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Showing results for tags 'Fatigue / exhaustion'.
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Content ArticleThis blog by the charity Picker explores concerns about the safety of staffing levels in the NHS, highlighted by the 2021 NHS Staff Survey. It talks about the potential impact of a recent drop in staff morale. The blog draws out these key findings from the survey: The proportion of staff who felt unwell as a result of work-related stress in the last 12 months rose to 46% – almost half. This was an increase of nearly 3% from the 2020 figure (44%) and continued a trend: the figure has risen each year since 2017, when 38% of staff reported work-related stress. Almost one-in-three staff members say they “often think about leaving” their organisation – an increase of 4% points vs the 26% recorded in 2020. And one-in-six (16%) say they will leave their organisation “as soon as I can find another job” – a 2% point increase from 2020. Only 52% of NHS staff say that they look forward to going to work – a decline of more than 6% points from 58% in 2020. New questions in the survey suggest that many staff are experiencing burnout. Overall, more than a third of staff (34%) said that they ‘always’ or ‘often’ “feel burnt out because of [their] work”. The proportion was even higher for staff in patient facing roles (for example, 41% of registered nurses and midwives) and especially for ambulance personnel (51%).
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Content ArticleHuman error is as old as humankind itself and widely recognised as a significant cause of mistakes. Much of the research in this area has originated from high-risk organisations (HROs), including commercial aviation, where even simple mistakes can be catastrophic. A failure to understand and recognise how Human Factors (HF), especially those that affect performance and team working, can contribute or lead to serious medical error is still widespread across healthcare. Sadly, this commonly occurs in the operating theatre, one of the most dangerous places in hospital. While attitudes and acceptance of pre-surgery briefings has improved using the World Health Service (WHO) Surgical Checklist, this does not address other 'personal' factors that can lead to error, including stress, fatigue, emotional status, hunger and situational awareness. Following initial work around HF perception amongst operating theatre teams, Peter Brennan's (student at the University of Portsmouth) research has lead to significant delivery changes to the high stakes Membership of the Royal College of Surgeons (MRCS) examination, taken by up tp 6,500 junior doctors per year. After recognising boredom and fatigue in examiners, further published studies found an improvement in examiner morale with no significant changes in exam reliability or overall candidate outcome. These changes have improved patient safety at a National level. Other high stakes National Events have been evaluated where repetitive assessment occurs during long days, providing reassurance to organisers and the General Medical Council. 28 HF-related publications have been included in this work, including several reviews of important personal factors that affect performance and how these can be optimised at work.
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Content ArticlePoster from World Physiotherapy for World Physiotherapy Day 2021 highlighting the symptoms of Long Covid similar to ME/chronic fatigue syndrome which can worsen with exertion.
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Content ArticleThe realities of our healthcare system are driving many health workers to burnout. They are at an increased risk for mental health challenges and choosing to leave the health workforce early. They work in distressing environments that strain their physical, emotional, and psychological well-being. This will make it harder for patients to get care when they need it. The USA is facing high levels of burnout among health care workers, which could lead to serious shortcomings in patient care, a new report from the U.S. Surgeon General has found.
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Content ArticleThis report from the Royal College of Nursing (RCN) reveals the full extent of the UK nursing workforce crisis. In March 2022, nursing and midwifery staff from across the UK were invited to tell the RCN about their experiences of the last time they were at work. The survey report provides valuable insight into the realities of staffing levels across the UK, and the impact on our members and the people they are caring for.
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Content ArticleIn this article for The BMJ, Matthew Limb looks at the findings of the British Medical Association's (BMA's) review of the UK's management of the pandemic. The review found that many doctors had traumatic experiences during the pandemic, and highlights the following areas where the government could have better supported doctors: Preparedness including chronic underfunding of the NHS Personal protective equipment (PPE) shortages Inadequate infection prevention and control guidance Testing failures Lack of risk assessment and failure to protect vulnerable staff Deaths Long Covid Exhaustion Mental health and emotional wellbeing Anxiety and moral injury Isolation Lack of support Career prospects The review did also highlight the vaccination campaign and rollout as a notable success in the government's response to the pandemic.
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Content ArticleThis article in the journal Trends in Neurology & Men's Health provides an outline of the role of human factors in preventing harm in healthcare. The authors describe the scale of medical errors and look at some specific ways that changes to personal and team working factors can improve safety for staff and patients.
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Content ArticleThis US study in BMJ Quality & Safety aimed to assess whether limiting the hours worked by first-year resident doctors' had an impact on patient safety. In 2011, The Accreditation Council for Graduate Medical Education (ACGME) enacted a policy that restricted first-year resident doctors in the USA to working no more than 16 consecutive hours. This policy was rescinded in 2017, and this study assessed the impact of the policy change by comparing the number of medical errors reported by first-year doctors in the five years before the ACGME was enacted (2002/2007) and in the three years following its implementation. The authors found that the 2011 work-hour policy was associated with a: 32% reduced risk of resident physician-reported significant medical errors 34% reduced risk of reported preventable adverse events 63% reduced risk of reported medical errors resulting in patient death They conclude that rescinding the policy in 2017 may be exposing patients to preventable harm.
