Multiple Jobs Add to Nurse Fatigue

Alexandra Wilson Pecci, for HealthLeaders Media , January 28, 2014

Nurses seeking higher incomes are working multiple jobs, which leads to fatigue and puts patient safety at risk. Should state nursing boards step in?

The author of a study linking nurses' decision regret with fatigue has called 12-hour shifts "one of the worst things we ever did."

I wrote about that study recently and it touched a raw nerve; I received email and comments from lots of readers. They not only agreed that 12-hour shifts are a bad idea, but also pointed out a number of nuances about the matter that working nurses know very well:

  • Hand-hygiene compliance declines throughout a shift;
  • Medication errors are linked with fatigue;
  • Nurses have noticed that patient requests fall through the cracks during 12-hour shifts;
  • 12-hour shifts might contribute to a lack of continuity in patient care; and
  • Nurses "stack" working days so that they work 6 days in a row and can have a week off ("I would not want to be the patient of that nurse doing the 6th shift," one reader wrote).

And more than one reader pointed out the issue of nurses working multiple jobs. This is an interesting problem because it undermines efforts from hospitals and sometimes even states to reduce nurse fatigue.

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6 comments on "Multiple Jobs Add to Nurse Fatigue"

Caitlin (2/26/2015 at 3:02 PM)
Those opposed have obviously never had financial hardships. It has nothing to do with "choosing the wrong field", but more with the unexpected life events everyone is bound to encounter. The beauty of Nursing, unlike any other profession, is that when you do need extra money you have the ability to work extra shifts or extra jobs to supplement income. It is one's own judgement to determine if and when to work those extra shifts or jobs and to not spread themselves too thin. It should not be used as a tool to punish those who can effectively manage their time to avoid fatigue. If anything individual facilities or directors can make regulations. The State Boards of Nursing should not be involved and have a say in how I choose to responsibly utilize my career to my benefit.

Jennifer Fox (2/18/2014 at 10:18 PM)
If a nurse cannot live on the meager income received with just one job while going to school and supporting a family, then perhaps that is the wrong field to pursue in the first place. Many nurses are trying to move out of the quagmire of all work no pay that nursing offers. There are plenty of well paying jobs with regular raises, advancement and educational assistance that would not require a second income in order to live a far better existence. Informed school counselors could curb a lot of the problem of students going into a field that looks much greener and friendlier than it is. Since there is no chance of increasing pay, improving working conditions or staffing appropriately for safe patient care, nipping the problem in the bud seems reasonable.

Andrea Sehmel (2/5/2014 at 2:08 PM)
I would say that nurses could benefit from financial counseling; it's definitely not part of our education - it's assumed that we absorb it somewhere, and that's not necessarily the case. It's like cutting out salt for a hypertensive patient, though, it's a hard habit to change - the long-term effects are not sufficiently tangible now. Further, pay for nursing educators has to change - I took on a teaching position after a back injury made direct patient care an impossibility... with a 60% pay cut. State nurse professional organizations could offer financial counseling for nurses. State legislatures need to significantly improve educator pay, or face dire shortages.




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