Fatigue regulations and guidelines have been long established in aviation, transportation and the nuclear industries (just to name a few). The science is solid supporting the correlation between human fatigue, and poor decision-making/poor responsiveness.
So why aren’t such fatigue regulations required in healthcare as a matter of standard like in other industries? Is there something different about the physiology and/or anatomy of a healthcare worker versus a pilot, truck/bus driver or nuclear operator?
In the other industries where fatigue standards have been long standing, they are in industries that protect human life (passengers and communities). In healthcare, their product in essentially helping ensure ‘quality of life’ for us all. That is a pretty important responsibility…surely us patients think so!
So why isn’t this industry leading in terms of applying such science-based rules for preventing the effects of fatigue and rather lagging behind other industries with not as great a moral responsibility (i.e. – Do No Harm)?
When I have asked this question of some healthcare professionals, some have responded:
1. “medical school teaches students how to compensate for fatigue and therefore it is not as much a factor” (if that is the case, they should teach other industries how to do this. However, the error rate in healthcare would not support the fact that this strategy is working).
2. Another responded to me this way, “Would you rather have a doctor who is tired but very familiar with your case, OR depend on a rested doctor to accurately convey all about your case info to the next shift?” To me this should not be an ‘OR’ statement because as a patient, I expect a well rested doctor capable of making decisions in my best interest AND to transfer all of that information to the next shift to ensure continuity of care. I should not have to pick one or the other.
This has been a long debated issue that is just resurfacing again. It would be interesting to hear from both sides of the aisle here on this very important issue that affects us all.
I do want to end with, in my 20 years in the healthcare space, the overwhelming predominance of caregivers are exceptionally well-intentioned in their efforts on our behalf. But in many situations, their deficient organizational systems (i.e. – policies, procedures, training, communication systems, purchasing habits, etc.) fail them in their efforts to do what is right. I have the utmost respect for those in the healthcare industry…those who have chosen a profession to help others!