1. Promote taking a break as the right thing to do for patient safety. The Washington State case found it was the hospital's responsibility to ensure nurses were receiving breaks, not the individual nurses. Leaders must step in. Ask nurse managers to pay attention to this issue and check whether staff are getting breaks. Support nurse managers to make the culture change when needed.
2. Educate nurses on the importance of breaks: Host a lunch and learn seminar on the importance of rest and the danger that fatigued nurses pose to patients. Provide strategies for busy units on how to ensure nurses are able to take breaks.
3. Implement fatigue countermeasures: It can be as simple as talking about breaks to change the culture of martyrdom too many nurses feel they must work under. Small investments can pay big dividends, particularly if you bring extra help. Consider having per diem or float pool nurses who work during meal periods. I've written before about creative scheduling for older nurses and those who want non-traditional hours. You'd be surprised at the number of people who would love to work two hours rather than a full shift. A hospital in California developed an SOS?save our staff—program to do just this. They have nurses who work 3- to 4-hours to cover lunch breaks. If a unit is stretched thin that day, they can ask the SOS nurses whether they want to stay longer.
Another option is to bring in nursing students. The hospital pays students to answer call bells or check dressings. It gives the students experience on the unit, which they want, and removes some of the burden from the RNs.
When budgets are stretched thin, it may appear the wrong time to focus on this issue. A little extra effort, however, can pay dividends in staff satisfaction and patient safety. And it just might stop those nurses ending up on the local evening news.