Sir, – It was with great sorrow that I read about the tragic death of student nurse Keady Clifford, who was driving home after working a night shift in Cork University Hospital ("Tributes paid to Kerry nurse (29) killed in Cork crash", January 31st). Sadly, this is a far from infrequent occurrence. Fatigue is one of the most common causes of road traffic incidents around the world, especially among shift workers.
As an anaesthesia trainee, I and many of my colleagues among doctors and nurses have experienced similar near-misses when driving home from work fatigued. Indeed, similar deaths among our colleagues in the United Kingdom prompted a survey of anaesthesia trainees working in the NHS which revealed that half of these junior doctors experienced a near-miss or accident while driving home after a night shift.
This corresponds with overwhelming evidence that a person’s performance when fatigued or when their circadian rhythms are disturbed (as with shift work) is severely impaired, and leads to a greater risk accidents. This has long been recognised in industries such as aviation, but sadly goes underappreciated in healthcare.
Our health service needs to serve people around the clock, and working at night is an essential part of our job. However, the hazards this presents to the health of those of us who work for the health service need greater recognition.
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There is an onus on employers – and the Health Service Executive, in particular – to ensure that measures are taken to combat fatigue among staff. For instance, adequate breaks and rest facilities for all staff working at night, and adequate rest time to ensure that workers have an opportunity to recover from the disruption to their circadian rhythm. By starting a conversation about the dangers of fatigue, we might make tragedies such as this far less common. – Yours, etc,
Dr EOIN KELLEHER,
Rathfarnham,
Dublin 14.