It is quite clear from all the reading that I have done on staff fatigue that there is much more that needs to be done to identify how best to manage the effects that staff fatigue has on patient safety. it is a personal responsibility as well as an organisational responsibility. Personal is how you manage your life and organisational is about appropriate skill mix, length of shifts and appropriate breaks within shifts, staff retention, having a just culture to enable staff to speak up about any issues that affects patient safety without reprisal etc.