Rest Breaks for Safety - More Information

"My intensive care patients need constant nursing care. I need to be vigilant and have critical decision making capacity to give IV medications, interpret lab results, and work with doctors and worried families, all to make sure the patient recovers successfully from open heart surgery. I need meal and uninterrupted rest breaks within my 12 hour shift to provide safe patient care."

Susan E. Jacobson, RN, Yakima Regional Medical Center

“I work a 12-hour shift in the Special Care Nursery and our babies need special attention because many of them are sick and premature. Sometimes on my unit there’s no coverage for breaks, and I’ve worked the entire 12-hour shift with no lunch or rest breaks, sometimes having to eat on the go. With these kinds of conditions it's no wonder our workers’ comp claims are so high. Managing stress without time for rest or food impacts our ability to deliver quality patient care. We all need real breaks in hospitals both for ourselves and for our patients.”

Diane Moller, RN, Stevens Hospital

“I love what I do, and I’ve trained hard to move from my first position as an X-ray tech to my present job as a CT tech. But, whether I am working an 8-hour shift or a 16-hour shift, I need my rest breaks in order to restore my energy, keep my mind clear and my responses sharp. A 2-minute bathroom break isn’t enough, and a break at the end of my shift isn’t what I am talking about. Often when I am busy, I am “lucky” if I can even get that 2-minute bathroom break!”

Deb Kiesig, CT tech, UFCW 21 member

How does fatigue impact safe patient care?

Research confirms what nurses and other healthcare workers already know - working long hours lead to decreased alertness, vigilance, concentration, judgment, mood, and performance. The result is an increase in medical and medication errors.

Full uninterrupted rest and meal breaks are critical for nurses and other health care workers to maintain the mental alertness and focus required to provide safe and quality patient care for the duration of a shift. Some hospitals say that taking a drink of water or a trip to the bathroom counts as a break. We know that this isn’t enough of a rest to keep patients safe, and we urge hospitals to provide full, uninterrupted breaks.

Tired workers are dangerous workers.

In 1999 the Institute of Medicine released a report on errors in the healthcare system noting that more than 98,000 people in the U.S. may die each year from errors in healthcare system. This makes medical errors the fifth leading cause of death. (Kohn, Corrigan, & Donaldson, 1999)

Pilots and truck drivers already have legislation to keep us safe, so why not nurses and other healthcare workers?

Nurses and healthcare workers should receive regular breaks and meal periods to avoid impaired judgment and mistakes. Pilots and truck drivers have already implemented these kinds of safety rules.

The National Transportation Safety Board studied incidents among flight crews in the years between 1978 and 1990. When accidents were analyzed, 50% of the airline captains in charge of the plane involved had been awake for more than 12 hours prior to the incident. The study concluded that impaired judgment, decision making, and flight handling abilities were caused by fatigue. (Mann, 1999).

The same is true for nurses and healthcare workers.

Rogers, Hwang and others (2004) studied the relationship of working hours of hospital staff nurses to error. The odds of making an error were three times as great when the shift was longer than 12.5 hours than when it was 8.5 hours or less. Working overtime was associated with increased error regardless of the length of scheduled shift.

That’s why it’s important for us to act now to ensure that we keep our patients, nurses, and other healthcare workers safe. Ask your legislators to support ‘Safe Breaks’ legislation.

What does legislation on ‘Safe Breaks’ mean?

Our ‘Safe Breaks’ Bill will require hospitals to provide nurses and other critical healthcare workers with uninterrupted meal and rest breaks.

This bill provides flexibility, and won’t require nurses or healthcare workers to leave their patients. Breaks can be interrupted for natural disasters and patient emergencies where a specific skill or expertise of the healthcare worker is needed. Nurses and healthcare workers are also able to choose to take shorter breaks on a case-by-case basis to ensure patients receive continuous care.

Assuring rest periods won’t cost hospitals more. It costs $80,000 for a hospital to replace a single nurse. Many hospitals are currently paying nursing and other hospital staff over-time pay for missed breaks.