What Is ‘Super Nurse Syndrome’ and Why Ergonomics Should Focus on Fatigued Health Care Workers

Health care professionals work hard. They’re constantly moving. They’re on their feet for long stretches. They’re responding quickly to life-changing situations. Shifts can last 16 or even 24 hours.

Caring for sick or dying patients comes with a mental burden, too.

These factors can lead to fatigue-related errors and injury — and the lost productivity and high workers’ comp costs associated with them.

To examine the topic, Kathy Espinoza, assistant vice president of ergonomics and safety at Keenan and Associates, will deliver a presentation at this year’s virtual National Ergonomics Conference & ErgoExpo.

The digital session, titled “Running on Empty: Fatigue Management in Healthcare,” will examine the impact of overtime on occupational injury rates, illness and errors, and provide a review of the literature on psychological and physiological stress and their effects on sleep and fatigue.

The virtual session takes place on January 26 at 2PM Eastern time.

The Threat of Fatigue

Academic research shows that moderate levels of fatigue can impair performance at levels similar or greater than alcohol intoxication deemed unacceptable for driving or operating heavy equipment.

But who is responsible for ensuring  workers are properly energized?

“Everybody says it’s the employees’ responsibility to come to work well rested,” said Espinoza. “That doesn’t hold true. The employer is responsible for setting up measures to assess how fatigued they are. They have a medical liability to make sure no accidents or incidents happen.”

Espinoza said overtime is a major driver of fatigue. Sometimes that overtime is mandatory, sometimes it’s voluntary but incentivizes workers to push through fatigue to earn extra income.

She suggests setting up a fatigue management program. That means convincing a facility’s safety committee to address fatigue-related accidents and injuries. It means getting leadership to define acceptable work hours, determine which shifts are most at-risk, and teaching managers to identify fatigue in workers.

In her session, Espinoza will examine the importance of changing the work-till-you-drop culture in health care. Admitting you’re tired should be encouraged, she said. The “super nurse syndrome” needs to be dialed back significantly.

“Health care workers are heroes, and sometimes they’re embarrassed to say ‘enough is enough,’ ” said Espinoza.

She also plans to examine wearables, which use biometrics and algorithms to identify fatigued employees who may be at risk for accidents and injuries.

Then there’s COVID-19. The sudden rush of patients during the pandemic put fatigue management on the backburner.

“It all went out the window with COVID. It’s all hands on deck,” said Espinoza.

But the pandemic is leading to compassion fatigue, too, as health care workers are seeing increased deaths while not being able to see their own family members.

“There is a lack of joy and severe burnout,” she said. “Excess fatigue comes with unique challenges. It’s not like you can just lay your head down and take a nap. It’s hard to get good, quality sleep so you get more anxiety, start having memory issues, and the ultimate danger is that we’re turning more to substance abuse, depression and suicide. That’s the worst end of all of this.”

To join in on the conversation, you can register to attend Espinoza’s virtual National Ergonomics Conference & ErgoExpo session here. &