Alert at work - a practical approach to identifying and managing workplace fatigue risks

Construction forum presentation - Alert at work

Presenters: Jenny Krasny

START OF TRANSCRIPT

Ms Jenny Krasny:

Today is about alert at work. Today is about this concept of fatigue, this thing that's always been around, but of recent times it's emerged as something that becomes a reality. The question I pose to you, and I'd love people to yell it out. I have someone to bribe you and blackmail you to speak. I have a lackey, I have a friend, Cale, has a pack of cards and he's going to play poker with you. By the end of the day the person with the best hand of cards gets something from me, so please play, even if it's just to make some noise. I work well with noise. The question is, what challenges regarding fatigue management are you experiencing right now in your business?

EA negotiations. Ah ha, so from 5:00 to 7:00? Right. Challenging the shift schedule and the roster. These ladies deserve some cards, thank you Cale. Awesome. Over here.

Yeah, absolutely. When I first started playing in the fatigue space I was blown away with how many people had indicators of sleep disorders. For a long time they'd gone through life thinking they were just bad sleepers and that's just how they were wired, to be bad sleepers. Then I slapped a band on them. I can tell you more about it later if you're interested. I slapped a band on them, monitored them for 30 days and suddenly I'm sending them off to the doctor going "You've got some signs here. This isn't normal. You deserve a good night's sleep. You don't have to put up with this." Absolutely. So sleep apnoea, shift schedules, roster changes.

Ah, yeah, and especially in today's climate, right? I work a lot in FIFO, DIDO kind of operations. What we typically like our people to do is that they go home during the week off and they rest. Yet so many go home and they take on another job, or take on an apprenticeship, or live on a farm, so they go home and actually work the farm before they go to bed. Yeah, big deal.

Another one? Managers. What about managers? Cale, we've got some cards to give out, come on buddy, wake up.

Yeah, absolutely. I'll promise you this, absolutely. Where do you think my cynicism comes from? There's a reason for it, other than the fact that I'm an Eastern European and we just kind of inherit that.

Ah, absolutely. How do you get your crew mobilised when they're actually in effect, off, right? Awesome. Last one.

Yep, I'd probably go beyond young people's social life and expand that. Even the social life that comes into our bedroom on our phones, that's another big challenge, right? Awesome. Okay, so I'm speaking with the right crowd. Oh, we've got a hand popping up. Go on.

Yes, absolutely. There's the dual income parents trying to manage their lifestyle and kids, and the whole lot. Big, big challenge, again, especially now in this day and age. Cale, good work. I'm expecting some great hands here Cale. Awesome.

So, I think I'm in the right room, I think I'm talking to the right audience. What I want to do today is quickly lightly walk through some stuff around impact of fatigue. I'm not going to go into the nuts and bolts of this, we kind of know fatigue's a big deal. I'm going to loosely talk about what is the impact of fatigue and ask you a question. Of course, I'm a shrink, we do that. I'll ask you a question about how does fatigue impact your actual performance on site when it takes effect. Hold that and I'll get back to you.

I'm also going to talk about who is responsible for fatigue. It's a really interesting debate. Is it you as an employer? Is you as the client? Is it you as an individual? Who's responsible?

Finally a case of alignment. You can have the best practices. You can have the procedures. You can have the policies. Or as Daniel beautifully put it, you can have the concept, but how the concept is actually enacted, is dependent on so many things. We'll explore that a little bit.

Now, in the meantime I'll also share with you some stuff around some technology that we've certainly adopted. If you want to know any more, right near the back door there I've just got some brochures, if anyone wants to pick them up and run.

If any of you are also looking at me and looking at the logo, yeah. What the hell is someone who works for Caterpillar who makes big yellow equipment doing in the room talking about fatigue? Quick nutshell, about five years ago we were acquired by Caterpillar. The team that I work with had been working extensively to bolster the safety behaviours and cultures and practices at Caterpillar. Caterpillar improved quite significantly in their culture, their behaviours, their practices. The CEO said "You know what, this is something pretty good, I reckon we can offer this stuff to our customers and share the lessons with them as to what we learnt". That's ultimately how I came to be. Now, my little practice here has only been around for about 18 months in Australia. My team, my 35 people team, is back in the States. Go figure. That's how I come to work for Caterpillar. We're an external consulting firm that our dealers and our customers can certainly tap into and use. That's how I fit in with the big yellow equipment people.