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Content ArticleThe Dr. Lorna Breen Health Care Provider Protection Act in the USA aims to reduce and prevent suicide, burnout, and mental and behavioural health conditions among healthcare professionals. Healthcare professionals have long experienced high levels of stress and burnout, and COVID-19 has only exacerbated the problem. While helping their patients fight for their lives, many health care professionals are coping with their own trauma of losing patients and colleagues and fear for their own health and safety. This bill helps promote mental and behavioural health among those working on the frontlines of the pandemic. It also supports suicide and burnout prevention training in health professional training programs and increases awareness and education about suicide and mental health concerns among health care professionals.
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Content ArticleBoth the US Senate and the House of Representatives passed a bill to “improve the mental and behavioral health among health care providers” that President Biden signed on Friday. The Dr Lorna Breen Health Care Provider Protection Act is named after Lorna Breen, a New York City emergency medicine physician who died by suicide in April 2020, as Covid-19 raged across the city and the country. By all accounts a tireless worker, she was ultimately overwhelmed by what she experienced during those dark early days of the pandemic. Even before the coronavirus pandemic, health care institutions were struggling with maintaining the wellness of their workforces. Rates of burnout, depersonalisation, and emotional exhaustion were all significantly higher among healthcare workers than in the general population. Even more alarming, physicians and nurses complete acts of suicide at rates significantly higher than workers in other professions. The pandemic added fuel to this fire, as healthcare workers fought to provide care to legions of sick patients amid staffing and equipment shortages. Before the pandemic, approximately 40% of health care workers reported feeling burnt out. Now, between 60% and 75% of US healthcare workers report feeling emotionally drained and depressed. Clearly, something has to change. With the Breen bill, Congress hopes to halt this tragic wave of depression and burnout among health care workers by providing grants to hospitals and other health care organisations to “promote mental health and resiliency among health care providers.” Yet the solution the Breen bill proposes will not lead to meaningful change. Giving hospitals money to “promote wellness” will not magically heal healthcare workers. During the pandemic, hospitals across the country put up signs lauding their workers as heroes. Though hospital administrators may have given themselves pats on the back for such efforts, the signs meant little to those working without adequate personal protective equipment, or telling family members they could not visit dying loved ones, or wondering if they'd bring Covid home to their families and friends. The signs haven’t stopped scores of workers from leaving the healthcare field.
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Content ArticleAnalysis suggests potential instability and workforce gaps in the US healthcare sector. A call to action for all stakeholders could help. COVID-19 has altered many US nurses’ career plans. Over the past two years, McKinsey has found that nurses consistently, and increasingly, report planning to leave the workforce at higher rates compared with the past decade. Even as COVID-19 cases fluctuate, US healthcare providers are still experiencing the workforce and operational challenges exacerbated by the pandemic. Patient demand is expected to rise, given the growing and aging population of the United States. Without addressing this potentially wider divide between patient demand and the clinical workforce, with a specific focus on nurses, the US health sector could face substantial repercussions. If no actions are taken, there will likely be more patients in the United States who will need care than nurses available to deliver it. This report from McKinsey& Company provides context for how COVID-19 changed the nursing workforce, the long-term implications for nurses and healthcare stakeholders, and actions to consider to increase the odds of closing the gap. In the last section, it highlights how healthcare providers, federal and state governments, the private sector, the nursing workforce, and broader society could encourage those who are training to be nurses.
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Content ArticleIn this article in the Patient Safety Journal, Mayher Profita, a third-year surgical resident in Pennsylvania, describers her residency and the burnout she experienced. "The burnout was making us care less about our patients and the care they received and more about whether we made the right career choice."
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Content ArticleA systematic review and meta-analysis from Hodkinson et al. examines the association of physician burnout with the career engagement and the quality of patient care globally. A joint team of British and Greek researchers analysed 170 previous observational studies of the links between burnout among doctors, their career engagement and quality of patient care. Those papers were based on the views and experience of 239,246 doctors in countries including the US, UK and others in Africa, Asia and elsewhere globally. This meta-analysis provides compelling evidence that physician burnout is associated with poor function and sustainability of healthcare organisations primarily by contributing to the career disengagement and turnover of physicians and secondarily by reducing the quality of patient care. Healthcare organisations should invest more time and effort in implementing evidence-based strategies to mitigate physician burnout across specialties, and particularly in emergency medicine and for physicians in training or residency. Read accompanying BMJ editorial here.
