Risking fatigue by working long hours
Nurses and nurse employers: A new provincial order authorizes health care professionals, including nurses, to provide patient care services outside their regular scope of practice. It also enables hospitals to engage regulated health professionals from out of province.
I recently read about the increased risk of errors associated with medical residents working long hours. I think this is potentially an issue for nurses as well. Does the College specify the maximum number of hours a nurse can work? Is there a plan to legislate the hours a nurse can work?
No, the College doesn’t specify the maximum number of hours a nurse can work, nor are there plans to legislate this. Nurses are expected to use professional judgment to determine whether fatigue might interfere with their performance and, if so, to refrain from practising. This is similar to nurses’ accountability to refrain from practising when their ability is affected by a substance (for example, pain medications, alcohol) or illness. Each nurse’s tolerance for fatigue is individual. For this reason, each nurse needs to assess if her/his ability is compromised and, if so, to take appropriate action.
Fatigue can impair the ability to think clearly, make sound judgments and act decisively. While it is the nurse’s and employer’s responsibility to find the right balance between work and time off, only the nurse can determine her or his tolerance level for stress, anxiety and fatigue.
The College encourages nurses who find themselves in situations where they or their colleagues are working while fatigued to take action. Nurses should discuss their concerns with their managers/supervisors, including the impact on client care and safety, and explore possible solutions. Nurses in administrative roles are accountable for ensuring that mechanisms allow for staffing decisions that are in the best interest of clients and professional practice. Working together, nurses and employers can discuss staffing issues and identify innovative and creative solutions.
When deciding to work overtime, accountability and commitment need to be weighed carefully against the degree of fatigue that the nurse is experiencing. Although nurses may want to accept extra shifts to help short-staffed colleagues or to earn extra money, their first priority is to assess their ability to continue to provide quality care. It is acceptable to work overtime only when they feel competent to provide safe and ethical care.