What is fatigue?
Fatigue is a psycho-physiological phenomenon that occurs naturally after a prolonged or intense period of physical or intellectual activity, resulting in difficulty in continuing the effort or work. It occurs in routine, low-stress situations, rather than in emergency situations, where adrenaline kicks in. It is reversible, through proper rest. It is generally associated with impaired responses, lack of alertness, poor risk assessment, increased risk-taking and poor quality decisions.
In this campaign, we want to cover two aspects of fatigue; short term temporary sleep deprivation, which is more easily reversed by rest, but also the prolonged fatigue from chronic sleep restriction leading to mental problems and even sometimes to burn out and/or deep weariness with the system.
In this section we have summarised what we have learned about fatigue from various scientific studies and from discussions with health professionals and fatigue experts. We wanted to provide a comprehensive view of what is fatigue and facilitate awareness of the fatigue-related risks. We invite you to consult our sources for more details.
Who is affected by fatigue?
Fatigue affects all medical professions, including doctors, nurses and care assistants working in or outside a health care institution.
However, it must be stressed that categories of staff who work at night and/or in shifts are more subject to fatigue-related risks. Especially doctors in training, who take frontline roles in delivery of overnight care, have high clinical workloads, pressure to pass postgraduate exams, and the stress of combining work with a young family, must receive special attention when assessing those risks.
What are the effects of fatigue?
After 12 h awake:
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Empathy starts to wane;
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Logical reasoning is harder;
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Vigilance becomes more variable;
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Vognitive and motor skills become worse.
After 16 to 18 h of wakefulness:
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Our performance is as bad as if we were under the influence of alcohol;
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Our mood deteriorates;
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We find it much more difficult to think flexibly and respond to quickly-changing situations;
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We are more likely to take risks
After the ninth consecutive hour of work:
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the risk of being involved in an accident increases
After a 12 h shift we are twice as likely to crash driving home than after an 8 h shift.
Reference: FATIGUE IN ANAESTHESIOLOGY – CALL FOR A CHANGE OF CULTURE AND REGULATIONS
Nancy Redfern, Federico Bilotta, Igor Abramovich, Ioana Grigoras, in European Journal of Anaesthesiology 40(2):p 78-81, February 2023.
In other safety-critical industrial sectors (nuclear, electrical, maritime, rail) as well as in commercial aviation, these effects are known, and systems and processes are in place to manage their potential impact on safety. Unlike in healthcare, preventing or limiting fatigue is integrated into a risk management policy and in individuals and teams behaviour.
Continue reading -> FATIGUE CAUSES