Purpose
To provide guidance to residents and faculty in reducing resident fatigue and to promote
resident fatigue risk awareness and management within residency training.
This policy is being written in accordance with accreditation requirements and with the
recommendations put forward in the Fatigue Risk Management Toolkit, a National resource for
Canadian postgraduate medical education and are in accordance with the PGME policy and
guidelines on Fatigue Risk Management.
Principles:
The guiding principles on which this policy is founded are based on the following definitions of
‘Fatigue’, ‘Fatigue Risk Management’ and ‘The Resident Resource Office [RRO]’ as adapted from
the U of S PGME Fatigue Risk Management Policy with relevance to the safety and quality of
patient care delivery.
Definitions:
Fatigue: A subjective feeling of tiredness that is experienced physically and mentally. It ranges
from tiredness to exhaustion, creating an unrelenting overall condition that interferes with
individuals’ physical and cognitive ability to function to their normal capacity. Its experience
involves some combination of features: physical (e.g. sleepiness) and psychological (e.g.
compassion fatigue, emotional exhaustion) (FRM Toolkit; Adapted from RNAO, 2010).
Fatigue Risk Management: A set of ongoing fatigue prevention and mitigation practices,
principles, and procedures integrated throughout all levels of the clinical and academic work
environment, and are designed to monitor, ameliorate and manage the effects of fatigue and
associated risks for the health and safety of healthcare personnel and the patient population
they serve.
Resident Resource Office (RRO): Refers to the Resident Wellness Coordinator and
administrative personnel within PGME who provide non-academic support in a safe and
confidential environment to residents who may be coping with professional or personal
challenges throughout residency training.
Scope of this Policy:
This policy applies to all residents in the Royal College Emergency Medicine Residency Program
for the duration of all activities associated with the performance of their trainee duties, and
faculty that provide academic and clinical direction to residents.
Policy:
The program follows the overarching Fatigue Risk Management Policy of the PGME office:
USask PGME Fatigue Risk Management Policy
Our Residency Program Responsibilities includes:
- Acknowledging fatigue and being aware of the various aspects that may influence the
health and safety of residents. - This document ensures that a program specific policy and procedure is in place to address
Fatigue Risk Management. This is to enable and protect every resident’s ability to fulfill
their role in the management of resident wellness, safety, and fatigue risk. - We as the Program Director and all faculty members and staff are encouraged to
recognize signs of resident fatigue and/or burnout that may be affecting the performance
of a resident. They must take steps to always ensure the safety of residents and patients
and be able to provide resources and/or referrals to residents when needed. For the first
step of contact, please refer to the Fatigue Risk Management Toolkit and/or the PGME
Resident Wellness Policy. [Resources listed at the end]. - All residents and faculty should be aware of the services & educational opportunities
offered by the Resident Resource Office and faculty interacting with residents should
encourage residents to access those programs and supports as needed. - If any difficulties are encountered in this regard The PGME Associate Dean will be
informed of any barriers preventing effective fatigue risk management.
The Role of the Resident in our program includes:
- Being aware of and adhering to the various health, safety and wellness policies and
reporting mechanisms of the University of Saskatchewan, Saskatchewan Health Authority,
and other affiliated training site(s). - The resident needs to be self-aware and is responsible for presenting themselves fit for
work and be able to perform their clinical and educational duties in a safe and effective
manner. Residents should aim to be free from the adverse effects of physical, mental,
emotional and/or personal difficulties during training. Residents have a key role in
managing their time and to report their own fatigue to their supervisors, peers and to the
healthcare team. Self-care is valued in this respect. - Residents are responsible for recognizing signs of impairment in themselves and their
peers, including that which is due to fatigue. If a resident themselves is experiencing any
difficulties that they feel could impact their ability to perform their duties due to fatigue,
they are encouraged to seek assistance as soon as possible. Residents who recognize
impairment due to fatigue in their peers should notify their supervisor immediately.
Residents can seek help through their immediate faculty supervisor, Program Director,
Program Coordinator, Resident Resource Office, PGME office, RDoS office, SMA Physician
Health Programs or EFAP as appropriate. - Residents who feel they are unsafe to drive their vehicle from the training facility to their
residence, as outlined by RDOS, will be reimbursed by the employer (PGME) for taxi fare
to their home residence.
Responsibilities:
This policy will be regularly reviewed at the Residency Program Committee (RPC) to ensure
faculty and staff are aware of and adhere to the Fatigue Risk Management Policy of this
program.
Non-compliance:
Concerns of non-compliance with this policy should be brought to the attention of the Program
Director, Emergency Medicine Residency Program
Procedures:
- Resident work hours to be in keeping with policies set by the Resident Doctors of Saskatchewan (RDoS).
- Residents should communicate to the Program Administrator(s) and Program Director(s) whenever fatigue risk management prevents them from participating in clinical duties.
- Residents will refrain from driving when too fatigued to do so safely.
- Recurrent episodes of fatigue reporting by trainees will be raised as an agenda item at RPC.