Nurses are tired of being tired
Jacqueline Vance, RN
The following headline “Tired, sleep-deprived nurses may regret clinical decisions” in Medscape Nursing News caught my eye. According to an article published in the January 2014 issue of American Journal of Critical Care (Am J Crit Care. 2014;23:13-23), nurses who stated that they were tired and did not get enough sleep were more likely than “unimpaired” nurses to regret some clinical decisions they made during their shifts.
And this is surprising how? Nurses have known for years that sleep deprivation messes with your ability to be “sharp,” but we still do it. (Doctors also do it — during their residencies, they are systematically tortured as sort of ritualized hazing of 36-hour shifts)
Nurses are an integral part of the healthcare team, and this article acknowledges that. But as much as we would like to think we are integral superhumans (I still have my Wonder Woman cuff bracelets), we are at best human, with all the flaws that come with being made of the flesh.
Simply put: We need sleep.
Sure, we want to serve and do our part. That's why we became nurses in the first place (and a little overtime never hurts). However, the expectation that we can work back-to-back shifts, 12-hour shifts days and days in a row, or endless days on end without a day off is unrealistic and outright dangerous.
We only have one life and um, so do our patients. So before we turn into somnolent zombies, think about all of the decisions we have to make that are critical in just one eight-hour shift. I guarantee you can't count all of them if you tried. (Yup, we are that essential!)
Personally, I think tired nurses regret more than clinical decisions. (A tragic hairstyle I got in 1996 after working 48 straight hours during a blizzard comes to mind.) I think we regret how we wound up in this position of back-to-back shifts in the first place.
I mean, what's behind this? Did we do this to ourselves? Are we afraid to say no or too willing to say yes that it has become the norm? Do we think, or are we being told, that there are plenty of nurses who will take our place if we don't abuse ourselves?
Is there a nursing shortage? Is there an economical model here that I am somehow unaware of that shows that working your staff overtime is more economical that having extra staff?
I would truly love to have your thoughts here. (Please use the comments box below this.) Maybe if we figure out how we got here, we can step back and find an answer to fix it —before we give the wrong patient the wrong med, while wearing a 1980s perm!
Just keeping it real,
The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, a 2012 APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse who is also the director of clinical affairs for the American Medical Directors Association. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. She has not starred in her own national television series — yet. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.