Help change the culture of fatigue in hospitals
Fatigue puts you, your colleagues and your patients at risk. There are a number of ways you can help to fight the culture of fatigue in hospitals. You can start by:
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Downloading the fatigue awareness educational resources and making sure they're used as part of the induction programmes for staff working in all departments
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Adopting the minimum standards for rest facilities
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Promoting positive attitudes towards rest across the workforce and help reduce the stigma attached to talking about fatigue by joining the #FightFatigue Twibbon campaign
Supporting your colleagues
If you think a colleague or colleagues are suffering the effects of fatigue it's important you let them know they have your support.
If you think a colleague is too tired to drive after a long shift you should speak to them about your concerns. It can be a difficult conversation to have, but it's vital we get better at talking about fatigue.
You can also introduce our simple fatigue tool into your team's practice. It offers easy to remember mnemonics that provide a structure for supporting colleagues who may be on the brink of driving when fatigued.
Tackling department challenges
You may be concerned that your department cannot meet the standards for rest facilities. These standards have been carefully designed, considered and debated. It was felt that all hospitals should be able to achieve the minimum 'amber' standard, even if physical constraints prevent dedicated on call rooms being available.
We are aware of hospitals who have managed to make changes, converting an office to an on call room for example or even just preventing re-allocation of on call rooms to offices.
You can also share the #FightFatigue resources; these simple guides contain evidence of why we need to improve attitudes to rest and practical ways for departments to support better rest breaks.
It might be helpful to look at examples of hospitals and Trusts where a change in culture is supported - for example the HALT - Take a break campaign at Guy's and St Thomas' NHS Foundation Trust.
Identify a small team of like-minded people who can help you make change in this area. You could approach your Linkman and College Tutor who should both have heard the talk by Dr Mike Farquhar, Consultant in Sleep Medicine at the Evelina London at Guy's and St Thomas', about fatigue. You can also watch his ARIES Talk at the RCoA.
If you feel you're at risk
If your rota and workforce constraints do not allow for rest after a period of on call, you may feel you have no option other than to carry on. The reality is, if you feel unsafe to work, you have a duty to declare this and must not work.
Just because you have always worked this way, doesn't mean you should continue to.
We appreciate that workforce constraints make this difficult. It might be useful to see what your Occupational Physician thinks. More and more is being written about the impact of fatigue on safety, and an Occupational Physician may know about this from work in other industries.
In fact most other safety-critical industries have a formal fatigue risk management strategy, for example the petrochemical industry, the nuclear industry, some road haulage firms, the electrical industry as well as aviation.
Another approach would be to start there, and draw up a departmental fatigue risk management strategy.