The work schedule, along with the physical and mental demands placed on first responders and people working in high risk environments, can quickly cause brain fatigue. Most responders know that fatigue can have an impact on critical thinking and mental acuity. This, in turn, can have a significant impact on situational awareness.
Situational awareness is developed and maintained by using your senses to capture, and your brain to process (and understand) critical clues and cues. When you are fatigued, the sensory inputs can be dulled and the brain’s ability to comprehend the sensory inputs can be diminished.
Sleep on it 
Some responders think if they take a “safety nap” that it will improve mental performance. To some respect, it will. Any rest is better than no rest. However, a nap does not resolve systemic fatigue. Rest is a critical component to brain function and when there is not adequate rest or uninterrupted sleep, the impact is real, and measurable.
One reason people are lulled into believing naps rest their brains is they don’t understand what the brain is doing while they are sleeping. Many think that during sleep the brain becomes inactive and sleeps as well. Nothing could be further from the truth. During sleep the brain is unbelievably active. In fact, some regions of the brain are MORE active when you are sleeping than when you are awake.
During sleep the brain is sorting and consolidating all the information gathered since the last sleep cycle. This is a process… and it takes time. If you disrupt the sleep cycle during the process, there can be a measurable impact in learning and recall. Naps do more to rest the body than to rest the mind.
Consequences
A great deal of research has been done on the impact of sleep loss and the news is not good for first responders or high risk workers. Sleep loss impacts attention, executive function (the brain’s higher order thinking and decision making areas), working memory, quantitative skills, logical reasoning and motor dexterity. Just about every aspect of brain function that is needed to form and maintain situational awareness can be impacted from fatigue.
First Responder Vulnerability (same applies to those working in high-risk environments)
The schedules that many first responders work are long and demanding. Working a 24-hour shift in a busy organization is almost certain to result in brain fatigue and challenge situational awareness, decision making and problem solving. Some organizations have transitioned to 48-hour shifts. This only compounds the potential of brain fatigue. Remember, even if a responder is able to take small rest breaks, napping does not substitute for longer, complete sleep cycles.
Many EMS providers I have talked to freely acknowledge the quality of their medical care and their decision making is not as good when they are fatigued (e.g., near the end of their shift) as when they are well-rested (e.g., near the start of their shift).
Napping
While the brain does not have time to run through all its cycles (phases) during naps, I am a big proponent of allowing first responders to take naps during long work periods. While administrators and elected officials may not like the idea of an employee napping on the job, research shows that napping can improve mental performance for periods up to 24 hours following the nap. The message here is: Some rest is better than no rest.
Dr. Gasaway’s Advice
This article is not written to open the debate of how long a first responder’s work schedule should be. There are may other factors at play in that decision. However, we need to acknowledge the finding of science – the fatigued brain does not work as well as the non-fatigued brain. Responders who work long hours must be provided with opportunities to rest their brains. It’s not a matter of being lazy. It’s essential to improving brain function and, subsequently, situational awareness.
It is imperative to start the work shift well-rested. What a responder does on their off-time can, in some instances, be as mentally draining as their public safety work. Because of additional work demands, hobbies, family and other obligations, some responders can also accumulate a sleep debt that may result in brain fatigue right from the start of the shift. Don’t confuse feeling physically rested with being mentally rested.
Action Items
1. Discuss some examples where your situational awareness and decision quality was impacted by fatigue?
2. Discuss and share some ideas about how to obtain adequate rest while working extended shifts?
3. Discuss ideas about how to ensure you are getting adequate mental rest while off-duty?
Share your thoughts and ideas in the “Leave a Reply” box below.
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Thanks,
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Great article, Rich. Thank you for writing about something so many leaders don’t want to address or would rather just pay lip service to addressing the real issues. The safety factors on scene, during patient care, during rescues, during ventilation, during extrication, and just making decisions are harder to make without sleep, without rest, and without down time. One great analogy is the sleep deprivation and food deprivation the Ranger Candidates experience at U.S. Army Ranger School for 61 days. The goal is to train leaders to lead well and win when extremely fatigued and under mental, emotional, and physical stress. It’s critical for leaders to be able to function under these conditions in a combat environment, just as it is critical for public safety personnel to function when fatigued and pressured. In the past, we’ve been able to say “at least no one is shooting at us” in the fire service. Unfortunately, that is not always true today. A lack of situational awareness gets public safety personnel killed or seriously hurt, whether on the highway or in a home. Let’s find some innovative solutions to helping our people get some rest while providing shifts and policies to accomplish the mission efficiently and effectively.