Abstract
Background: The female nurse exhibits a multitude of personal and environmental characteristics that renders this population especially prone to fatigue. The consequences of fatigue in nurses are widespread and impactful at the personal, organizational, and societal levels. These include high injury rates and burnout in the nurse and poor patient and organizational outcomes.Objective: This article discusses the implications of fatigue in female nurses, including the impacts of fatigue across multiple entities (e.g., worker, patient, organization). It also reviews the current state of the research, including recent work on nurse fatigue and work schedule characteristics, and key areas for future work that would help empirically establish approaches to counter the detrimental and widespread effects of fatigue.Method: A narrative literature review was conducted resulting from an analysis of the literature limited to peer-reviewed studies.Results: A confluence of factors combines to elevate the prevalence and risk of fatigue in the female nurse. Numerous measures have established that performance-based fatigue results from nursing work schedules in nurses. Data also demonstrate that fatigue accumulates across successive shifts. Recent evidence supports the use of objective fatigue measures, including psychomotor reaction time and muscle function-related variables. Current gaps in the literature are delineated in the text.Conclusions: Strategic and well-designed research studies, as well as recent technological advances in fatigue tracking tools have the potential to help workers, administrators, and organizations develop fatigue management programs that could reduce the heavy burdens of fatigue on a multitude of health, safety, and economical outcomes.
Highlights
The female nurse exhibits a multitude of personal and environmental characteristics that renders this population especially prone to fatigue
The ability to modify fatigue as a risk factor in nurses will require establishing scientifically valid, objective, and field-friendly fatigue monitoring tools as a means to (1) increase the sensitivity, accuracy, and scientific basis for identifying and tracking fatigue in the field and (2) help garner widespread acceptance and adoption of the best tools and techniques so that they can be readily used by organizations, administrators, and nurses in a collaborative effort to better manage the problems associated with fatigue that have become so routine and pervasive in the health care enterprise
Fatigue is highly prevalent in female nurses due to individual, environmental, and work-specific factors
Summary
Fatigue is especially prevalent and consequential in the health care labor sector. Nurse-related fatigue has been defined as a ‘‘work-related condition that ranges from acute to chronic in nature and can produce an overwhelming sense of tiredness, decreased energy, and exhaustion resulting in impaired physical functioning, cognitive functioning, or both’’10 (pg. 488). The results of the aforementioned two studies are important in that they do empirically establish that fatigue (in different forms) accumulates across successive work shifts for a number of different subjective and objective measures.[42,51] Such a finding is alarming because it raises concerns for heightened risks for nurses working a commonly implemented schedule of successive 12hour shifts in a short time period (known as compressed schedules)—and shows that it is not just longer shifts or rotating shifts that are the cause for concern for inducing substantial fatigue, but that an increasing number of shifts worked with low intershift recovery time[21,58] is an important risk factor as well. Advances in wearable technologies have allowed researchers to use wearable devices and proprietary algorithms based on physiological-based data, such as activity and sleep patterns, to accurately capture and predict fatigue in other working populations (e.g., railroad, commercial aviation industries) Such a tool would be desirable to be used in health care workers because it overcomes fatigue management barriers by combining objective, biologically derived reliability with field-friendly features. The ability to modify fatigue as a risk factor in nurses will require establishing scientifically valid, objective, and field-friendly fatigue monitoring tools as a means to (1) increase the sensitivity, accuracy, and scientific basis for identifying and tracking fatigue in the field (i.e., hospital) and (2) help garner widespread acceptance and adoption of the best tools and techniques so that they can be readily used by organizations, administrators, and nurses in a collaborative effort to better manage the problems associated with fatigue that have become so routine and pervasive in the health care enterprise
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