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Showing results for tags 'Fatigue / exhaustion'.
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Content ArticleThis blog by doctors Clare Rayner and Amali Lokugamage argues that Long Covid rehabilitation needs a wider focus that goes beyond a purely biomedical paradigm to include complementary therapies and methods. The authors—who have both lived with Long Covid for more than two years—argue that although patients were the first to raise concerns about Long Covid, describe its symptoms and patterns and even research the condition, their narratives and voices are not being included in approaches to treatment. While the biomedical evidence surrounding Long Covid is currently limited, they highlight that there is much valuable lived-experience to be found in patient support and campaign groups, and that patients' knowledge should be drawn on to shape policy and guidance about the condition.
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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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News Article
RCGP warns 19,000 GPs could quit in 'mass exodus' over next five years
Patient Safety Learning posted a news article in News
Polling by the Royal College of General Practice (RCGP) as part of a campaign to make NHS GP services sustainable for the future found that 42% of 1,262 GPs and trainees who took part said they were likely to quit the profession in the next five years. A workforce exodus on this scale would strip the health service of nearly 19,000 of the roughly 45,000 headcount GPs and GP trainees currently working in general practice. RCGP chair Professor Martin Marshall warned that general practice was a profession in crisis - with the intensity and complexity of GP workload rising as the workforce continued to shrink. He warned that 'alarming' findings from the RCGP poll must serve as a stark warning to politicians and NHS leaders over the urgent need for solutions to begin to tackle the crisis facing general practice. Four in five respondents told the RCGP they expect working in general practice to get worse over the next few years - while only 6% expected things to improve. Nearly two in five respondents said GP practice premises are not fit for purpose, and one in three said IT for booking systems is not good enough. Professor Marshall said: 'What our members are telling us about working on the frontline of general practice is alarming. General practice is significantly understaffed, underfunded, and overworked and this is impacting on the care and services we’re able to deliver to patients. Read full story Source: GP, 22 June 2022 -
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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News Article
Patient safety incidents are the third leading cause of death in Canada
Patient Safety Learning posted a news article in News
The COVID-19 crisis has both divided and galvanised Canadians on healthcare. While the last three years have presented new challenges to healthcare systems across the country, the pandemic has also exacerbated existing challenges, most notably the high levels of errors and mistreatment documented in Canadian health care. According to a 2019 report from the Canadian Patient Safety Institute, Canada was already facing a public health crisis prior to the pandemic: a crisis of patient safety. As the report details, patient safety incidents are the third leading cause of death in Canada, following cancer and heart disease. Few studies calculate national data on this topic, but a 2013 report found that patient safety events resulted in just under 28,000 deaths. Many Canadians who have experienced these errors have shared their experiences with media in an effort to raise awareness and demand change. The impact of the COVID-19 pandemic has created a moment of dual crises. First, the pre-existing crisis of patient safety, and second, healthcare overall is now at a breaking point after three years of COVID-19, according to healthcare workers. Edmonton physician Dr. Darren Markland, for example, recently closed his kidney specialist practice after making a few "profound mistakes." In an interview with Global News, he explains he could no longer work at the current pace. He is not alone in this decision. Across the country, there have been waves of resignations in health care, leaving some areas struggling with a system that is "degrading, increasingly unsafe, and often without dignity." Read full story Source: MedicalXpress, 17 June 2022 -
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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News Article
USA: Job burnout threatens health care workforce
Patient Safety Learning posted a news article in News
The U.S. 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. Burnout among health care workers was a serious problem even before the COVID-19 pandemic, but the stress caused by the ongoing pandemic has made things much worse, said Surgeon General Dr. Vivek Murthy. “The pandemic has accelerated the mental health and burnout crisis that is now affecting not only health workers, but the communities they serve,” Murthy said. “Already, Americans are feeling the impact of staffing shortages across the health system in hospitals, primary care clinics, and public health departments. As the burnout and mental health crisis among health workers worsens, this will affect the public’s ability to get routine preventive care, emergency care, and medical procedures. It will make it harder for our nation to ensure we are ready for the next public health emergency. Health disparities will worsen as those who have always been marginalized suffer more in a world where care is scarce. Costs will continue to rise.” The report calls for several steps to address the burdens on health care workers. These include: Protecting the health, safety, and well-being of all health workers by ensuring they have proper equipment, training, and are protected against workplace violence. Eliminating punitive policies for seeking mental health and substance abuse care. Reducing administrative and documentation burdens and improving health information technology and payment models. Prioritising health worker well-being on an organizational level—this includes providing competitive wages, paid sick and family leave, rest breaks, educational debt support, and other steps to ease the burden on health workers. Read full story Source: BenefitsPro, 6 June 2022 -
