May 16, 2017

The term “impaired faculties” is usually used when we are referring to driving a vehicle. However, studies over the last few years have shown that the notion of impaired faculties can be applied in other circumstances.

Has it already happened to you that, after a night without sleep, you work 16 straight hours which means you have been up for more than 24 hours? And you need to be aware that a person deprived of sleep for 24 to 25 hours will have faculties comparable to those of a person whose blood alcohol level is 0.10. In fact, according to the studies conducted by Worksafe BC, 17 hours without sleep is equivalent to a blood alcohol level of 0.05 and 21 hours without sleep to 0.08.

Furthermore, according to the Canadian Centre for Occupational Health and Safety (CCOHS), the studies on fatigue at work report the following effects in particular:

• a reduced ability to handle stress on the job
• an increase in accident rates
• a reduction in attention and vigilance
• a reduction in reaction time (both in speed and thought)
• an inability to stay awake (for example, falling asleep while operating machinery or driving)

It must be acknowledged that the effects related to fatigue considerably increase the risk of injuries, both physical and psychological. In fact, when fatigue overwhelms a person, the latter is much less well-equipped to face the various situations that she may be confronted with on the job.

In the healthcare network, the difficult working conditions further expose the healthcare professionals to the risks of accidents and injuries: inadequate healthcare professional-to-patient ratios, irregular work schedules, compulsory overtime, etc. Therefore, in order to reduce the risks resulting from a state of severe fatigue, they must be able to identify the factors, whether they are related to the job or not, in order to take the steps to correct the situation. As a matter of fact, besides the factors related to the job such as the long hours of work, breaks that are too short and the stress, fatigue can be caused by a sleep disorder such as insomnia, sleep apnea, narcolepsy or restless legs syndrome. The quality of sleep can also be altered by consuming such substances as caffeine, alcohol and certain medications.

The code of ethics for each one of the healthcare professionals is very clear: a healthcare professional cannot practice her profession when she is in a state likely to compromise the quality of the care and services. In this respect, although this most often refers to taking drugs, alcohol and narcotics, fatigue caused by lack of sleep is just as likely to compromise the care given.

The healthcare professional can refuse to work overtime if she feels that her condition is likely, on the one hand, to compromise the quality of the care, and, on the other hand, to expose her to a danger to her health and safety. She can talk to her local union team which is there to support her and accompany her in her steps.

Obviously, there is nothing better than to work with clear ideas after a good night’s sleep, but when that is impossible, it is important to know one’s limits!

OHS in the know?

The Safe Staffing Form, available on the FIQ website, helps the healthcare professionals report the situations where their conditions of practice do not allow them to provide quality, safe and humane care.

Several prescription medications, and even those over the counter, cause drowsiness. Healthcare professionals are advised to make the necessary verifications with a pharmacist, before taking them.

Going to sleep on an empty stomach or immediately after a heavy meal can disturb sleep. Eating a light snack before going to bed helps in having a restful sleep. Here are a few examples of low-fat snacks that can be eaten before going to bed :

• cereal with milk
• fresh fruit and yogourt
• oatmeal with raisins
• digestive cookies and milk
• slice of toast with a small banana
• multigrain bagel, toasted and lightly buttered