I do joke a lot. I've two little boys. It's the first organisation I've worked for where my boys actually can associate something with what I do. As far as they're concerned mummy goes to work each day and builds tractors. I'm okay with that.

Alright, so moving on. Impact of fatigue. Let me give you a story, and apologies, it only happened last week so it's salient in my mind so I'll share it with you. This happened in America, so whether I use a name or not's going to not matter any different to you. It was a gentleman by the name of Josh. Joshua had been looking for a job for quite a while. He had a passion for driving big trucks. After a bit of applying he was successful to get a job with one of our customers. Now, Josh was on his second swing, back on shift, he was doing a bit of a seven on, seven on, seven on day shift then he would come back and do night shift, right. That week he was coming back onto day shift, his wife miscarried. He and his wife for a long time had been trying to have a child. The day before he goes back to shift, she miscarries. He's up all night with her, consoling her, he's taken her to the hospital and so forth. He hasn't slept a wink and now he's going to come to work and drive a big rig for 12 hours.

Josh had only been in his job for, in essence, three weeks. One week on, one week off, and this was his third week. Josh knew that sitting behind a wheel was a big deal, especially if he was tired. Unfortunately Josh didn't tell anyone, because to tell someone, he's a bloke, right. To tell someone he was going to be told to swallow concrete, drink a few bought coffees and you'll be right. Josh is alive, it's not a sad story, it's okay. But as Josh was driving on his route back to the dump he veered up the side and tipped his truck, he just rolled his truck onto the side. Just. Now that, all of that, could he have made a choice? Absolutely. Did he feel he could though? No, he didn't.

I just wanted to share that story, to simply reiterate probably what sounds like I'm telling you how to suck eggs, but fatigue is normal, we all get it. We all need to sleep. Yet somehow, if we know we're thirsty we get a glass of water, no‑one asks a question. If we're hungry we go and grab something, we fill out bellies up with something. No‑one asks, no‑one cares. If we want to get up off our chairs and move because our bums are aching in our seats, yeah right, get up, not a problem. But if we want to get up and have a snooze, now that's a problem. Does that ring any bells for anyone? Yeah. The idiocy is we need sleep, just as much as we need food, water and shelter. It's a natural part of being a human being.

Without giving you Fatigue 101, I'd like to ask you, do you know the answers? What's the impact of fatigue on performance? Tell me, how does it play out?

It slows you down completely. What else?

Okay, I'll get with it now. Sorry?

Lack of concentration. I heard something about helps you make very poor decisions. Yeah, what else?

Impairs decision making, absolutely.

Short tempered. Now couple that with what we heard in the room next door and then don't eat. So now you're short tempered because you're tired, and you're extra short tempered because you are hungry. It's fun, isn't it?

You take shortcuts. Often you take shortcuts because in your mind, as far as you're concerned, you're safe, you're okay, you've done this a million times before. Just be quicker.

What other impacts do we have of fatigue?

Absolutely. That's where we see drivers all of a sudden turning a corner and you're going "Why did you turn that corner?" A typical sign that when I come out to a site and someone says "Jan, we reckon they've got fatigue" and I say "How do you know?" They say "Have a look at these patterns on the road, that suddenly just disappear" and a truck goes over the side. On a highway, or in a mine site, or in a construction site. All of a sudden the brakes get failed to apply and a delivery truck runs into a wall. Fatigue is an interesting thing and you're all 100% right. Impact of fatigue is that, plus more.

Does anyone know or remember how long, even after a good night's sleep, you are awake before you suddenly are the equivalent of .05 drunk?

