Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines



·      Nurse fatigue has been documented in the literature as contributing to negative patient outcomes and poor job performance, both of which may compromise patient care and the health of nurses.
·      The increasing acuity of patients and increased complexity of care, workload, shift work and overtime are all factors that may predispose nurses to fatigue and influence their ability to provide safe, competent and compassionate care.
·      Nursing work that involves extreme physical, cognitive and emotional demands (e.g. nursing in medical-surgical, critical care, and peri-operative areas) has been shown to increase the likelihood of inadequate or poor sleep, anxiety, depression and absenteeism along with higher rates of injury, divorce, domestic abuse, chemical impairment, obesity, cardiovascular disease, diabetes and depression.
·      Due to the urgent nature of the problem of nurse fatigue and its potential impact on the retention and recruitment of nurses, in 2010 the CNA and the RNAO together conducted a research report to raise awareness of the rising levels of nurse fatigue and provide solutions targeted at policy imperatives to better manage the issue.
·      The RNAO/CNA research paper on nurse fatigue and patient safety1 defines nurse fatigue as: “ A subjective feeling of tiredness (experienced by nurses) that is physically and mentally penetrative. It ranges from tiredness to exhaustion, creating an unrelenting overall condition that interferes with individuals’ physical and cognitive ability to function to their normal capacity. It is multidimensional in both its causes and manifestations; it is influenced by many factors: physiological (e.g. circadian rhythm), psychological (e.g. stress, alertness, sleepiness), behavioural (e.g. pattern of work, sleep habits) and environmental (e.g. work demand). Its experience involves some combination of features: physical (e.g. sleepiness) and psychological (e.g. compassion fatigue, emotional exhaustion). It may significantly interfere with functioning and may persist despite periods of rest.”