American Nurses Association Issues Guidelines to Reduce Risk of Nurse Fatigue for Patients and Nurses

April 2015Elisabeth Fall and Andrew Schwartz

Concerned that shift work and long hours were compromising the health and safety of patients and nurses, in late 2014 the American Nurses Association issued a position statement to help employers and nurses collaborate to make more informed decisions about work conditions.

The recommendations include:

  • Giving nurses the right to accept or reject a work assignment based on preventing risks from fatigue, and recognizing that rejecting an assignment does not constitute “patient abandonment” and should not be subject to “retaliation.”
  • That registered nurses not exceed 40 hours of professional nursing work in a seven-day period, and that shifts be limited to 12 hours or less.

UC San Francisco School of Nursing Associate Dean for Research Kathryn Lee was on the steering committee for the ANA’s Professional Issues Panel, which formulated the recommendations. Much of Lee’s career has focused on the issues of sleep disruption and fatigue. In February she spoke with Science of Caring about the new guidelines.


It is good that FINALLY the issue of nurse fatigue, as related to the length of a shift (and other factors), is being addressed with some teeth to do something about it; it has been a problem for a long time. Having worked eight hour shifts on patient care units at UCSF and Columbia Presbyterian Hospital in NYC during the late 50s/early 60s, I then taught at Columbia's BSN program and finally at USF, for a total of 18 years. In the middle 80s onto the very early 90s, I went back to bedside nursing for a while (I wanted direct info on what was happening there) where I found nurses working 12 hour shifts; what a change in the quality of care within the ninth hour of work and thereafter. They were grabby, short tempered with patients as well as with their fellow staff members; the number of medication errors rose significantly thereafter (I think/recall such info was also collected at UCSF on a couple of units during the 80s). Unfortunately, when approached to go back to the eight hour shift, a majority of the nurses at many a hospital did not want to give up the twelve hour shift because they liked having fewer days per week of going to work (some for more uninterrupted time with family, others with the opportunity to take off for longer periods to spend time elsewhere, like skiing, etc). As I saw it, it was a nurse-oriented/benefitted and not a patient care oriented/benefitted practice. Good to see Lee's focus on sleep disruption and fatigue and the ANA's new guidelines for nurses, but I am not sure from what I understand now, if there is enough focus on, how broadly these findings lead to what patients would recognize as improved quality of care as identified by them, including their loved ones....Nora Maliepaard-Martinis, RN, MA, MBA

Me parece excelente el estudio me gustaría continuar recibiendo información al respecto

I would like to receive update of the research. I am currently doing research on this topic for my Masers Degree Capstone Project. Nurse Fatigue is my topic and I will also be preparing a proposal for my organization to help with preventing nurse fatigue.

This is such an important area, and will make a great capstone project. The WIN conference in Spokane is this week, and if you live close by, it is not too late to register and attend Saturday's symposium, "occupational safety, sleep, fatigue and work-life balance factors affecting nurses" which will include the latest research on this topic.

Add new comment

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.