getting enough sleep is important and yet, many do not heed their own warning. I know I did not until I hit the wall. The problem is that adrenal fatigue takes a very long time to come back from and it requires a regimen of supplements, diet and meditation or other relaxation practice to reset the adrenals. I know this having had an Integrative Health Practice and specializing in adrenal fatigue with education and certification in Functional Nutrition. I have helped hundreds of people reclaim their lives after losing so much of it due to their lack of energy and interest.

This article is also about those lost moments personally and professionally. Fatigue can cost you a precious moment with your child when they want your attention but you are too tired to care. What about times with your sweetheart that is lost because you are too tired? How does this affect relationships long term? Too often nurses are too tired to care.

Living a life of constant fatigue not only compromises patient safety, it compromises the relationships and people in nurses' lives that mean the world to them - family.

The risk of fatigue to nurses is that when left unchecked, this becomes the new normal; flat, cynical and disinterested. Here are a couple of simple yet very effective suggestions to naturally energize your body.

1. Drink water, not coffee.

Water is a natural energizer. Add in cucumber, mint and lemon or strawberries and you will have a burst of flavor. This is also helpful in burning fat! The more water you drink, the more you boost metabolism. Adding in these flavors enhances the process.

Coffee dehydrates you and reduces your body's stores of magnesium. This is an important mineral. More reason to drink water and keep your coffee to 2 cups per day.

2. Eat more vegetables.

Vegetables are filled with minerals which are the spark plugs of the body's energy-generating machine. Magnesium is an important mineral that has been found to be important in the sleep cycle and also helpful in combating fatigue. It has been found to be involved in hundreds of important functions in the body.

When you eat more vegetables you are eating less of the sugars and simple carbs in fast food. Just think about how you feel after eating fast food. Are you energized or do you feel like falling asleep?

The ugly truth about fatigue is that the consequences are far-reaching. Patients, relationships and especially the nurse can be harmed when nurses are tired. Fatigue sets up low expectations for life that can be full of potential.

As you approach the New Year, make a commitment to yourself to get the sleep you need and do what you have to do to recover from 'having to get just one more thing done' syndrome.

1 Votes
Cynthiahowardrnphd

About Cynthiahowardrnphd

Mentor to Healthcare Leaders; from US Specialty: 36 year(s) of experience in Leadership Development

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Specializes in Psych.

The best thing I have ever done for myself was to get a job that did not require shift work. I lost so much during the years that I was a sleep deprived mess: I actually thought that all those night shifts were necessary and would help me to advance my career. I was wrong and I lost more in life than the few extra dollars I earned.

Specializes in Certified Med/Surg tele, and other stuff.

This is so true. Drinking fluids at work can be difficult at times because no food or drink can be at the station. :(

Specializes in Psych, Substance Abuse.

I'm just thrilled that I'll have day shift hours at my new job beginning in January.

Here's an interesting article: Nurse Staffing and Patient Mortality .

Not interesting, wrong word. Very, very sobering :(

I didn't have a problem with not enough sleep, but I still had problems with 'fatigue' that was more mental/emotional than physical. That would be 'compassion fatigue' which is a whole 'nother story.

But my guess is that fatigue in nursing includes lack of quality sleep, among other issues that need to be addressed, such as compassion fatigue.

Having just returned to night shift I am learning how to attempt to get adequate sleep. I have worked nights in the past, but being older, I have found this time to be more difficult. I know the sleep I get during the day is not the same quality that I would get at night. Daytime sleep must not be as deep and as far as I know the deep or REM sleep is when our body rejuvenates. Therefore, I am feeling the drain of working nights and working 12 hours is impossible!!! I truly do not understand the national wave of forcing hospitals to work nurses these very long shifts. Was it to eliminate the middle 3-11 shift? It certainly was not to create better patient outcomes with more consistent nurse-patient relationships!! And, if the nurses are working 12 hours, what about the rest of the ancillary staff, like respiratory or diagnostic staff? If we are truly operating on a 24 hour day then why cannot certain testing be done during the night etc?? Wouldn't that shorten the amount of time patients are in the hospital? Do the larger medical centers have 24 hour care including diagnostic testing available for patients?? Why is nursing the only ones to work 12 hours??