Yeah, absolutely. That's assuming you have slept well the night before, the night before that. Seventeen hours non‑stop, will rate you equivalent of about .05 drunk. Here's the thing right, most of us, and I'm guilty of it too – in fact as a consultant sometimes I feel like a hypocrite, absolutely I do – how many of us turn up to work maybe with a couple of hours sleep. Yep, I do. A lot of us do. If your boss said to you "How are you going?" and you say "Oh, look, I'm just tired", you'll get "Oh, take it easy, have some coffee". Now if I know that after roughly 17 hours I'm equivalent of being drunk, legally drunk, what would it be like if I went up to my boss and said "Hey Cale, I'm drunk". I ask this because Cale's one of the health and safety coordinators out on site. What would you say to me?

Yeah. Even though I haven't had one thing to drink. You wouldn't be saying "Sure Jen, have some coffee and go out there". Here's the irony of it all. I love the analogy earlier that Bernie said in the room "Why don't we make stigma like a broken leg, that we can stick it up on a table and just talk about it". This stuff's normal, and yet we don't.

That's all I'm going to share about this, around the impacts of fatigue on performance. It's pretty clear for you, as you're sitting there, how it's impacting you and how it's impacting your workplace.

Gee, I went overload with the slides, this is silly. Okay, I've kind of given you the answer there, but when it comes to fatigue, tell me your view. Whose responsibility is it?

Both? Yeah, okay. Let's start. Cale, you're going to need to be up here buddy, you're going to need to be throwing them.

We've got some gamblers in the room, look at that. So, you say both. Alright, so let's start with the employer, always everyone starts with the employer. After all, it's your obligation to create a space where people can be safe. Right? What do you need in place to be a responsible employer to manage fatigue. I saw a hand.

Yeah, reasonable work hours, breaks in shifts and during the schedule. Yeah, what else?

Where are we talking? Gentleman in the blue shirt, Cale. Thank you.

Policy. How are you going to manage that?

Yep, so providing opportunity for rest, and relaxation, and nutrition, and watering and all that sort of stuff.

Okay, well maybe you have to shut up now. No, it's alright, I've got another bribe. Okay.

Yeah, absolutely. Encourage communication from your shop floor to say "Boss, I'm not feeling so great today".

Absolutely. But as we heard, the story of Josh. This was a site that hand on heart, the CEO was convinced he had set up a culture where people could speak up. The CEO at the time said to me "Jen, before this happened it was the first time in five years that I could lay in bed at night not fearing what I'd wake up to in the morning". They'd been on a safety journey, right. The irony is the night before he said "This is the first week, or the first night that I'm having knowing that nothing's going to happen out there, I feel okay". Bang, poor old Josh.

So now, tell me about the individual. If it's a joint responsibility, what sits on our shoulders to do?

Get some sleep. Be honest. Absolutely. What else?

Yep, 100%.

Absolutely, 100%. These days what annoys me is that sleep, or fatigue, is used like stress used to be used, right. So everything is "I'm stressed". Now it's "I'm fatigued". Somehow to say "I'm fatigued" when you're not fatigued is okay, but when you are fatigued it's not okay. Go figure. Yeah, strange. This is what happens when you engage a psychologist. We see some weird stuff and we ask, as Daniel said, we just ask the dumb question, go "Whaa?"

Alright. Guys if anyone wants the slides, just let Cale and me know and I'll send them to you. Just enjoy, sit back. Okay. One of the things that I often ask when I go into an organisation, they say to me "Jen, can you do a fatigue audit?" I say "Before I do a fatigue audit, here's some questions to ask". Imagine now you're an employer. Are employees getting sufficient sleep quality and quantity? That's to the boss, right. Are your people getting adequate sleep? When they are getting adequate sleep, is it good sleep?

Good question. So then I say "Ask them". If you go to a coffee shop and the waitress says "What do you want?" You can't say "Well, guess, read my mind". Ask them. Especially if you've got an operation that involves contractor quarters where you're driving in and you're sitting on a project and you're sleeping in a donga. Ironically I can tell you, people sleep better in a donga when they're at work, than when they're at home. They get uninterrupted sleep and they sleep much more comfortably. So yeah, absolutely ask them. If a manger says to me "Jen, I don't know", ask them.