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Content Article
Joy in work: presentation from Julia Wood (22 July 2022)
Patient Safety Learning posted an article in Culture
Presentation from Julia Wood given to the Patient Safety Manager Network (PSMN) on the importance of finding joy and happiness in work and how you can support your staff. -
Content ArticleDavid Oliver is a consultant in geriatrics and acute general medicine who has worked in the NHS for 33 years. In this blog, he talks about his personal experience of running covid 'hot' wards during the different waves of the pandemic, describing the toll working in these conditions has taken on the health of him and many of his colleagues. He highlights the impact of looking after dying patients without adequate PPE, informing family members of patients' death over the phone, being responsible for many more patients than usual and witnessing colleagues die from Covid-19. The result has been burnout, mental health issues and low morale for a workforce that was already stretched before the pandemic hit the UK. David finally caught Covid-19 himself in March 2022 and he talks about how the virus—plus the cumulative effect of working under such strain for over two years—has meant he is not able to work and has been signed-off sick since mid-May.
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Content Article
Psychological safety Padlet board
Patient-Safety-Learning posted an article in Culture
Psychological safety refers to creating and maintaining an environment in which members of a team feel able to speak up without fear of negative consequences. It allows healthcare professionals to take the interpersonal risks needed to engage in effective teamwork and to maintain patient safety. This Padlet board set up by Becky Thomas is a place to post resources and articles related to promoting psychological safety. -
Content ArticleThe Pharmaceutical Journal speaks to formerly fit and well pharmacists and technicians whose lives have been devastated by Long Covid.
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Content ArticleThis BMJ Practice Pointer discusses how we can support our colleagues with their mental health.
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Content ArticleThis editorial in BMJ Quality & Safety examines literature that looks at the negative side effects of quality improvement (QI) approaches and initiatives, arguing that QI can contribute to staff burnout, stress and reduced engagement. The authors make a number of recommendations for avoiding the negative side effects of QI.
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Content ArticleMany nurses also act as family caregivers, and this study in the journal Nursing Outlook aimed to examine the impact of family caregiving on nurses, their colleagues and the organisations they work for. Nurse caregivers and healthcare organisation leaders completed two surveys about views on family caregiving. The authors found that healthcare leaders perceived family caregiving to have a larger impact on the nurses’ health and work performance than nurses themselves. Family caregiving was also identified as a potential contributor to burnout, and the authors highlight that lack of workplace support for family caregiving may influence nurses decisions about leaving or reducing their role.
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Content ArticleThis Health and Social Care Select Committee report examines the pressure currently facing general practice, which is leading to low morale, GPs leaving the profession and problems recruiting new GPs. In turn, patients are increasingly dissatisfied with the level of access they receive. The root cause of the situation is that there are not enough GPs to meet the ever-increasing demands on the service, coupled with patients presenting with increasing complexity due to an ageing population. The report outlines the Committee's assessment of the key issues, including the problems with reliance on locum doctors and lack of continuity of care, and outlines what the Government should do to equip general practice for the future.
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Content ArticleTalking General Practice speaks to Dr Helen Garr, medical director of NHS Practitioner Health, the NHS service that looks after doctors and dentists - and also other NHS staff - who are experiencing mental ill health. In this conversation, Helen talk about the impact that pressures on the NHS are having on doctors’ wellbeing and how this is affecting GPs in particular. Helen also explains what doctors and other NHS staff can do if they are suffering from burnout, how to prevent burnout, what people can do if they are worried about a colleague and how NHS Practitioner Health supports doctors who seek help from the service. She also outlines how she thinks the NHS could change to help ensure better mental health for doctors and other staff.
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Content Article
Keep your light shining bright – three tips from Sally Howard
Sally Howard posted an article in Blogs
One of the many Covid challenges is that there hasn’t been an opportunity for frontline staff to pause for breath and pay even a small amount of attention to looking after themselves. And when times are really tricky we only have so much energy. So this is just about you and three things that may help you keep going and keep your brilliant light shining. -
Content ArticleThis article from Peden et al. reviews of some of the key topics and challenges in quality, safety, and the measurement and improvement of outcomes in anaesthesia. Topics covered include medication safety, changes in approaches to patient safety, payment reform, longer term measurement of outcomes, large-scale improvement programmes, the ageing population, and burnout. The article begins with a section on the success of the specialty of anaesthesia in improving the quality, safety, and outcomes for our patients, and ends with a look to future developments, including greater use of technology and patient engagement.
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Content ArticleIn this powerful article, GP Katie Musgrave, says that the profession is overwhelmed and under resourced. She argues that they are unable to provide the service that patients deserve and that action is needed to prevent patents from suffering harm. Her suggestions include:A COVID-pressures support fund, where part time GPs can be offered extra protected sessions in their own surgeriesThe extension of the ARRS to cover nurse practitioners or GPsA suspension of all but the most crucial bureaucracy: we certainly don’t need to be thinking about QOF this winter.