Specializes in Community Health/School Nursing.

I have always said that 12 hr nursing shifts should be illegal. It is unsafe. What nurse really works just 12 hrs? They are probably working 12+ hrs due to charting, patient care, meetings......a code. And why is it that a patient is more likely to code at the end of our shifts? Right as our brains have had all it can take and we are probably not thinking very clearly anymore.

When I started praying to have a "small" fender bender on the way in to work just so I could call out, go home and go back to sleep......I knew I had lost it. lol

This is why I switched to school nursing for my full-time job.

Specializes in Leadership Development.

firstinfamily, I have said the very thing... I wrote an article on 12 hour shifts once and the pushback was unbelieveable. Nurses feel like i gives them more time off and t does... I personally felt the quality of time was compromised. I see the lack of true 24 hr care the inability of healthcare to truly be innovative...

Specializes in Psych, Substance Abuse.

I would prefer 8 hour shifts, but I welcome 12 hours shifts because I worked two 16 hour weekend shifts for the past 2 years at a drug rehab center. It was draining, mentally more than physically. There were times when I had almost nothing to do because I was in charge of admissions, but just being there was grueling, and trying to squeeze in 7 hours of sleep between shifts was sometimes impossible, especially if I had a late admission. And then there was the day when the night shift nurse called out and no one else volunteered to work. I did a 24 hour shift. Patients were all asleep, so no errors were made. I don't ever want to have to do that again. Don't ever want to do 16-hour shifts again either.

Specializes in ER, cardiac, addictions.

I'm glad to hear that others wonder at the wisdom of having nurses work 12 hour shifts! I know that, in many cases, nurses prefer to work fewer, longer shifts, especially if they work full time. After all, 3 12 hour shifts per week, with 4 days off, sounds a lot more attractive than 5 8 hour shifts, with only 2 days off per week.

In my ER job, I work 3 8 hour night shifts per week, whereas most (not all) of my coworkers work various 12 hour shifts. I've found that many of them are really dragging when it gets to be 4 am, whereas I'm still pretty energetic. It might be different if the 12 hour shift were being worked in a low stress situation, but 12 hours of constant activity, juggling tasks, remembering and documenting a million and one details, and being constantly under pressure, doesn't seem healthy to me. It's also a big problem to get coverage when a 12 hour employee calls in sick, or goes on vacation. Very, very few coworkers want to pick up an extra 12 hours on short notice, so they've got people coming and going, working 4, 6, or 8 hours of that shift.

Specializes in Med-Surg, Emergency, CEN.

So to get more sleep no one should work night shift? So what are all those sun-downing, newly admitted, short of breath, active labor, hip breaking, wandering, coding or other patients going to do while all of the life saving staff is just happily snoozing away with their 10 perfect hours of fatigue reducing rest?

I've worked night shift jobs for 14 years, and all this feels like more complaining about something that isn't going to change in our continuously non-perfect world. Instead of saying "nurses don't sleep enough", I'd like to see someone trying to find practical and realistic ways to work with the world we have. So we are working nights and still being told we have to find time to sleep, work out, lose weight, find quality time for ourselves and family, and still take care of dishes, laundry, bills, appointments, classes, repairs, etc.

I've never found a decent study on what actually works to help get more sleep. Thank you for this. Most of the studies all say "It's a problem" without offering one shred of practical advice I can use to solve it.

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I haven't worked in the hospital for a hundred years but back when I did, the 12 hr shifts were nurse driven. I hated them and my request for 8hr shifts was granted but I was the odd man out.

Back then, in addition to shift differentials there was also the OT that came with longer shifts. The acuity was also soooo much lower, though I remember just as much grumbling about patient ratios. I heard the same thing about paperwork in HH, when we were doing BID W-D dressing changes and we would have a day's worth of patients within a square mile of each other.

Makes me wonder what nursing will look like 20 yrs from now.