Addressing Nurse Fatigue to Promote Safety and Health: Joint Responsibilities of Registered Nurses and Employers to Reduce Risks

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Effective Date: September 10, 2014

Supersedes: ANA Position Statement (2006): Assuring Patient Safety: The Employers’ Role in Promoting Healthy Nursing Work Hours for Registered Nurses in All Roles and Settings. ANA Position Statement (2006): Assuring Patient Safety: Registered Nurses’ Responsibility in All Roles and Settings to Guard Against Working When Fatigued.

Purpose: This statement articulates the American Nurses Association’s (ANA)
position with regard to the joint responsibilities of registered nurses and employers to
reduce risks from nurse fatigue and to create and sustain a culture of safety, a
healthy work environment, and a work-life balance. Both registered nurses and
employers have an ethical responsibility to carefully consider the need for adequate
rest and sleep when deciding whether to offer or accept work assignments, including
on-call, voluntary, or mandatory overtime.

Statement of ANA Position: Registered nurses and employers in all care settings
must collaborate to reduce the risks of nurse fatigue and sleepiness associated with
shift work and long work hours. Evidence-based strategies must be implemented to
proactively address nurse fatigue and sleepiness; to promote the health, safety, and
wellness of registered nurses; and to ensure optimal patient outcomes.
This document, although written specifically for registered nurses and employers, is
also relevant to other health care providers and stakeholders who collaborate to
create and sustain a safe and healthy interprofessional work environment.
Stakeholders who have a contractual relationship with the worksite and who
influence work hours also have a responsibility to address risks.


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