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In this article, Jane Coombs gives an introduction to the key issues and conditions raised by tiredness at work, the tools available to measure the problem, and the role of occupational health in protecting affected employees.
“Head Nurse Parker!” I opened my eyes to see the night matron glaring at me in the twilight world of the nurses’ night station. I was sitting with my head resting on my cupped hands, elbows conveniently resting on a pile of fluid charts. It was 2am in January 1975, and I had fallen asleep sitting upright.
I tried to remember the name, date of birth and diagnosis of my 22 patients as the night matron escorted me round the ward, getting increasingly angry as my mind emptied itself of anything remotely useful.
I had been “in charge” for the past nine nights, starting at 8.30pm and finishing at 8am, working through Christmas and Boxing Day. That night, New Year’s Eve, was my last working night.
Nowadays, employers have a duty to take all practicable steps to ensure that employees are safe at work, and fatigue is a workplace hazard that they must manage.
One thing a night shift would not include is giving out a large glass of sherry to all head nurses to celebrate the new year, especially to those who were already fatigued with eight nights’ work under their belts and struggling to sleep through the celebrations in the nurses’ quarters.
What is fatigue?
Fatigue is a general term used to describe a wide variety of conditions, but is generally accepted as feeling very tired, weary or sleepy as a result of insufficient sleep, prolonged mental or physical work, or extended periods of stress or anxiety.
Boring or repetitive tasks can intensify feelings of fatigue. Fatigue can also be described as either acute (usually reversed by sleep and relaxation) or chronic (the constant, severe state of tiredness not relieved by rest).
Guidance from the Royal College of Nursing on shift work published in 2012 sets out how shift work affects the occupational health of workers (especially health workers) – although the guidance is useful for anyone wanting to protect and enhance the health of shift workers generally.
Humans follow an “internal” or “biological clock” cycle of sleep, wakefulness and alertness. Although these “circadian” rhythms