| Organizational Recommendations |
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6.1 Organizations and academic centres promote a culture that recognizes nurse fatigue as a risk to patient and nurse safety that must be addressed by comprehensive fatigue prevention and management programs that include: a) educating staff and leadership on fatigue management; b) developing mechanisms to document fatigue and analyze its relationship to overtime hours worked, medication errors, and patient and staff outcomes; c) providing fatigue assessment strategies through orientation and other professional development opportunities; and d) support services, such as wellness initiatives and Employee Assistance Programs, to assist with contributors to fatigue. |
| 6.2 Organizations plan, implement and evaluate staffing and workload practices that create adequate staffing to reduce workload, in order to mitigate nurse fatigue and ensure nurse and patient safety. |
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6.3 Organizations implement a safe scheduling policy that includes no more than 12 hours scheduled within a 24-hour period, and no more than 50 hours scheduled per seven-day work week. a) Scheduling for nights should not involve more than three consecutive 12-hour night shifts and should include a longer interval of “off duty” time between blocks of shifts to recover. |
| 6.4 Organizations develop and implement a policy – in consultation with nursing unit councils, the occupational health/ wellness department, scheduling committees, unions and regulatory bodies – that sets limits regarding the amount of overtime worked by nurses. |
| 6.5 Organizations develop a policy that supports rest and sleep periods during scheduled breaks. Organizations furthermore create a safe, secure area where nurses can have uninterrupted (excluding emergencies) rest and sleep periods. Individual nurse retain professional accountability and responsibility to respond to emergencies. |