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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News Article
Sleep-deprived medical staff ‘pose same danger on roads as drunk drivers’
Patient Safety Learning posted a news article in News
About half of all hospital doctors and nurses have had accidents or experienced near misses while driving home after a night shift. The risks they pose to themselves and other road users have been calculated as the same as those posed by drivers who are over the legal alcohol limit, delegates at a European medical conference were told last week. As a result, health experts have called for doctors and nurses to be allowed to take 20-minute power naps during night shifts. This would make their journeys home safer and would also help to protect patients from mistakes they might make through tiredness when administering drugs or other treatments. “When fatigue sets in, we in the medical and nursing team are less empathetic with patients and colleagues, vigilance becomes more variable, and logical reasoning is affected, making it hard for us to calculate, for example, the correct dose of drugs a patient might need,” consultant anaesthetist Nancy Redfern of Newcastle hospital said last week. “We find it hard to think flexibly, or to retain new information, which makes it difficult to manage quickly changing emergency situations. Our mood gets worse, so our teamwork suffers. Hence, everything that makes us and our patients safe is affected.” Research found that workers who drive home after a 12-hour shift are twice as likely to have a crash as those working eight-hour shifts. Read full story Source: The Guardian, 4 June 2022 -
News Article
‘Demoralised’ nurses ‘driven out’ of profession, survey finds
Patient Safety Learning posted a news article in News
Most nurses warn that staffing levels on their last shift were not sufficient to meet the needs of patients, with some now quitting their jobs, new research reveals. A survey of more than 20,000 frontline staff by the Royal College of Nursing (RCN) suggested that only a quarter of shifts had the planned number of registered nurses on duty. The RCN said the findings shone a light on the impact of the UK’s nursing staff shortage, warning that nurses were being “driven out” of their profession. In her keynote address to the RCN’s annual congress in Glasgow, general secretary Pat Cullen will warn of nurses’ growing concerns over patient safety. Four out of five respondents said staffing levels on their last shift were not enough to meet all the needs and dependency of their patients. The findings also indicated that only a quarter of shifts had the planned number of registered nurses, a sharp fall from 42% in 2020 and 45% five years ago, said the RCN. Ms Cullen will say: “Our new report lays bare the state of health and care services across the UK. “It shows the shortages that force you to go even more than the extra mile and that, when the shortages are greatest, you are forced to leave patient care undone. Read full story Source: The Independent, 6 June 2022 -
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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News Article
Numbers of nurses and midwives leaving NHS highest for four years
Patient Safety Learning posted a news article in News
More than 27,000 nurses and midwives quit the NHS last year, with many blaming job pressures, the Covid pandemic and poor patient care for their decision. The rise in staff leaving their posts across the UK – the first in four years – has prompted concern that frontline workers are under too much strain, especially with the NHS-wide shortage of nurses. New figures show the NHS is also becoming more reliant on nurses and midwives trained overseas as domestic recruitment remains stubbornly low. In a report on Wednesday, the Nursing and Midwifery Council (NMC) discloses that the numbers in both professions across the UK has risen to its highest level – 758,303. However, while 48,436 nurses and midwives joined its register, 27,133 stopped working last year – 25,219 nurses, 1,474 midwives and 304 who performed both roles. That was higher than the 23,934 who did so during 2020 after Covid struck, and 25,488 who left in 2019. Andrea Sutcliffe, the NMC’s chief executive, said that while the record number of nurses and midwives was good news, “a closer look at our data reveals some worrying signs”. She cited the large number of leavers and the fact that “those who left shared troubling stories about the pressure they’ve had to bear during the pandemic”. Read full story Source: The Guardian, 18 May 2022 -
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 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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News Article
US faces deficit of 450,000 nurses by 2025
Patient Safety Learning posted a news article in News
The United States could see a deficit of 200,000 to 450,000 registered nurses available for direct patient care by 2025, a 10 to 20% gap that places great demand on the nurse graduate pipeline over the next three years. The new estimates and analysis come from a McKinsey report published this week. The shortfall range of 200,000 to 450,000 holds if there are no changes in current care delivery models. The consulting firm estimates that for every 1% of nurses who leave direct patient care, the shortage worsens by about 30,000 nurses. To make up for the 10 to 20%, the United States would need to more than double the number of new graduates entering and staying in the nursing workforce every year for the next three years straight. For this to occur, the number of nurse educators would also need to increase. "Even if there was a huge increase in high school or college students seeking nursing careers, they would likely run into a block: There are not enough spots in nursing schools, and there are not enough educators, clinical rotation spots or mentors for the next generation of nurses," the analysis states. "Progress may depend on creating attractive situations for nurse educators, a role traditionally plagued with shortages." Read full story Source: Becker's Hospital Review, 12 May 2022 -
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 Article
