Newcastle Hospitals NHS Foundation Trust and Consultant Anaesthetist Dr. Nancy Redfern will present a review at the 2022 Euroanaesthesia conference in Milan, Italy (4-6 June), talking about the likely deadly consequences of exhaustion on nurses and doctors themselves, as well as the impact on their clinical work quality, judgment, and patient safety.

She will end by emphasizing that as a result of these vulnerabilities, “healthcare deserves proper threat control systems like the ones needed by statute in virtually all other safety-crucial establishments.”

She recommends all nurses and physicians take twenty minutes of power snooze every night to work optimally for their patients (and make their after-work home trips safer), as well as recommends that no nurse or doctor works successive night shifts for 3 nights.

Dr. Redfern will address data from a variety of origins, such as the Faculty of Intensive Care Medicine, Royal College of Anaesthetists, and Joint Association of Anaesthetists’ group research publicized in the journal Anesthesia. According to the research, half of the nurse trainees, consultants, and doctors had either had an accident or had a close-shave while driving home after closing from a night shift.

Studies indicate that driving after staying awake for over twenty hours especially early in the morning or late at night is as risky as driving drunk. Also, the chance of an accident is doubled for workers that drive home after a twelve-hour shift than those that do so after eight hours. 

A “sleep deficit” builds from two nights of limited sleep upward, and it takes a minimum of two nights of excellent sleep to recuperate from the deficit. 

After sixteen to eighteen hours of staying awake, the cognitive function of medical personnel degenerates, making it tough for them to interact effectively with coworkers and sick people. “once tiredness starts, our empathic power with coworkers and patients dips, rational thought is hampered, and attentiveness becomes less meticulous leading to error in the correct calculation of patient’s doses,” explains Dr. Red

“We have a tough time thinking flexibly, or remembering fresh details, which makes it challenging to react to swiftly altering emergency situations. Our attitude sours, and our collaboration suffers as a result. Eventually, everything that keeps us and our patients safe is impacted.”

The second half of the course will focus on how exhaustion causes spontaneous, unrecognized unintentional “sleep lapses” or “microsleeps,” which means getting behind the wheel tired is the most hazardous thing a medical practitioner does. Evidence encircling quick twenty-minute power naps in enhancing staff and patient safety both in clinical settings and at home will be presented as well as discussions on how to integrate this practice into the health system. 

The consequences of fatigue are being addressed on many fronts. The European Society of Anaesthesiology and Intensive Care (ESAIC) (that organizes Euroanaesthesia) is developing policies for night shifts, while the Association of Anaesthetists has a #fightfatigue initiative going. 

Dr. Redfern notes that several European nations, including Portugal, The Netherlands, Romania, and the United Kingdom have taken action in this area.

Dr. Redfern says, “We hope regulators will come to the conclusion that healthcare workers have similar physiology as everyone else in critical-safety sectors and should be required to employ standard exhaustion hazard control as part of their overall strategy to staff and patient safety.”

She adds, “We must alter how we handle night shifts to avoid the consequences of exhaustion. “People who work shifts must ensure all staff gets a power nap and assist themselves to stay safe and attentive when working late nights. Health facilities should give ample time between shifts for the staff to rest adequately, and no staff should do more than three straight nights.”

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