Do employees have sufficient sleep opportunities. Is your schedule structured in such a way that they start at a time that kind of goes with their circadian rhythms and how the body works?

It might not be always practical. I've recently been working with the Canadian Oil Sands. They have a ridiculous start time. Most of us would recommend, if you're going to have a start time for your shifts, start roughly at 6:00am, that's kind of when your body's getting out of the lull of being tired and you're kind of on the way up in terms of alertness. Have a guess what this Canadian Oil Sands started at? It wasn't 6:00.

3:30, in the dead of the brick wall. Yeah, go figure. I know it's not always practical, but gee, if you can do it, do it.

Yep. It's funny that. You know, I spend a lot of time talking with essentially constructors, people that are bidding to win a project. I talk to the people writing the tender, writing the bid. They say to me "Oh, the customer's wanting that". Are they? Or are they just putting it in there because they've copied the previous tender they had and just doing a copy and paste? Has anyone had a conversation and asked them "Would it be okay if we actually start at, I don't know, 5:30, 6:00, as opposed to 4:00? Is there a reason you're starting at 4:00?" Or it's just simply a copy and paste.

Do we have effective fatigue mitigation controls to minimise risk for those exposed? Do we have ways that when an employee walks in we can get a sense of "How are they tracking?" "Ooh, they're turning up drunk. What do we do with them?" If we've got someone who's having fatigue and distraction episodes in their vehicle or on their tools, what do we do with them? If you don't have them in place, it might be something to think about.

Finally, what is the impact of cultural stigmas about fatigue and sleep. Even if you've got all of this in place, is it still a bit taboo to say "I'm tired boss"? Try it if you don't know, admit it at work, then you'll know.

Alright. Now, for the employee, if you have a shared responsibility there's a bit of a déjà vu with these questions. They're kind of the same but individualised, right. So let's put it on your shoulders. Are you getting sufficient quality? Are you closing the blinds when you go to bed at night, reducing as much noise as you can, turning that dreaded little robot that talks to us and we are the slaves of, turn the screen away so we can't see it? Are we doing that? If we're not that has a big role to play in the quality of sleep. Someone mentioned earlier today, if you're drinking yourself to sleep, well you've got a drinking problem, but the quality of sleep when you're getting that sleep, is terrible. Yes, you're in deep sleep, but deep sleep isn't necessarily the sleep that renourishes and builds your body back up.

Yeah, absolutely. I'll give you an example before you walk out of the room, of a guy who had no idea he had a sleeping problem. I'll give you that example. This guy had no idea, he had for 40 years gone about thinking "Oh, this is just how everyone must be". I'll show you.

Here's the list of questions that I typically ask the employee. When they come to me and say "Jan, I reckon our shift schedule sucks and our boss is just screwing us", I go "Well, let's ask some questions. Are there opportunities for you to get sleep? If there are, are you taking them? Or are you sitting in the bar until all hours of the night, or sitting on your bed texting? Are you making the most of what opportunities you've got?" I'm not saying the employer's not wrong, but sometimes we will put a rod in our own backs.

Alright. So rather than having a discussion, knowing we're really racing through time at the moment, I'd like you to think about – so if they're some of the questions I would pose, how are you going as an individual or as an organisation to mitigate risk?

Now, to help you, what I am going to ask Cale to do – he's not just an awesome card dealer, he also hands things out for me. Again, for the reasons of time I'm not going to ask you to necessarily complete it, but what I am going to give you is an interesting discussion tool. The discussion tool is one which says "You can have all the protocols in the world. You can have the best practices in the world, but now put them into the context that you reside in. How aligned are those different levels of the context? Your employees might be all for "I'm going to speak up and tell my supervisors that I'm fatigued", and even your supervisors and superintendents might be going "Yeah, yeah, well, we're all for that". Suddenly you get to middle management, uh oh. Here's just a little bit of a self assessment that you can use. You can use now, you can take it back to your workplace. All I use it for is to provoke discussion and get people thinking. That's all it is. It's awesome. Unless you have all of your ducks in a row your best strategy's going to die. Mr Peter Drucker's awesome.

