AER

As lead author on the study in question, I'm finding this discussion fascinating. I am a sleep researcher so our focus was on fatigue, and the effects of fatigue on errors. There is no doubt that workload is a factor-and that nurses have very heavy workloads (I've worked neuro-med, neuro-surg, neuro ICU and on rehab floors as a staff nurse). But our study didn't examine that, only fatigue. Our next study will look at workload, shift duration and errors. And if we're funded, we plan to ask a couple of questions about whether or not you're being paid for all the times you stay late (if not, and you're paid an hourly salary, the hospital is in violation of the law). What we recommended was that 12 hour shifts be eliminated or curtailed unless nurses could get out on time. In fact, the error rate was lowest for 12 hour shifts that ended on time. Unfortunately, 78% of the 12 hour shifts involved overtime (and 85% of the 8 hour shifts involved overtime)! From a physiological perspective, there is no justification for scheduling nurses to work 14 hour or even 20 hour shifts. As you can imagine, even when working 20 hour shifts, nurses ended up putting in overtime!