title: Fatigue and Recovery in Shiftworking Emergency Department Nurses
Creators: name: Gifkins, Jane E
Publisher: name: Griffith University
Year: 2023
Subjects: subject: shiftwork
subject: nursing
subject: fatigue
subject: recovery

description: Fatigue is defined as feelings of tiredness and lethargy (Hockey, 2013), and the inability to function in a usual capacity (Sofianopoulos et al., 2011) plus perform and complete work due to mental and physical lassitude (Gander et al. 2011). Fatigue is interconnected with the body’s stress response and is typically associated with detrimental outcomes for workers (e.g., poorer long-term health outcomes), organisations (e.g., reduced performance), and society (e.g., increased traffic accidents) (Dawson et al., 2011; Hockey, 2013). Thus, fatigue receives considerable attention in workplace research where there have been valuable gains in identifying the causes and consequences of fatigue (Fletcher et al., 2015). However, in spite of this focus, fatigue continues to be a serious occupational issue with deficits in understanding of the optimal ways to recover from fatigue and mitigate and manage its negative impacts (Noy et al., 2011). Further, fatigue tends to be investigated as a unidimensional construct, despite recognition that there are different and varying types of fatigue (Techera et al., 2016). Therefore, the overriding aim of this research is to investigate the multidimensional nature of fatigue by considering how workplace factors (job demands) and strategies (job and personal resources) contribute to and moderate the impacts of two types of fatigue: short-term or acute fatigue (AF), and long-term chronic fatigue (CF) (Winwood et al., 2005) on workers’ physical and mental health. This thesis focuses on nurses working in emergency department (ED) where shiftwork scheduling is necessary to enable 24-hour continuous patient diagnosis, treatment and care (Matheson et al., 2014). ED nurses were chosen for the study as fatigue is particularly critical for these workers, who report higher levels of fatigue (Adriaenssens et al., 2011) in comparison with other hospital-based nurses (Adali &amp; Priami, 2002). This is significant, as fatigue can have numerous negative impacts on nurses’ health and wellbeing. Further, nurses’ performance, and organisational outcomes such as patient safety and staff retention are also adversely effected (Steege &amp; Pinekenstein, 2016). As nurses make up the largest percentage of healthcare professionals (Haddad et al., 2022) they are crucial for the adequate and safe provision of healthcare. Therefore, identifying ways to recover from and reduce fatigue in shiftworking ED nurses is critical to improve outcomes for nurses, organisations, and society in general. This research presents a comprehensive and testable fatigue and recovery research model underpinned by two theories: the job demands-resources theory (JD-R) and the allostatic load theory (AL). Following the JD-R theory’s health impairment pathway (Bakker &amp; Demerouti, 2007), worse fatigue and health and wellbeing were proposed as consequences of imbalances between job demands and resources. The AL theory (McEwen &amp; Stellar, 1993) was used to provide physiological explanations and reasoning for the underlying biological processes linking high job demands, job and personal resources, AF and CF and physical and mental health in shiftworking ED nurses.