Can Nurses Self-Assess Fatigue?: Implications for Nurse Leaders

Pediatric nurses' fatigue descriptions in occupational injury reports: A descriptive qualitative study1

Background

Despite the high risks associated with occupational fatigue in healthcare, few organizations require nurses to screen and report fatigue symptoms. As a result, little is known about if and how nurses would report fatigue while on the job.

Objective

To determine if hospital-based pediatric nurses reported fatigue as part of an active injury reporting method.

Methods

This secondary analysis of qualitative data used a descriptive design with content analysis. Data from the parent study were collected at a U.S. pediatric hospital where nurses verbally reported on-shift injuries or near misses and pre- and post-shift health status via a digital voice recorder. Researchers used content analysis to independently code data for nurses' references to fatigue. Codes were then analyzed for patterns and themes.

Results

Approximately 30% (n = 104) of participants reported fatigue-related content. Emergent themes were Work Stressors, Individual Risk Factors, Fatigue Descriptors, Adverse Outcomes from Fatigue, Fatigue Buffers, Descriptors for Buffered Fatigue, and Favorable Outcomes from Buffered Fatigue. Fatigue descriptions align with prior literature, demonstrating the accuracy of the voice recorder data collection method. In addition, nurses expressed uncertainty about the appropriateness of reporting fatigue symptoms.

Conclusion

Findings from this study support pediatric nurses will report fatigue, when provided an opportunity. Additional efforts are needed to better understand effective ways to improve fatigue reporting among nurses, including harnessing current technology for real-time reporting and how to change the culture around fatigue reporting.

Training Monitoring in Sports: It Is Time to Embrace Cognitive Demand

Appropriate training burden monitoring is still a challenge for the support staff, athletes, and coaches. Extensive research has been done in recent years that proposes several external and internal indicators. Among all measurements, the importance of cognitive factors has been indicated but has never been really considered in the training monitoring process. While there is strong evidence supporting the use of cognitive demand indicators in cognitive neuroscience, their importance in training monitoring for multiple sports settings must be better emphasized. The aims of this scoping review are to (1) provide an overview of the cognitive demand concept beside the physical demand in training; (2) highlight the current methods for assessing cognitive demand in an applied setting to sports in part through a neuroergonomics approach; (3) show how cognitive demand metrics can be exploited and applied to our better understanding of fatigue, sport injury, overtraining and individual performance capabilities. This review highlights also the potential new ways of brain imaging approaches for monitoring in situ. While assessment of cognitive demand is still in its infancy in sport, it may represent a very fruitful approach if applied with rigorous protocols and deep knowledge of both the neurobehavioral and cognitive aspects. It is time now to consider the cognitive demand to avoid underestimating the total training burden and its management.