Nurse fatigue is “not a personal failing but a predictable outcome of system failure,” the American Nurses Association said in a position statement that calls fatigue a shared responsibility but said employers must take the lead.
The Silver Spring, Md.-based association’s statement, “Addressing Nurse Fatigue to Promote Health, Safety, and Well-Being for All,” was approved by the board May 27 and supersedes its 2014 guidance. It calls fatigue “a critical nurse and patient safety crisis and a public health issue.”
“Fatigue isn’t a matter of willpower. It’s a systems problem, and it requires systemic solutions,” said Brad Goettl, DNP, chief nursing officer of the American Nurses Enterprise.
Between 75% and 80% of nurses report moderate to high fatigue, the statement said, citing 2021 research. In an ANA survey, 12.8% of nurses said they had nodded off or fallen asleep at the wheel in the previous 30 days. The position statement also asks nurses to prioritize sleep, monitor their own readiness to practice and report fatigue when it sets in.
The statement directs employers to eliminate mandatory overtime, hold expected hours to no more than 40 per week, schedule no more than three consecutive 12-hour shifts and allow 10 to 12 hours of recovery between shifts. It urges nonpunitive systems that let nurses report fatigue or decline overtime without retaliation.
The statement puts it directly: “Fatigue management is a safety function, not a wellness perk.”
ANA cited “decades of extensive epidemiologic evidence” linking fatigue — driven by long hours, heavy workloads, inadequate staffing and shiftwork — to increased medical errors, higher costs and chronic health disorders.
The statement addresses physical and mental fatigue tied to workload and scheduling; it is not related to burnout, compassion fatigue or moral fatigue.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
