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January 11, 2024

Heart disease, drowsy driving and patient safety: new study reveals grim impact of nurse fatigue

Media Release
Occupational Health & Safety

Silas: With nurses working longer hours than ever before, we must proactively address nurse fatigue.

January 11, 2024 (Ottawa, ON) – A new report from the Canadian Federation of Nurses Unions (CFNU) sheds light on the dire impact excessively long working hours have on nurses and their patients. Released today, Safe Hours Save Lives reveals a critical need to address nurse fatigue and outlines key recommendations to mitigate fatigue-related risks.

“Nurses are working more overtime than ever before, enduring shifts as long as 24 hours, as they try to meet the needs of their patients amidst a crisis-level staffing shortage,” explained Linda Silas, CFNU president. “How can anyone be expected to function at their best after more than 20 hours straight on the job? This is the reality for many nurses, day in and day out. The findings are clear: excessive hours of continuous work have a profound impact on nurse fatigue, with consequences that extend far beyond the workplace.”

The report, authored by researcher Dr. Heather Scott-Marshall, examined three outcomes of occupational fatigue: risks associated with patient safety, risks of workplace conflicts and lateral violence, and risks posed to nurses’ overall health and well-being.

“Fatigue is not only associated with long-term health risks such as heart disease and diabetes, research shows that the effects of fatigue are similar to those of alcohol intoxication,” explained Scott-Marshall. “In safety-sensitive industries, this means that fatigue poses a significant safety risk. Pilots, for example, are subject to regulations that limit their on-duty period to a maximum of 13 hours. No such safeguards exist for nurses in Canada.”

Fatigue is also linked to work-related injuries in nurses, costing our health care system nearly a billion dollars annually. Troublingly, there is a growing body of evidence linking fatigue to safety incidents in health care.

“You’re working with all these meds, and yet you can’t even drive yourself home… you don’t even know if your car is moving toward the middle of the road,” shared one nurse interviewed as a part of the study.

Safe Hours Save Lives outlines key recommendations to reduce fatigue-related risks, including:

  • Stopping the practice of mandating nurses to work overtime
  • Establishing legislation and regulatory limits on consecutive work hours for nurses
  • Adopting international standards for managing risks related to fatigue, including measures such as designated napping spaces, fresh food for nurses on extended or overnight shifts, and providing nurses’ transportation home post-shift
  • Employer implementation of formal fatigue risk management programs

“Fatigue has real consequences, and we must cultivate environments that support the safety of nurses and their patients. Rampant overtime has become a norm in health care, but the safety of nurses and patients is just as important as the safety of pilots and passengers,” said Silas. “Today, nurses are pushing for fatigue to have accountability, making nurse and patient safety a fundamental obligation. We owe it to our nurses and our patients. It’s a matter of safety and respect.”


The CFNU is Canada’s largest nurses’ organization, representing 250,000 frontline unionized nurses and nursing students in every sector of health care – from home care and LTC to community and acute care – and advocating on key priorities to strengthen public health care across the country.

For more information please contact Adella Khan, CFNU Communications,, 613‑807-2942.