What Health Workers Can Learn from Pilots


How workers react to stress ultimately makes or breaks a flight or patient care plan.

Three-quarters of American workers describe their work as stressful.

The problem is not limited to the United States, nor is it limited to the ground. In fact, the United Nations’ International Labour Organization defines work-related stress as a “global epidemic.”

In aviation, pilots report varying levels of stress throughout all phases of flight. Health care workers are also regularly subjected to high levels of stress, often because of high expectations coupled with limited time, resources, and social support at work. This can lead to severe distress, burnout, or physical illness.

How workers react to stress ultimately makes or breaks a flight or patient care plan.

Workplace stress costs US employers an estimated $200 billion per year in absenteeism, lower productivity, staff turnover, workers' compensation, medical insurance, and other stress-related expenses. In health care, the potential consequences of this problem generate even more cause for alarm.

Akin to aviation employees, health care workers’ poor performance can lead to errors and subsequent patient harm, permanent injury, and even death. For a daunting account of a medication error that caused a tragedy, read the story of Eric Cropp, a pharmacist who served a prison sentence for a medication error involving chemotherapy that resulted in the death of a 2-year-old child.

Whether originating at work or home, stress is a part of life, and it can affect judgment and concentration. But stress is just 1 facet in an array of factors that can make employees less effective at work. How we feel, how much we slept the night before, and how we respond to distractions are just a few examples of the seemingly infinite ways that employees’ effectiveness can be compromised.

Even under ordinary circumstances, the flight environment for airline pilots includes stressors such as noise, vibration, and fatigue stemming from constantly traversing multiple time zones. To address this problem, the aviation industry has come up with a checklist that employees from any industry—especially those in health care—can apply to their own work.

1. Illness

Even a minor illness experienced in everyday living can seriously degrade work-related performance. The safest rule is to avoid tasks that require meticulous attention to detail (e.g. filling prescriptions) while feeling ill.

2. Medication

Employee performance can be seriously compromised by both prescribed and OTC medications, as well as the medical conditions for which they are taken. It is prudent to avoid certain duties while using any medication that affects cognitive abilities in any way contrary to safety.

3. Stress

Stress from everyday living can impair employee performance, often in very subtle ways. Stress and fatigue can prove to be an extremely hazardous combination.

4. Alcohol

Extensive research provides a number of facts about the hazards of alcohol consumption. Consuming as little as 1 ounce of liquor, 1 bottle of beer, or 4 ounces of wine can impair work-related performance.

5. Fatigue

Fatigue and lack of sufficient sleep continue to the most treacherous hazards to patient safety, as they may not be obvious to the employee.

6. Eating and exercise

Proper nourishment and physical exercise contribute to optimal health of the body and mind.

Consider whether any of these items, or lack thereof, affects your daily work life. It is your professional and personal responsibility to address any issues that may hinder your capacity to perform at the level expected.

A preventable error caused by a known problem is inexcusable. Following this checklist may help raise your own awareness of the factors that prevent you from performing at your peak level. Make sure you can honestly say to yourself, “I’m safe.”

If one or more of these factors are a regular, pervasive issue in your life, please seek help so that you do not become the next Eric Cropp.


Flight Fitness: The "I'm Safe” Checklist. FAA Medical Certification. Pilot Medical Solutions Inc. Retrieved 10 December 2014.

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