Doctors and nurses need 20-minute power naps during night shifts to keep patients safe

A review was done at the Euro anaesthesia congress on the potentially lethal effects of fatigue on doctors and nurses themselves, and its impact on the quality of their clinical work and judgement and therefore patient safety. It was found that due to these risks, healthcare should have formal risk management systems like those required by law in every other safety-critical industry.

A 'sleep debt' begins building after 2 or more nights of restricted sleep, and it takes at least 2 nights of good sleep to recover from this. Cognitive function is impaired after 16-18 hours awake leading to a deterioration in the medical worker's ability to interact effectively with patients and colleagues. 

When fatigue sets in, the medical and nursing team are less empathic with patients and colleagues, vigilance becomes more variable, and logical reasoning is affected, making it hard to calculate, for example, the correct doses of drugs a patient needs.

Doctors find it hard to think flexibly, or to retain new information which make it difficult to manage quickly changing emergency situations.  Their mood gets worse, so the teamwork suffers.  Hence, everything that makes us and our patients safe is affected.

Researchers therefore concluded that they need to change the way night shifts are managed to mitigate the effects of fatigue.  Those working shifts must ensure everyone gets a power nap, and that there is support for each other to remain safe and vigilant when working through the night.  Staffing schedules should allow sufficient time between shifts for proper rest, and no-one should do more than 3 night shifts in a row.