Tired Nurses Are More Likely to Play the Second-Guessing Game

Feb 6, 2014, 2:09 PM

What drives “decision regret,” the negative cognitive emotion that occurs when an actual outcome differs from the desired or expected outcome? For nurses, fatigue is a big factor, according to a study in the current issue of the American Journal of Critical Care.

The study found that nurses impaired by fatigue, loss of sleep, daytime sleepiness, and an inability to recover between shifts are more likely than well-rested nurses to report decision regret. And while decision regret reflects previous decisions and adverse outcomes, it may also contribute to work-related stress and compromise patient safety in the future, the researchers found.

“Registered nurses play a pivotal role as members of the health care team,” lead author Linda D. Scott, RN, PhD, NEA-BC, FAAN, associate dean for academic affairs and an associate professor at the University of Illinois at Chicago College of Nursing, said in a news release. “Proactive intervention is required to ensure that critical care nurses are fit for duty and can make decisions that are critical for patients’ safety.”

More than 600 nurses working full time in critical care units were surveyed on personal and work-related factors such as sleep quality, daytime sleepiness, sleep quantity, clinical-decision self-efficacy, and decision regret. Male nurses who worked 12-hour shifts and had lower levels of satisfaction with their clinical decisions were the most frequent reporters of decision regret.

Recommendations in the study include implementing scheduling models that maximize management of fatigue, ensuring that support resources for clinical decisions are available, and encouraging the use of relief staff to provide completely relieved work breaks and strategically planned nap times.

Read the study in the American Journal of Critical Care.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.