"AHRQ aviation FAA fatigue Julie Thao Patient Safety"

Odd working schedules

Originally posted 4-17-2011:
I love it when current events make writing a blog entry easier. I am looking at the Aviation world again, and the new concerns about Air Traffic Controllers sleeping on their shifts.  If you have not been following the story - there have been 5 reported incidents to the FAA of an air traffic controller falling asleep on duty in the last month. Apparently, many of these controllers are doing a night shifts mixed with day shifts leading to fatigue issues. 

The AP wrote a brief article about what these odd work schedules can do to someone.  On top of fatigue, some other scary side effects these work schedules can cause include:
  • "all kinds of problems related to memory and learning"
  • "inability to concentrate"
  • "affects...the ability to understand how one thing is related to another"
And finally the biggest kicker - "people working night shifts are more subject to chronic intestinal and heart diseases and have been shown to have a higher incidence of some forms of cancer." 

Not exactly the side effects you want from someone doing a job that requires critical thinking and could impact your safety.  It can be just plain dangerous in some situations. This is why fatigue for healthcare workers has been a concern for patient safety advocates for some time now. In fact, AHRQ has been looking closely at healthcare worker fatigue for about 10 years now.  I know nurses that have been subjected to similar work schedules in the last few years, and I always wonder if they really 100% at doing their job when they are not on a regular sleep cycle. 

The AP article does have a wonderful solution - naps. The suggestion is to allow on-shift naps, have someone else run the shift temporarily, to get someone running on their full cognitive abilities. I always thought the Spanish had it right with with their siestas. And even if naps are not practical, the FAA is going to look at changing the way shifts are scheduled for air traffic controllers. 

Maybe on-shift naps are an appropriate solution for healthcare workers fighting fatigue from odd work hours.  And even if not, administrators should be making sure they are not setting up healthcare providers to risk a potential error from harming a patient. Julie Thao had worked 16 hours, and slept in the hospital overnight before she accidentally switched an epidural and IV medication for a patient.

Think of it this way - "Studies have shown that a sleep-deprived driver is as impaired as someone with enough alcohol in his blood to be considered a drunken driver." I don't want someone that sleep deprived on the same road I am driving. Nor do I want someone that sleep deprived treating me or a member of my family in a healthcare setting.