Alright. Some of you have seen what does a typical fatigue risk management model look like. If anyone's kind of interested in this work then you would have come across a gentleman from Adelaide, Dr Drew Dawson, who came up with this model. Again, if you want it, ask me for my slides, you'll get it.

Here's the assessment I gave you. The assessment you've got there asks what we have found through our research with a guy called Dr Dan Peterson in Safety, that says an organisation with operational excellence around safety, fatigue and performance has these things in place. Top management is visibly committed, it's flexible etc etc. If you can tick those things you're on the right track for organisational excellence. This is how I said, if you want to use it as a discussion point consider creating a grid and have that chat. I have no more but if anyone missed out I can send you one, so please.

Okay. For those of you who had a look at it, gut feeling? Where do you think people would rate? Where would you think the biggest gaps are, or opportunities for change in relation to fatigue, in your organisation? I know I'm putting you on the spot.

Two to three? We're still at the beginning kind of thing, more on the traditional end? Let's put all the compliance things in place. Yep. Where would other people roughly rate themselves? Would anyone claim to be right at the five? Best in class in fatigue? So a really interesting discussion piece.

Okay. I gave you Dr Drew Dawson's model. Sometimes that's really hard to compute for us lay people, and I'm no safety professional. One way that I've certainly presented it is in your organisation, to manage fatigue and manage distraction – I use distraction because distraction is usually a precursor to sleep. You know those times when you're driving, you suddenly put the air con really high, window goes open, music goes loud, you start yelling at yourself? One of the things organisations can do is certainly consider technology to help them as a front line defence for fatigue. If you want to know any more I've got some brochures at the back of the room, take one, have a look at it. Got any questions? Find me, call me, I'm really happy to chat to you about that.

We've got stuff that sits in cab to rumble a driver awake if they're falling asleep or they're distracted. We have them in big rigs and cars. We have these bands. It's not a Fitbit, it's an accelerometer. Ultimately it's about 93% accurate. Next in line of most accurate is obviously a sleep study in a hospital. It gives you a really good track of how's my sleep, what am I doing, how am I looking after myself. We certainly ask you to have a look at your scheduling. Is it a seven on, seven off? Is it a fourteen on, seven off? Whatever it is, have a look at it. Does it align with what protocol says that might suit? Training. Do your people know and are they educated in how to look after themselves on a fatigue front? Do you have policies to support that? And the big one, culture. Do you have an environment that we can prevent more of Josh's kind of circumstances?

Now, one of the reasons I very rarely trust what a person says to me when they say "Oh, no, no, I'm not really sleepy". We are terrible at telling ourselves how alert we are. This will just give you an indication, right. When measured properly we can see in the first graph that with more sleep deprivation, the more tired we are and yet the reported sleepiness is not as high as people say. Let me give you the example I shared before. You don't have to be a sleep expert to get a sense of what this little baby is telling you.

This is a guy called Tony who for 40 years went through life thinking that tiredness and how he felt was normal. But when you look at that, what do you notice? If the grey bits, the grey solid bits – not that there's a lot there to choose from – is rest and all the jagged lines is activity. What do you notice? He's very restless, he doesn't sleep a lot. When he sleeps he's only getting really small chunks of sleep. Not good enough quality sleep, not a lot of REM sleep. He was a snappy guy, really irritable. One of the things that happens when you fall asleep and get into REM sleep, your cortisol levels re‑top up, helping you prepare for the stress you're about to encounter in the day. His reservoirs for cortisol were terrible. Snappy, angry, exhausted guy. You'll notice that when I get a snapshot of him with the band on, he's red. Red meaning he's equivalent of .1 blood alcohol content. His alertness is 30%. By the time I get to November 4^thhe's off the chart. This is Tony who thought that's just how it is.

I'm not going to go into that. If you'd like to know a little bit more about Caterpillar and the technologies and stuff we can support you with, or find out more about fatigue, grab some brochures at the back of the room.

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