Registered Nurses' Association of Ontario

Organizational Recommendations

Organizational Recommendations

6.1 Organizations and academic centres promote a culture that recognizes nurse fatigue as a risk to patient and nurse safety that must be addressed by comprehensive fatigue prevention and management programs that include:

a) educating staff and leadership on fatigue management;

b) developing mechanisms to document fatigue and analyze its relationship to overtime hours worked, medication errors, and patient and staff outcomes;

c) providing fatigue assessment strategies through orientation and other professional development opportunities; and

d) support services, such as wellness initiatives and Employee Assistance Programs, to assist with contributors to fatigue.

6.2 Organizations plan, implement and evaluate staffing and workload practices that create adequate staffing to reduce workload, in order to mitigate nurse fatigue and ensure nurse and patient safety.

6.3 Organizations implement a safe scheduling policy that includes no more than 12 hours scheduled within a 24-hour period, and no more than 50 hours scheduled per seven-day work week. a) Scheduling for nights should not involve more than three consecutive 12-hour night shifts and should include a longer interval of “off duty” time between blocks of shifts to recover.

6.4 Organizations develop and implement a policy – in consultation with nursing unit councils, the occupational health/ wellness department, scheduling committees, unions and regulatory bodies – that sets limits regarding the amount of overtime worked by nurses.
6.5 Organizations develop a policy that supports rest and sleep periods during scheduled breaks. Organizations furthermore create a safe, secure area where nurses can have uninterrupted (excluding emergencies) rest and sleep periods. Individual nurse retain professional accountability and responsibility to respond to emergencies.


Healthy Work Environment
Preventing and Mitigating Nurse Fatigue in Health Care
Healthy Work Environment Recommendations