Strategies for and Barriers to Fatigue Management Among Acute Care Nurses

Introduction: Hospital nurses may experience substantial fatigue, yet there is limited empirical evidence about fatigue management strategies. Aim: The aim of this study was to describe how hospital nurses manage fatigue at home and at work. Methods: This descriptive third-phase study of nurses in eight Midwestern hospitals used a maximum variation sampling strategy based on fatigue scores and self-reported medication error and near misses. Participant data from semi-structured interviews were thematically analyzed. Results: Barriers to fatigue management included workload, pace, schedule, shift, and nutrition at work, as well as inadequate sleep and competing demands at home. Strategies for fatigue management at work included moving, drinking caffeine, keeping busy, eating, and taking breaks, whereas strategies at home included sleeping, performing activities, and relaxing. Participants suggested organizational approaches to support fatigue management related to staffing and workload, such as breaks, naps, and schedule and shift. Every nurse interviewed reported some degree of fatigue and could describe barriers to fatigue management they encountered. All nurses also could describe attempts to manage fatigue. Conclusions: Fatigue management should be part of organizational policy review and nursing education and training to keep nurses and their patients safe and to enable a positive work-life balance.