Nursing fatigue initiative tackles quality worklife and patient safety

A two-pronged initiative that tackles both quality of worklife and quality of patient care is geared to empowering nurses at The Scarborough Hospital while assisting them in recognizing signs of fatigue.

The Nursing Practice Committee (NPC) has launched the two-part project this month which involves all nursing categories among TSH’s 1,300 nursing staff: RNs, RPNs, Advanced Practice Nurses, Clinical Resource Leaders, managers and directors.

“The two areas we are working on are based on studies, projects and research that’s already out there, namely, nurse fatigue and empowering nurses to lead the safety culture of their units,” explains Rhonda Seidman-Carlson, Vice-President, Interprofessional Practice and Chief Nursing Executive. “While other hospitals are embarking on similar projects, I think what sets TSH apart from most is that the concept for the initiative came from the nursing staff, not from management.”

The NPC split into two working groups: one to identify, plan and implement ‘safety huddles’ on the nursing units; and the other to address nurse fatigue.

Sarah Aiken, a Charge Nurse with Mental Health, leads the safety huddles while Tanja Futter, RN with the Sexual Assault/Domestic Violence Care Centre, leads the project on nurse fatigue.

“These safety huddles are patient-focused, but also interdisciplinary focused, and are aimed at identifying primary patient outcomes,” Sarah explains. “It results in a more unified, streamlined process for clearer communication and effective early discharge.

“The nurses are thrilled with how effective it is, and how empowering it is for nurses to take the lead in patient safety.”

There is considerable data available about nurse fatigue and the affect on patient safety. The Canadian Nurses Association’s report on ‘Nurse Fatigue and Patient Safety’ offers numerous recommendations, specifically at the individual level.

“We are developing a tool – a self-assessment questionnaire – where our nurses can identify fatigue before it starts and look at ways to care for themselves before it becomes unmanageable,” Tanja explains. “This is a tool that they can use as a resource for many years.”

Nurses can easily identify when they’re getting tired, Tanja adds, “but maybe not realize just how tired they are and may not recognize the early signs of fatigue.”

“Working in a field with trauma victims, I know that if I couldn’t identify when I was getting fatigued and care for myself before it led to burn-out, I wouldn’t still be in this field,” she says, “even though I love what I do and it’s something I want to do for the rest of my career.”

Ade Oyemade is the Manager of Interprofessional Education at TSH and the chair of the NPC. She says frontline nurses are excited about the initiatives.

“For example, fatigue is not just an individual thing; it’s systemic. We want to improve and enhance safety and help nurses understand fatigue,” Ade explains. “What organization support can we put in place to help nurses reduce fatigue? Our focus is to ensure nurses ‘own’ the initiatives and are engaged in it.”

The project is being funded through the Ministry of Health and Long-Term Care’s Nursing Secretariat in support of initiatives that enhance quality of worklife and quality patient care.