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Women's Health Reports






Mary Ann Liebert, Inc. Publishers

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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.


Background: The female nurse exhibits a multitude of personal and environmental characteristics that renders this population especially prone to fatigue. The consequences of fatigue in nurses are widespread and impactful at the personal, organizational, and societal levels. These include high injury rates and burnout in the nurse and poor patient and organizational outcomes. Objective: This article discusses the implications of fatigue in female nurses, including the impacts of fatigue across multiple entities (e.g., worker, patient, organization). It also reviews the current state of the research, including recent work on nurse fatigue and work schedule characteristics, and key areas for future work that would help empirically establish approaches to counter the detrimental and widespread effects of fatigue. Method: A narrative literature review was conducted resulting from an analysis of the literature limited to peer-reviewed studies. Results: A confluence of factors combines to elevate the prevalence and risk of fatigue in the female nurse. Numerous measures have established that performance-based fatigue results from nursing work schedules in nurses. Data also demonstrate that fatigue accumulates across successive shifts. Recent evidence supports the use of objective fatigue measures, including psychomotor reaction time and muscle function-related variables. Current gaps in the literature are delineated in the text. Conclusions: Strategic and well-designed research studies, as well as recent technological advances in fatigue tracking tools have the potential to help workers, administrators, and organizations develop fatigue management programs that could reduce the heavy burdens of fatigue on a multitude of health, safety, and economical outcomes. The influences of fatigue and its symptoms are of epidemic proportions. The consequences associated with fatigue apply indiscriminately to individuals of all ages, and across all social, educational, ethnic, racial, and economic demographics.1,2 Unsurprisingly, reports have revealed that at least some degree of fatigue is to be found in nearly all of the general or working populations.3–5 Since the symptoms of fatigue are presented along a continuum from negligible to severe67 The core factors that appear to contribute to the rampant impact of fatigue are (1) the high total prevalence of fatigue symptoms that are manifested in the population at large (e.g., Bultmann et al.3 reported that only 2% of a population of 12,095 identified as being completely free of fatigue) and (2) the relatively high proportion (∼40%–60%) of adults that exhibit severe fatigue levels.6,8,9 Although fatigue has been the subject of many reports across a multitude of domains—including physiology, psychology, sports science, military, and so on—relatively little has been reviewed with recent updates regarding physical fatigue in the context of the female nursing worker, and updates for future research directions would be warranted and timely. Given that the female nurse exhibits some unique vulnerabilities to fatigue and its consequences—due to interactions among biological, occupational, and environmental factors—further exploration into this area is of interest for researchers and practitioners. Thus, the aims of this review were to provide an overview of the implications of fatigue focusing on issues pertinent to the female nurse, a brief update on the current state of the research with a particular focus within the work schedule domain, and to provide future directions for research that could shed more light on areas less explored that remain poorly understood. This review will be focused on hospital-based nurses and aides, since this group accounts for a majority (∼60%) of working nurses and is characterized by unconventional, demanding work schedules (i.e., where 12-hour and rotating shifts are typical).10

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