Workplace fatigue is a huge issue in healthcare, putting both doctors and their patients at considerable risk. The evidence in the published literature is clear about the dangers of working long hours: one study has shown that a person working 17 hours or more has the abilities equivalent to someone with a blood-alcohol reading of 0.05. Another found that doctors working 24-hour shifts were around one-third more likely to commit a serious medical error.
That finding was replicated in a trial that randomised junior doctors working in intensive care to their usual 24-hour-plus shifts, or to shifts without extended hours. Those who didn’t have to work the long shifts made 22% fewer errors.
While patients obviously suffer from such errors and poor decision-making, constant fatigue can also put an intolerable strain on doctors: in the long term it can lead to depression, anxiety, heart disease or diabetes.
Then there’s the medico-legal angle. Doctors may be subject to complaint or discipline in cases where a patient is harmed due to errors linked to fatigue. For example, in one recent case conditions were placed on a junior doctor’s registration after a child died due to deficient treatment. The harmful treatment happened when the doctor was in the 20th hour of a 24-hour shift.
At the same time, doctors often feel under huge pressure to continue working even when they know that fatigue may be clouding their judgement. In the case of understaffed hospitals, doctors may consider it simply unethical to walk away from patients in need.
They are also less likely to seek medical help than the rest of the population are less likely to have a GP, and are more likely to self-medicate and self-diagnose.
Here are some tips for doctors to better manage their fatigue at work:
- Complete the AMA’s online safe hours audit. It takes around 10 minutes, can be done anonymously, and generates an instant risk assessment report;
- Make sure you have a good sleep environment, free of screens and technology;
- Managing fatigue means managing lifestyle factors, including regular exercise and moderation in alcohol consumption;
- While at work, make sure you keep yourself well-hydrated, and take regular short naps throughout a long shift;
- See your GP for advice before fatigue becomes a problem;
- Contact your local Doctors’ Health Advisory Service for support and advice.
For more information about managing fatigue and other health issues for doctors, access a range of online resources from Doctors’ Health Services Pty Ltd.