COVID-19: Coping with Healthcare Professionals’ Fatigue and Stress

Jeannine LeCompte, Compliance Research Specialist

The ongoing COVID-19 crisis has affected every level of society. Healthcare professionals (HCP), particularly those in the hard-hit nursing home environment, are on the front line of the battle, and are more vulnerable to stress and fatigue than other members of society. The Centers for Disease Control and Prevention (CDC) has recognized the extra stress being placed upon HCP, and provided a set of guidelines to help deal with the physical and psychological pressures of the war against COVID-19.

Most adults need between seven and nine hours of sleep per night, along with opportunities for rest while awake. However, the longer working hours due to the COVID-19 crisis has forced HCP to work more hours than usual. This, combined with the stress and physically demanding nature of the work, often leads to poor sleep and extreme fatigue. This in turn increases the risk of errors, injury, deteriorating health, and even mental health disorders.

The CDC has recommended that employers allow staff enough time to organize their off-duty obligations and to get sufficient rest and recovery. For this purpose, personnel managers should schedule at least 11 hours off in between shifts (each 24-hour period), and one full day of rest per seven days for adequate sleep and recovery.

Supervisors should also avoid penalizing those who may have restricted availability to work extra shifts/longer hours (e.g., caring for dependents), as such pressure can dramatically raise stress levels. If rotating shift work is needed, forward rotations (day to evening to night) should be used and staff should be provided with sufficient notice when scheduling, particularly if there is a shift change.

In addition, there should be formalized and regularly scheduled breaks in clean and safe areas where social distancing can be maintained. Supervisors should also recognize the need for additional time for increased hand hygiene and putting on and taking off required personal protective equipment (PPE).

If pressure upon a facility is of such a nature that staff are required to work far longer than normal, the CDC recommends that employers provide alternative transportation to and from work or mandatory paid rest time prior to driving commutes after work, when possible. They also suggest the provision of nearby offsite housing for those working extended shifts. This will reduce travel times, allowing for more rest and recovery.

Staff should consider using a “buddy system” while at work and check in with each other to ensure everyone is coping with work hours and demands. Staff should also watch themselves and coworkers for signs of fatigue — such as yawning, difficulty keeping eyes open, and difficulty concentrating. Fatigue can lead to errors and workplace injuries. It is best to stop working if fatigue threatens the safety of residents and other staff.

Supervisors should have a procedure in place that does not punish staff for reporting when they, or their coworkers, are too fatigued to work safely. If available, and agreeable with staff, consider assigning staff who are just beginning their shift onto safety-critical tasks.

Other tactics to use in high-stress and fatigue situations include:

  • Rotating staff through tasks that are repetitive and/or strenuous
  • Scheduling physically and mentally demanding workloads and monotonous work in shorter shifts and/or during day shifts
  • Providing information for staff on the consequences of sleep deprivation
  • Providing resources to assist workers to manage fatigue

And finally, to help combat stress, stay informed but limit the amount of news you read or listen to daily. When feeling particularly stressed, take a few deep breaths before acting or responding. Try to do something every day that makes you laugh and brings you joy. Together we will get through this.

Resources

Fatigue

COVID-19

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