A significant challenge for anyone working in health care is long and challenging shifts. These demanding shifts seem to occur far too frequently. COVID-19 has increased the strain on health care professionals, with teams being stretched thin and staff working longer hours than usual. Furthermore, staff members receive less sleep and less time to recharge for their next shift. Long shifts combined with stressful and physically demanding work can lead to poor sleep and extreme fatigue. This fatigue increases the risk for injury, infections, illnesses and mental health disorders. A single solution will not meet the needs of all workers, so here are some general ideas for helping your medical staff cope with long and challenging shifts.
Create a Culture of Safety
Recognize that we are in unprecedented circumstances with stressful and unusual events. The risk for fatigue during these long shifts rises dramatically. It is essential that you establish a culture of safety that includes precise coordination and communication between management and workers. Share strategies for fatigue mitigation and ensure that employees understand the process. Instruct employees on the consequences of sleep deprivation and provide resources to assist workers with fatigue.
Know the Signs and Symptoms of Fatigue
Know how to recognize the indicators of fatigue. Your team members might be yawning, having difficulty keeping their eyes open, and inability to concentrate. These minor signs can easily lead to a fatigue-related injury. You might wish to create a process that does not penalize workers for reporting when they or their workmates are too fatigued to work safely.
You may wish to assign safety-critical tasks to team members who are just starting their shift and are fresh. Rotate workers or groups of workers through duties that are repetitive and strenuous. If possible, try to schedule physically and mentally demanding workloads and monotonous work in short shifts or daytime shifts.
Encourage Scheduled Breaks
After a long and challenging shift, it is vital that you allow your staff enough time to coordinate their off-duty obligations and get sufficient rest and recovery. Schedule a minimum of 11 hours off in-between shifts, every 24 hours, and one full day of rest per seven days for sufficient sleep and recovery. Try to avoid penalizing those employees who have restricted availability to work extra shifts and longer hours.
If your medical unit requires rotating shift work, use forward rotations, which are typically a day to evening to night. Provide your staff with sufficient notice when scheduling, especially if there is a shift change, and avoid scheduling your team members for more than 12 hours. Encourage staff to take regularly scheduled breaks in clean and safe areas where they can maintain social distancing. Be cognizant of the additional time required for hand hygiene and donning personal protective equipment.
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