BY: Fidelindo Lim, DNP, CCRN Recently I met with a former male student (now a successful RN) of mine and we had a spirited discussion about his “life-saving” activities. At some point I was positively moved when he declared, “I really love being a nurse. I have absolutely no regrets.” The phrase “no regrets” stuck with me and struck a different cord in the symphonic discussion of nursing care. In the January 2014 issue of the American Journal of Critical Care, researchers reported that nurses who experience impairments due to fatigue and lack of sleep are more likely than unimpaired nurses to report clinical decision regret (Scott, Arslanian-Engoren & Engoren, 2014). Could it be that lack of sleep makes a nurse regret being a nurse?
The talk about how little sleep mankind is getting lately is not new. Pundits and sociologist have been lamenting on the loss of the last of the horizontal joys since the invention of the light bulb. In health care, this goes to the core safety and quality - for both the patient and the provider. In 2011, The Joint Commission issued a Sentinel Event Alert on Health Care Worker Fatigue and Patient Safety (http://www.jointcommission.org/assets/1/18/SEA_48.pdf) to raise awareness and address this issue. Essentially, lack of sleep is bad for the nurse and worse for the patient.
So far, I have not come across a study that correlates lack of sleep with patient death. I take that as good news. However, we must keep watch as there have been many studies that associate fatigue with negative effects among health care workers. Notably, fatigue can lead to lapses in attention and inability to stay focused; reduced motivation; compromised problem solving; confusion; irritability; memory lapses; impaired communication; slowed or faulty information processing and judgment; diminished reaction time and indifference and loss of empathy (Joint Commission, 2011). The last two, indifference and loss of empathy are of particular importance (at least for me) because as nurses we pride ourselves as the most trusted of all professions, if not the most emphatic. Apathy and inertia, the antithesis of caring, would be the glaring examples of miscarriage of nursing care. And as the recent study has shown, we are bound to regret.
I am hoping that the readers will share their reflection and offer some hints on how to improve sleep quality. There is no doubt, sleeping well is a matter of self-care and self-healing. What do you do to keep yourself from burning out and staying fired up to save lives, with no regrets?
Joint Commission. (2011). Health care worker fatigue and patient safety. Sentinel Event Alert, (48). Retrieved from http://www.jointcommission.org/assets/1/18/SEA_48.pdf
Scott, L. D., Arslanian-Engoren, C., & M. C. Engoren. (2014). Association of sleep and fatigue with decision regret among critical care nurses. American Journal of Critical Care, 23, 13-23. doi: 10.4037/ajcc2014191