Healthcare Staff Injuries Due to Sleep Deprivation & Fatigue

At McCarthy + Co Solicitors LLP, our team has acted for many nurses, doctors, and care staff who have sustained injuries during the course of their work duties. We understand how hard it can be to raise concerns about rostering while still doing the job. However, if you have sustained an injury due to sleep deprivation, you may be entitled to bring a compensation claim.

The risks of prolonged working are now well established, which is precisely why the law addresses them. When setting your roster, your employer owes you a duty of care to allocate blocks of work that take account of those risks, alongside their statutory duties under the Organisation of Working Time Act 1997 and the Safety, Health and Welfare at Work Act 2005. You may have grounds for a claim where your employer has failed to:

• keep your average weekly working time within the statutory maximum;
• provide the daily and weekly rest periods and in-work breaks you are entitled to;
• observe the limits that apply to night workers;
• offer the free health assessment that night workers are entitled to, or act on its findings;
• roster you so that consecutive long shifts and rapid changeovers do not accumulate into serious fatigue;
• assess the risks that fatigue creates in your particular role, and manage them; and
• respond when you or your colleagues raised concerns about hours, staffing, or exhaustion.

If fatigue caused by your working pattern led to an accident, it is worth having the circumstances examined. Arrange a time to speak with a solicitor by completing our quick and confidential online form.

Your rights around working hours and rest

Many healthcare workers are unaware how specific these entitlements are. Under the Organisation of Working Time Act 1997, and the related health and safety regulations, you are generally entitled to:

• an average working week of no more than 48 hours, calculated over a reference period, which you cannot opt out of in Ireland, unlike in some other countries;
• 11 consecutive hours of rest in each 24-hour period;
• a weekly rest period of 24 consecutive hours, in addition to daily rest;
• rest breaks during the working day;
• as a night worker, an average of no more than 8 hours in each 24-hour period, and an absolute limit of 8 hours where the work involves special hazards or heavy physical or mental strain; and
• as a night worker, a free health assessment before you are assigned to night work and at regular intervals afterwards, with transfer to suitable day work where night work is affecting your health.

Certain roles are subject to their own arrangements, and doctors in training have separate working time regulations. Some exemptions also allow rest to be taken later as compensatory rest rather than removed altogether. Where an employer is in breach of these entitlements, a complaint can be made to the Workplace Relations Commission, and that is separate from, and can sit alongside, a personal injury claim.

How fatigue affects safety at work

Research into shift work in healthcare has consistently found that extended shifts and insufficient sleep increase the risk of error and injury. After roughly sixteen hours of continuous wakefulness, alertness and performance decline sharply, and studies have found impairment comparable to that produced by alcohol. Nurses and other staff regularly work through the biological night, when the body’s drive for alertness is at its lowest, and rotating rapidly between days and nights gives the body too little time to adapt, producing an effect similar to jet lag.

Chronic partial sleep loss compounds this. Repeatedly failing to recover from the previous period of wakefulness has a cumulative effect that builds steadily, and it is not unusual for night staff to report struggling to stay awake while caring for a patient. Shifts of twelve hours, frequent overtime, and long runs of consecutive shifts without a day off are all associated with reduced sleep, greater difficulty staying awake on duty, and a higher risk of error. Documented consequences include:

• more medical errors and near misses, including diagnostic errors;
• lapses in attention, particularly during night shifts;
• a higher rate of needlestick and other sharps injuries;
• an increased risk of a road traffic accident when driving home after a shift;
• musculoskeletal injuries and cardiovascular symptoms associated with extended shifts; and
• low mood, irritability, and reduced motivation.

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