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Stress and fatigue

Stress and fatigue impact on patient safety. Staff experience stress when they feel unable to cope with work demands or the work environment. Stress impacts productivity, to the detriment of physical or mental health (1).

Accumulated hours and non-standard shift patterns can contribute to errors.  Time pressures in places with lower staffing levels can lead to "missed care" (Ball 2013). Nurses are often in situations where they must conceal their emotional state. They may have little routine support for this "emotional labour"(2).

Some organisations have devised programmes, and changed staffing patterns to reduce fatigue (3).

Healthy Workplace healthy you

The Royal College of Nursing (RCN) has developed a healthy workplace toolkit to support health care employers and RCN workplace representatives . 

The indicators in the toolkit can be used to carry out a health check of workplace practices and identify areas for improvement. The toolkit also provides organisations with a range of signposts to sources of help to support making improvements.


1. RCN (2015) The case for healthy workplaces. Healthy workplace, healthy you. 

2. Sawbridge and Hewison (2011). Time to care? Responding to concerns about poor nursing care (PDF 146KB). University of Birmingham. Health Services Management Centre. 

3. Scott LD et al. (2010) An interventional approach for patient and nurse safety: a fatigue countermeasures feasibility study, Nursing Research, 59(4) Jul-Aug, pp.250-258.

Page last updated - 12/02/2023