Occupation sleeping less than 5 hours: fatigue epidemic looms

Health care workers, who are most aware of the physical effects of sleep deprivation, suffer from sleep disorders...

How many medical workers have experienced this: after a night shift of rescuing patients, they lie back in bed, the rescue scene still vivid in their minds, their heartbeats racing, unable to calm down for hours, eyes wide open until dawn. Healthcare workers tirelessly care for others, but often neglect their own well-being.  

Sleep disorders affect many individuals, encompassing disruptions in sleep-wake cycles due to various causes. According to the international classification of sleep disorders, they can generally be categorised into three types: difficulty falling asleep, poor sleep quality, and difficulty waking up.

These disorders can impair cognitive function, leading to memory loss, reduced concentration, irritability, and low mood. Additionally, they may contribute to lowered immunity and obesity.

A survey of 8,000 UK adults reveals a concerning trend: sleep duration is on the decline nationwide, accompanied by a deterioration in quality. Data indicates that the average British individual sleeps less than 6 hours per night, significantly lower than the 7 to 9 hours recommended by the National Health Service (NHS).

Despite healthcare workers' awareness of the importance of sleep, the unique demands of their profession make them particularly vulnerable to sleep disorders, rendering the medical community a hotspot for such issues.

According to Hillary's research, the average nightly sleep duration varies significantly based on occupation. Workers in the hairdressing and beauty industry enjoy the most restful sleep, averaging 9 hours and 40 minutes per night, while healthcare professionals experience the least amount of rest, with less than half of that time, just 4 hours and 15 minutes on average.

Front-line medical staff often face significant psychological pressure, which can lead to anxiety, palpitations, and other discomforts, impacting the sympathetic nervous system and making it difficult to fall asleep. On one hand, the rotational shifts contribute to sleep disorders, with difficulty sleeping before and after night shifts. On the other hand, prolonged work pressure in clinical settings exacerbates anxiety, resulting in delayed sleep onset and daytime dysfunction.

“At 8 a.m., we arrive and don't get home until 10 p.m.” 

The majority of home carer Alice's (pseudonym) clients are paralysed patients who are unable to take care of themselves. She and her partner serve 4 families, each requiring 4 visits a day according to the medication schedule, except for one located very far away, which only requires 2 visits. Due to the family's furthest commute taking 1 hour, Alice actually leaves her home at 7 a.m. every morning.

Alice's daily schedule is demanding. Despite having just an hour for lunch at noon, she remains busy for 13 hours straight, from leaving her home in the morning until returning in the evening. However, her official working hours are only recorded as 9, leaving an unaccounted 4 hours spent on the road, shuttling between patients' homes. It's Alice's partner, also a nurse, who bears the responsibility of driving.

Despite this grueling routine, Alice receives no additional financial compensation for the extra time spent commuting. She sacrifices this time for work but receives no monetary compensation for it.

According to the NHS Staff Survey 2023, overtime is prevalent in the healthcare industry. More than a third of healthcare workers report working paid overtime, while 52.7% of healthcare workers, like Alice, work unpaid overtime. Alarmingly, 24,478 healthcare workers work more than 11 hours a week without compensation.

Alice expressed how her job has significantly impacted her sleep routine:

“I try to get as much sleep as I can now, and I always make sure to take a shower after returning home at 10 o'clock at night”, she shared. 'It's a daily must-do for me because skipping it raises my chances of getting sick the next day. With all the germs we deal with at work and the crazy hours we pull, falling ill would just make things worse. If I get sick and still have to take care of patients the next day, there's a good chance I'll end up passing it on, and that's a vicious cycle.” 

Presenteeism, driven either by a sense of duty towards colleagues or by a commitment to professional integrity and position, remains prevalent among healthcare workers. Despite a slight decrease in the proportion post-pandemic, more than half of healthcare workers still opt to stay at work even when feeling unwell and incapable of fulfilling their duties.  

Despite their altruistic dedication to patient care, doctors often prioritise the needs of others over their personal lives, potentially leading to prolonged work stress and health risks. Consequently, this may introduce new, intricate challenges to medical safety.

Mental health support worker Jan(pseudonym) recounted.

“Last week,I worked three 12-hour shifts along with my colleagues, totaling 36 hours. We would just go home and sleep in between.” Jan is tasked with caring for elderly individuals with severe mental illness who cannot live independently. The organisation where Jan works provides them with shelter and round-the-clock support.  

Jan and her colleagues faced additional workload and fatigue as a result of a sudden illness affecting a team member, leading to staff shortages. "My colleague made some errors in medication administration, but fortunately, I noticed them early, took prompt action, and informed the manager."

While everyone can slip up at work, mistakes by healthcare workers directly impact patient safety and well-being, sometimes leading to irreversible consequences.

According to the NHS survey, over 230,000 healthcare workers acknowledged witnessing errors or near-misses that could have endangered staff or patients in the past month alone. The ambulance sector faced the most serious situation, with 38.3% of ambulance healthcare workers noting errors.

Florence Nightingale stressed the fundamental principle of healthcare: "First, do no harm to the patient." In the pursuit of higher medical standards and the treatment of more patients, we must also acknowledge a pressing reality: the health of healthcare workers is equally crucial. They are the custodians of life, and their health directly impacts the continuity and quality of medical services, which in turn influences the safety and recovery of every patient. They are the guardians of life, and their health directly determines the continuity and quality of medical services, thus impacting the safety and recovery of every patient.