About half of health care workers who have to drive home after a 12-hour night shift have either had an accident or at least a near miss, according to a presentation at a European medical conference.
Delegates were told the risks these sleep-deprived doctors and nurses pose to themselves and others are the same as those of drunken drivers.
Because of these risks, health care “should have formal risk management systems like those required by law in every other safety-critical industry,” explained Dr. Nancy Redfern, consultant anesthetist at Newcastle Hospitals NHS Foundation Trust, Newcastle, United Kingdom.
Redfern said doctors and nurses should be allowed to take 20-minute power naps during night shifts, and they should be scheduled for no more than three consecutive night shifts.
Her presentation at this year’s Euroanaesthesia congress in Milan focused not only on the lethal effects of fatigue on doctors and nurses, but also on the quality of care their patients receive.
“When fatigue sets in, we in the medical and nursing team are less empathetic with patients and colleagues, vigilance becomes more variable, and logical reasoning is affected, making it hard for us to calculate, for example, the correct dose of drugs a patient might need,” Redfern said, according to the Guardian.
“We find it hard to think flexibly, or to retain new information, which makes it difficult to manage quickly changing emergency situations. Our mood gets worse, so our teamwork suffers. Hence, everything that makes us and our patients safe is affected.”
Moreover, Redfern told the Observer, “Fatigue played a key role in accidents like Chernobyl and the Exxon Valdez disaster. As a result of these spectacularly horrendous incidents, these industries had to make legal changes to prevent fatigue and further disasters.
“Meanwhile in the health service, we just go on quietly dying one at a time,” she added. “There has been no push to bring things up to date. Doctors and nurses are still being asked to work long hours and into the early hours.”
Redfern said the health care industry should be required to put formal risk management systems in place — just like in every other safety-critical industry, including pilots and truck drivers.
“Healthcare workers have the same physiology as employees in other safety-critical industries,” she said. “They require the same protection.”
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