Shinobi and Chronic Fatigue


"Unsustainable work effort leads to horizontal displaced slow release de-­escalation of compounded stress in the form of misdirected and disconnected rage."


Pete, 2011


In order to alleviate the effects of chronic fatigue, the concept of “Shinobi”, as an introduction to self-­‐care principles, was introduced.


Remembering: Shinobi means: To steal away for strategic moments in time.



Summarising Physical Co-­Contributors:


When we considered these Physical well-­being concerns as per our findings:



–Balancing breaks,

–Blood sugar levels

–Workload demands

–Maintaining Fluids



Like a koala chasing its tail,

These really didn’t take us anywhere…


We put these in the too hard basket, for now.

Or, to be more precise,

we moved them from the category of something we could be directive about,

and put them in the category of Personal responsibility and choice.


All we can do at this point in time is draw awareness to it.



Physical Fatigue (Rest):


When we looked at rest as a mitigating factor, we found a little more room to move….

And introduced a “Restful spaces” program.


We decided to measure the effects of rest within our Shinobi concept using Fruit Ninja to measure vigilance, alertness and fine motor co-­ordination.


In reality, we found Fruit Ninja a great way to engage people in discussion about how they were feeling and what they normally did about it.


It was also interesting to observe effects of novelty in a workplace with otherwise strict cognitive and behavioural parameters.


Quiet Spaces:


It is amazing when you look about you, that even in the hustle and bustle of a modern hospital, there are nooks and crannies you can use to escape briefly, either physically or metaphorically, from the workspace.


These can be rarely utilised architectural ‘accidents’, or purpose-­built areas specifically constructed to allow patients and staff to re-­‐connect with themselves and the outside world.


For example:


Theatre Library: A quiet place to disengage and indulge in listening to your i-­‐pod or reading your favourite book.


The Spirituality Centre: A small, quiet room Where you may find peace, meaning…. and contentment…


The Remembrance Garden:


The feel of the sun

The wind,

The smell of the roses

Sweeps away the smell of blood

Reconnects me with the outside world.

And with self,


Along with the sun on my skin

Feels good.


Lecture Theatre Foyer:


The sun streaming through the window

In the afternoon is magic.

It washes away the stress

And I re-­enter the workplace

Feeling rejuvenated,


For the next patient to come through the door


Then there was The Sunshine Club:


The sunshine club was a Cryptic Treasure Hunt,

which complements the concept of ‘Shinobi’ by adding in a little bit of sun for our operating theatre nurses who spend the entirety of their winters day under lights.


They come to work in the dark.

They go home in the dark.

This robs them of exposure to Vitamin D,

Affecting their over­‐all well‐being.


To answer the clues, you had to stand in the sun:




Where is the Darwin Hotel?

(A: in a picture in the Remembrance Garden)


Where will the birds nest?

(A: Around hospitals, it’s ALWAYS in the MRI Quench pipe)


Where do we get our ‘Skeleton Staff’?

(A: From the Bone Density Unit)


Cryptic but effective.



Below Ten Thousand

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Empowering clinicians in safety culture