Hospitals are rejecting GP referrals for investigations and outpatient treatment at an increasing rate. In this blog, Patient Safety Learning looks at the patient safety issues caused by rejected referrals and lack of capacity in outpatient specialities. We call for the government and NHS leaders to investigate the problem and take action to mitigate risks to patient safety. -
News Article
Hospital robots are helping combat a wave of nurse burnout in the US
Patient Safety Learning posted a news article in News
Since February, the nurses at Mary Washington Hospital in Fredericksburg, Virginia, USA, have had an extra assistant on their shifts: Moxi, a 4-foot-tall robot that ferries medication, supplies, lab samples, and personal items through the halls, from floor to floor. After two years of battling Covid-19 and related burnout, nurses say it’s been a welcome relief. “There's two levels of burnout: There's ‘we’re short this weekend’ burnout, and then there's pandemic burnout, which our care teams are experiencing right now,” says Abigail Hamilton, a former ICU and emergency room nurse that manages nursing staff support programmes at the hospital. Moxi is one of several specialised delivery robots that has been developed in recent years to ease the strain on healthcare workers. Even before the pandemic, nearly half of US nurses felt that their workplace lacked adequate work–life balance. The emotional toll of seeing patients die and colleagues infected at such a large scale—and fear of bringing Covid-19 home to family—has made feelings of burnout worse. Studies also found that burnout can have long-term consequences for nurses, including cognitive impacts and insomnia years after the exhaustion of their early careers. The world already had a nurse shortage going into the pandemic; now, roughly two out of three nurses in the US say they have considered leaving the profession, according to a survey from the National Nurses United union. Moxi has spent the pandemic rolling down the halls of some of the largest hospitals in the country, carrying objects like a smartphone or beloved teddy bear to patients in emergency rooms when Covid-19 protocol kept family members from bedsides. Read full story Source: Wired, 19 April 2022 -
Content ArticleAfter two years under siege from COVID, many nurses in the United States are reconsidering the profession.
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News ArticleFive thousand nurses at Stanford and Lucile Packard children’s hospital in Stanford, California, are preparing to strike in demand of wage increases, mental health and wellness support, better healthcare benefits, and a focus on hiring and retaining nurse staff. The union has set a strike date for 25 April. Stanford hospital at Stanford University in California has been consistently ranked among the top hospitals in the US by US News, but nurses say high turnover rates, understaffing, and inadequate proposed wage increases and benefits have contributed to high burnout rates. In a survey of union members, 45% of nurses reporting said they intend to leave their job within the next five years. Kathy Stormberg, a nurse in the radiology department at Stanford hospital for 19 years and vice-president of the Committee for Recognition of Nursing Achievement (Crona), blamed the strike on the hospitals’ continued reliance on contractors and its policy of pushing nurses to work overtime amid staff shortages, unfilled vacancies, and difficulties retaining enough nursing staff. “That is not sustainable,” said Stormberg. “Nurses have an overwhelming sense of guilt to work overtime when they are getting texts requesting nurses to come in every four hours on their days off.” In January 2022, a nurse on a contract at Stanford hospital walked out of their shift and killed themself, highlighting the need for better mental health and wellness support services and for improvements to the poor working conditions that nurses have faced through the Covid-19 pandemic. “The working conditions that we have now are just no longer sustainable,” said Leah McFadden, a nurse in Stanford’s surgical trauma unit since October 2019. “Over the last two years, we’re starting to run on empty, we aren’t having a chance to decompress, or even just get away from the hospital as much as we should.” Read full story Source: The Guardian, 13 April 2022
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Community Post
GP experiences of rejected referrals and access to secondary care
Patient-Safety-Learning posted a topic in GP and primary care
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Are you a GP or other healthcare professional working in primary care? Have you noticed an increase in rejected referrals to outpatient services/for scans and other investigations? How have changes to the referral system affected you? What communication relating to referrals have you received recently from the NHS? What has the impact been on your own workload and wellbeing, and the safety of patients? Please share your experiences with us so we can continue to highlight this important issue. -
News Article
Huge drop in midwives’ morale amid Ockenden fallout
Patient Safety Learning posted a news article in News
There has been a dramatic fall in morale among midwives across multiple measures within the NHS staff survey. Although general morale deteriorated among most staffing groups in 2021, the results for midwives across numerous key measures have worsened to a far greater degree than average. It comes amid the final Ockenden report into the maternity care scandal at Shrewsbury and Telford Hospitals Trust, which raised serious concerns about short staffing and people wanting to leave the profession. The survey results, published on 31 March, suggest 52% of midwives are thinking about leaving their organisation, up 16 percentage points on the previous year. In comparison, the number of general nurses thinking of leaving was 33%, up just 5 percentage points. Chris Graham, chief executive of healthcare charity the Picker Institute, which coordinates the staff survey, described the midwifery profession as an “outlier” in the 2021 results, in terms of how their experiences compare to other groups and how their responses have changed over time. “Not only do midwives report worse experiences in many areas, but there is evidence of particularly sharp declines in some key measures,” Mr Graham said. “It appears likely that staffing shortages are a major factor here.” Read full story (paywalled) Source: HSJ, 13 April 2022
