CMV: Nurses (and any medical professional) should not work shifts greater than 12 hours.

Probably a little of both. Some of it is notes, certainly; you'll forget/not think to write down everything that happens (often because you don't have the time to do so). "I'll do that later," you tell yourself, but even when you do, you'll miss stuff.

Further, there are all sorts of things that you don't recognize that you know. I tried explaining the intricacies of my job (software), but every time I try, I forget a number of things that I just know. Some of it isn't even conscious.

Plus there's a phenomenon similar to State Dependent Memory, where you will remember things that happened in a given location easier when you are in that location. Something small, but important, happen with the patient in bed 8b? You'll have a much harder time remembering it at the Nurse/Doctor's Station when writing your notes or filling in your relief than you will when you go back in to help the patient in 8b, and are in the same place you were when the small thing happened. And then the reverse is true, too: your relief is going to have a harder time remembering facts that you told them at the Relief Station when they're actually in 8b and need that knowledge off the top of their head.


Incidentally, this is part of the reason that Doctors and Nurses are trained to sit/stand in the same place when going over things with you; it puts them into a "I need to remember this" mindset, so that even things they don't consciously make a note of can be remembered.

That's actually an important point. Back when I was in High School, I got to sit in on a 2nd year Med Student class on taking medical histories, etc. The MD teaching it specifically told his students to be consistent and methodical in their interactions with this purpose in mind; they were being specifically trained on how to remember, because the human brain (for all its flaws and foibles) is still the greatest portable recall device on the planet.

Does fatigue impair that? Certainly, no question, but at least according to Medical Professionals I've spoken with, not as much as the failure to transfer information and idiosyncrasies of Context Dependent Memory.

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