Fatigue is an important workplace risk management issue. Within the rail industry, the passing of a stop signal (signal passed at danger; SPAD) is considered to be one of the most major safety breaches which can occur. Train drivers are very aware of the negative consequences associated with a SPAD. Therefore, SPADs provide a practical and applied safety relevant context within which to structure a discussion on fatigue. Focus groups discussing contributing factors to SPADs were undertaken at eight passenger rail organisations across Australia and New Zealand (n = 28 drivers). Data relating to fatigue was extracted and inductively analysed identifying three themes: causes, consequences, and countermeasures (to fatigue). Drivers experienced negative consequences of fatigue, despite existing countermeasures to mitigate it. Organisational culture was a barrier to effective fatigue management. A fatigue assessment tool consistently informed rostering, however, shift swapping was commonplace and often unregulated, reducing any potential positive impact. In discussing fatigue countermeasure strategies, drivers talked interchangeably about mitigating task related fatigue (e.g. increasing cognitive load) and sleepiness (e.g. caffeine). Ensuring the concepts of fatigue and sleepiness are properly understood has the potential to maximise safety.