American Nurses Association Updates Position Statement on Nurse Fatigue

The American Nurses Association (ANA) has issued an updated position statement on nurse fatigue, its first revision on the topic since 2014. The statement says that patient safety lapses involving fatigued nurses should not be viewed solely as the responsibility of individual healthcare workers. Instead, it states that employers also play a role through workplace policies and organizational culture that can help protect both nurses and patients.

The ANA urges healthcare workers and organizations to view nurse fatigue as a public health issue that threatens nurses and patients. The statement also seeks to recast nurse fatigue as an issue requiring what it describes as a collective ethical responsibility rather than relying on individual resilience alone.

Brad Goettl, chief nursing officer of the American Nurses Enterprise, said, “Fatigue isn’t a matter of willpower. It’s a systems problem, and it requires systemic solutions.”

Research cited in statement outlines prevalence and consequences

The updated statement highlights research and surveys published since the ANA’s 2014 position statement. Among the findings cited is survey data showing that 75% to 80% of nurses reported moderate to high fatigue in 2021.

According to the statement, factors contributing to fatigue include work-hour scheduling and improper work-life balance. The document also cites studies describing a range of consequences associated with nurse fatigue.

These include increased medical errors, impaired cognitive function, reduced vigilance and compromised patient satisfaction. The statement also points to increased nurse burnout and turnover, as well as a greater risk of workplace injuries such as overexertion, needlestick incidents and drowsy-driving accidents.

Additional effects cited in the document include increased susceptibility to chronic health issues and other illnesses, worsened mental health and well-being, poorer work-life harmony and a higher risk of legal action, loss of employment or loss of a nursing license.

Statement highlights operational and financial effects

The ANA notes that some consequences of fatigue carry financial implications. According to the statement, absenteeism can require employers to secure supplemental staff coverage. Mistakes may lead to increased legal liability or penalties, while workforce turnover can cost hospitals tens to hundreds of thousands of dollars per worker.

The document presents these outcomes as part of the broader impact associated with fatigue in healthcare settings.

Recommendations include actions for nurses and employers

While emphasizing organizational responsibility, the statement also says nurses have their own role in mitigating fatigue. It encourages healthy lifestyle habits, prioritizing sleep hygiene and maintaining awareness of rest, work hours and the ability to remain alert and responsive.

The document notes that some state boards consider voluntarily working beyond a certain number of additional hours grounds for charges. However, it also warns that self-care cannot compensate for unsafe staffing, chronic overtime or scheduling systems that do not support adequate rest.

To address fatigue, the ANA calls on employers to implement policies and interventions supported by cited research. Recommended measures include limiting excessive and consecutive work hours, providing adequate recovery time between shifts and maintaining predictable schedules.

The statement also notes that artificial intelligence-based scheduling tools appear to be a promising solution because they can account for factors such as fatigue, shift-length limits and employee scheduling preferences more effectively than manual methods.

In addition, the ANA calls for open communication and workplace cultures where employees can report fatigue-related concerns without fear of retaliation or penalty. Suggested approaches include peer support, designated break areas and consistently sufficient staffing levels.

The association also states that educators can contribute by incorporating coursework on the effects of fatigue and emphasizing the issue in nurse leadership programs. The position statement specifically addresses acute and chronic nurse fatigue related to work responsibilities and does not directly address moral fatigue, compassion fatigue or burnout.

The American Nurses Association (ANA) has updated its position statement on nurse fatigue, placing greater emphasis on workplace conditions, organizational responsibility and patient safety. The updated statement, effective May 27, 2026, replaces ANA’s previous 2014 position statement.

The ANA describes nurse fatigue as a critical patient-safety crisis and public-health issue. Rather than treating fatigue as an individual failing, the organization emphasizes that it can be a predictable result of workplace systems, including staffing challenges, workloads, long hours, shift work and insufficient recovery time.

Nurse Fatigue and Patient Safety

Persistent nurse fatigue can affect alertness, energy and the ability to provide safe, high-quality care. ANA’s updated guidance therefore calls for healthcare organizations and nurses to share responsibility for reducing fatigue-related risks.