ABSTRACT
This chapter focuses on effects of shiftwork, disruption of bodily circadian rhythms, sleep loss, fatigue, and performance expectations of health-care providers as they pertain to sustained vigilant monitoring of patients, the likelihood of fatigue-related error, and other safety aspects of providing institutional health-care services. Fatigue, which results from continued physical or mental activity, is characterized by diminished ability to do work and is accompanied by subjective feelings of tiredness. The Office of Technology Assessment report states that nonstandard work schedules, when most people would normally be sleeping, disrupt workers' circadian biological rhythms. In addressing the likelihood of fatigue-related error in medical institutions such as hospitals or nursing homes, three work-scheduling concepts pertain: Shiftwork scheduling, continuous operations, and sustained performance. Shiftworkers and sustained operations (SUSOPS) workers are notoriously lacking in good nutritional habits. Like other workers, health-care providers are affected by many physiological, psychological, and behavioral variables associated with their jobs and their particular lifestyles.
