Fatigue among healthcare shiftworkers, and nurses specifically, has been a growing body of research in employment relations. As we have now seen the far-reaching effects of COVID-19 on society, and understand that a pandemic could always be on the horizon, investigation of how to support frontline nurses is more important than ever.

WOW HDR candidate Jane Gifkins has co-authored a paper with her supervisors Dr Amy Johnston (UQ), Associate Professor Rebecca Loudoun (WOW) and Professor Ashlea Troth (WOW) in the International Journal of Nursing Studies titled: Fatigue and Recovery in Shiftworking Nurses; A scoping literature review

What is nurse fatigue?

According to My American Nurse,  nurse fatigue is described as feeling emotionally, mentally, or physically tired as a result of the demands of nursing. There is a significant amount of research examining what causes such high levels of fatigue in this sector, linking lack of sleep or low-quality sleep as a result of work demands, personal responsibilities, and other lifestyle factors. The literature also cites long work hours, not enough recovery time between shifts, night shifts, rotating shifts, excessive workload and job demands, staffing shortages, and dangerous work environments as main causes of nurse fatigue.

Photo credit: Nurse Service Organization

Fatigue among nurses is dangerous as mental impairments and physical tiredness can lead to decreased work performance, compromising patient safety and satisfaction – not to mention it decreases job satisfaction!

This scoping literature review is part of Jane’s PhD research project titled ‘Fatigue and recovery in shiftworking healthcare professionals’ and identifies factors impeding or enhancing recovery from fatigue in shiftworking nurses.

What is already known about this topic?

  • Fatigue associated with shiftwork is linked to impaired patient safety and poorer health and wellbeing in nurses.
  • Shiftwork related fatigue is linked to nurses’ high intention to leave the profession, staff turnover and associated increased healthcare costs.
  • The primary causes of fatigue are sleep disturbance and loss, circadian disruption, high job and work demands and previous sleep/wake history; all reported in shiftworking nurses.

What does this paper add?

  • Themes elucidated from the scoping review enquiry were factors impeding recovery from fatigue at work: the ‘how’ and ‘when’ of shiftwork scheduling and high work demands. Factors facilitating recovery from fatigue at work: work and shift control and work breaks.
  • Further identified were factors impeding recovery from fatigue at home: age, and family responsibilities with factors enhancing recovery from fatigue at home: recovery activities (exercise) and time at home to recover from shifts.
  • While long-term chronic fatigue significantly impacts shiftworkers’ health and wellbeing, there is less emphasis in the literature on adequate recovery from fatigue and time frames associated with the proposed transition from acute (recoverable) to chronic fatigue.

‘I am interested in the health and wellbeing of healthcare professionals as Australian society is dependent on their care’, says Jane.

‘Fatigue is a serious occupational hazard – high levels of fatigue in shiftworking nurses are linked to poorer safety and patient outcomes as well as impacting long term on the health and wellbeing of the nurses themselves. There is far less research around recovery from fatigue and particularly in shiftworking nurses; we hope our research can discover the most effective strategies and ways for shiftworking nurses to recover from shiftwork related fatigue; to assist these crucial members of Australia’s workforce in both their work and home domains’.

Photo credit: The Conversation

Jane has also been first author on two other publications during her PhD candidature:

‘My advice to other PhD candidates is just to have a go and write something. If I can publish, then I think we all have the potential to do so’.

Jane plans to complete her PhD within the next 2 years.