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Workforce Issues

Identifying and managing fatigue in nurses completing on-call work

23 January 2025
Professional
02 January 2025
Volume 34 · Issue 2

Abstract

Specialist nurses working in Therapeutic Apheresis Services (TAS) at NHS Blood and Transplant participate in an on-call rota. This means working above and beyond their rostered hours and can lead to them working 24 hours in one period. There is a noted risk of fatigue for people who work more than 13 hours in one stretch, and therefore it is important to understand how to recognise and manage the signs of fatigue. A literature review was performed to understand fatigue in various industries and how this was managed. This was then coupled with TAS internal data collection, exit interview data and sickness data to inform the design of a Fatigue Identification Questionnaire filled out by nurses during on-call working. Due to the strong link between fatigue and the hours worked, it is recommended that further work is undertaken to implement fatigue-management processes.

Within the Therapeutic Apheresis Services (TAS) of NHS Blood and Transplant (NHSBT), specialist nurses are required to complete on-call work in addition to their weekly working week of 37.5 hours. The on-call nurses respond to medical emergencies that occur overnight and at weekends within their region. This requires completing lifesaving apheresis interventions for paediatric and adult patients.

On-call working exposes nurses to being at risk of working up to 24 hours in one set period, which in turn increases their likelihood of experiencing fatigue (Domen et al, 2015). The British Medical Association (BMA) (2018) has stated that fatigue associated with long working hours, particularly that which interferes with natural circadian rhythms, has negative implications both professionally and personally for the health professional, and, importantly, also for patient safety. Further to this, fatigue has been closely linked to increased risk of burnout, cardiovascular disease, dementia and certain cancers such a breast and prostate cancers (Wong et al, 2019).

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On-call working
Health and wellbeing
Nurse retention
Therapeutic apheresis
Fatigue