About half of all hospital doctors and nurses had accidents or nearly missed while driving home after a night shift.
The risks they pose to themselves and other road users are calculated to be the same as those posed by drivers who are above the legal alcohol limit, European Medical Conference delegates said last week.
As a result, health experts called on doctors and nurses to take a nap for 20 minutes during night shifts. This would make their travel home safer and also help protect patients from mistakes they may make due to fatigue when taking medication or other treatments.
“When fatigue occurs, we in the medical and medical team are less sympathetic to patients and colleagues, vigilance becomes more volatile and logical reasoning is affected, which makes it difficult for us to calculate, for example, the right dose of medication a patient may need,” he said. anesthesiologist consultant Nancy Redfern of Newcastle Hospital last week.
“It is difficult for us to think flexibly or withhold new information, which makes it difficult to manage rapidly changing emergencies. Our mood is deteriorating, so our teamwork is suffering. Therefore, everything that makes us and our patients safe is affected. “
Studies show that fatigue causes spontaneous, uncontrollable interruptions of sleep or microsleep, which can be extremely dangerous for machine operators, power plant controllers and drivers. This problem begins to build up after two or more nights of limited sleep, and it may take at least two nights for you to recover from this condition.
It has also been found that workers who return home after a 12-hour shift are twice as likely to have an accident as those who work an 8-hour shift.
Measures have been taken to tackle the problem in other industries, where damage or malfunction could lead to loss of life, serious injury or serious damage to the environment, Redfern told a congress on Euro-anesthesia in Milan last week.
Fatigue has played a key role in Chernobyl accidents, but in the health service we just keep quietly dying one by one. Nancy Redfern, anesthesiologist
She told the Observer: “Fatigue has played a key role in accidents such as Chernobyl and the Exxon Valdez crash. As a result of these spectacular horrific incidents, these industries had to make legal changes to prevent fatigue and further disasters.
“Meanwhile, in the health service, we just keep quietly dying one by one. There was no pressure to update things. Doctors and nurses are still asked to work long hours in the early hours. “
Sleep studies have shown that cognitive function is impaired after 16 to 18 hours of prolonged wakefulness, which limits a healthcare professional’s ability to interact effectively with patients and colleagues. And if a doctor or nurse comes home after being awake for 20 hours or more at night or early in the morning when sleep is most needed, the danger is equivalent to driving with blood alcohol levels above the legal limit. border.
“I know of a few colleagues who died fighting at home while they were really tired,” Redfern said. “Really, I don’t think you could name a doctor or a nurse or another related health professional who hasn’t been affected by this kind of thing.”
A study published in the journal Anesthesia in 2017 reported that fatigue was prevalent among young anesthesiologists, with most saying it affected their physical health, psychological well-being and personal relationships. Much of the problem was due to night work, with respondents commenting on inappropriate places to rest and lack of rest.
Of these respondents, 57% said they had an accident or almost missed when returning from a night shift. “I strongly suspect that this figure is an understatement of the problem,” Redfern added.
She told the conference that the healthcare industry should be required by law to establish formal risk management systems – as is the case with any other safety-critical industry, including those involving transport and electricity generation.
Redfern said all doctors and nurses should be allowed to sleep for 20 minutes during night shifts and recommended that no doctor or nurse be required to work more than three consecutive night shifts.
“Healthcare workers have the same physiology as employees in other safety-critical industries,” she said. “They require the same protection.”
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