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How to Prepare for Post-COVID-19 Fatigue

A Guest Blog Post by Mary Alice Anderson, MSN, RN, CNOR

AORN Perioperative Practice Specialist

 

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May 27, 2020

How to Prepare for Post-COVID-19 Fatigue

Specialized nurse fatigue is no surprise to the perioperative nursing profession. Even before COVID-19 mandated an elective surgery overhaul, the norm for personnel working in a surgical suite was demanding work hours, clinical complexity, and limited resources, with potentially challenging on-call schedules.

Now, with the return to standard operations phasing back in, perioperative leadership is tasked with balancing the normal challenges of perioperative nursing along with the new risks associated with re-establishing the surgical suite for operation, rescheduling postponed elective cases, and launching surgeries for a potentially infected patient population.1

Establish a safe environment to combat fatigue

In the wake of these challenges, it is important that nursing leadership take care of themselves and establish a safe environment for their staff to combat fatigue as well. Perioperative nurses may already be coping with the physical, cognitive, and professional challenges related to their work environment and the changes required to care for patients diagnosed with COVID-19. It’s up to leaders to develop systems that mitigate these and future effects on their team.2

Nursing staff fatigue has been addressed widely, however according to OSHA,3 the first step in the hierarchy of controls to protect personnel from workplace hazards is to actually eliminate the threat. In the perioperative suite, this may include following the AORN Position Statement on Perioperative Safe Staffing and On-Call Practices recommendations regarding working hours, while fostering a culture that promotes personal wellbeing and sleep health.4

Do you have a Fatigue Reduction Plan in place?

The next level, substitution, may include developing a Fatigue Reduction Plan1 for your healthcare organization or nursing unit, where perioperative staff may be relieved by peers in order to perform indirect patient care work duties during extended work hours.

Organizations may implement engineering controls to prevent mental and physical exhaustion when working extended work hours, such as using lifting equipment and allowing on-site naps.

Administrative controls, which may include recommendations outlined in the ANA Principles for Nurse Staffing,5 could entail changing workflows to optimize the environment, technology, and staffing to decrease fatigue during extended work hours.

On a smaller scale, I know from experience that getting at least 7 hours of sleep between shifts, asking for help lifting patients or equipment, and receiving real-time information from my charge nurse greatly reduced my occupational stress, even during long shifts or overtime. In the same token, when I had less time between shifts, I moved items alone for speed, or did not know what to expect, I was less resilient to the stress and more fatigued for the next case or shift.

And finally, protect staff with efficient communication to support autonomy and respect in the workplace. For example, inform staff as soon as you know extended work hours will be required and give them options concerning appropriate assignments for their capabilities and current level of fatigue if possible.

  1. Battié RN, Rall H, Khorsand L, Hill J. Addressing perioperative staff member fatigue. AORN Journal. 2017;105(3):285-291. doi: 10.1016/j.aorn.2017.01.003.
  2. RNAO. Preventing and mitigating nurse fatigue in health care. Updated 2011.
  3. OSHA. Hazard prevention and control. Updated 2016.
  4. Kyle E, Spruce L. Clinical Issues—November 2019. AORN J. 2019;110(5):536-546. doi: 10.1002/aorn.12846.
  5. ANA. Principles for nurse staffing: 3rd ed. Updated 2020.

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