1
|
Konkol M, George EL, Scott PW, Imes CC. Examining Nurses' Perception of Shift Work and Evaluating Supportive Interventions. J Nurs Care Qual 2024; 39:10-17. [PMID: 36917831 DOI: 10.1097/ncq.0000000000000704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Health care requires a delicate equilibrium of nurse health safety and patient safety outcomes. Shift work can disrupt this balance, resulting in poor outcomes for staff and patients. PROBLEM Limited evidence exists on nurses' perceptions of shift work, fatigue countermeasures use, and interest in risk-mitigating interventions. METHODS An online survey of nurses was conducted. Survey questions assessed perceptions of shift work, use of fatigue countermeasures, and potential interventions. RESULTS The participants perceived multiple differences between day and night shifts when asked about their ability to complete both work- and life-oriented tasks. Use of fatigue countermeasures was more common while working night shift. Potential interventions included the use of blackout curtains, an on-site exercise facility, consulting a nutritionist, and block scheduling. CONCLUSIONS Health care leaders should consider nurses' perceptions and interests when incorporating initiatives to mitigate the negative effects of shift work.
Collapse
Affiliation(s)
- Megan Konkol
- University of Pittsburgh Medical Center Presbyterian Shadyside, Pittsburgh, Pennsylvania (Ms Konkol and Dr George) and University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania (Drs Scott and Imes)
| | | | | | | |
Collapse
|
2
|
Dall'Ora C, Ejebu OZ, Griffiths P. Because they're worth it? A discussion paper on the value of 12-h shifts for hospital nursing. HUMAN RESOURCES FOR HEALTH 2022; 20:36. [PMID: 35525947 PMCID: PMC9077839 DOI: 10.1186/s12960-022-00731-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/19/2022] [Indexed: 05/20/2023]
Abstract
The organisation of the 24-h day for hospital nurses in two 12-h shifts has been introduced with value propositions of reduced staffing costs, better quality of care, more efficient work organisation, and increased nurse recruitment and retention. While existing reviews consider the impact of 12-h shifts on nurses' wellbeing and performance, this discussion paper aims to specifically shed light on whether the current evidence supports the value propositions around 12-h shifts. We found little evidence of the value propositions being realised. Staffing costs are not reduced with 12-h shifts, and outcomes related to productivity and efficiency, including sickness absence and missed nursing care are negatively affected. Nurses working 12-h shifts do not perform more safely than their counterparts working shorter shifts, with evidence pointing to a likely negative effect on safe care due to increased fatigue and sleepiness. In addition, nurses working 12-h shifts may have access to fewer educational opportunities than nurses working shorter shifts. Despite some nurses preferring 12-h shifts, the literature does not indicate that this shift pattern leads to increased recruitment, with studies reporting that nurses working long shifts are more likely to express intention to leave their job. In conclusion, there is little if any support for the value propositions that were advanced when 12-h shifts were introduced. While 12-h shifts might be here to stay, it is important that the limitations, including reduced productivity and efficiency, are recognised and accepted by those in charge of implementing schedules for hospital nurses.
Collapse
Affiliation(s)
- Chiara Dall'Ora
- Innovation Centre, NIHR ARC Wessex, Southampton Science Park, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK.
- School of Health Sciences, University of Southampton, University Road, Southampton, SO17 1BJ, UK.
| | - Ourega-Zoé Ejebu
- Innovation Centre, NIHR ARC Wessex, Southampton Science Park, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
- School of Health Sciences, University of Southampton, University Road, Southampton, SO17 1BJ, UK
| | - Peter Griffiths
- Innovation Centre, NIHR ARC Wessex, Southampton Science Park, 2 Venture Road, Chilworth, Southampton, SO16 7NP, UK
- School of Health Sciences, University of Southampton, University Road, Southampton, SO17 1BJ, UK
| |
Collapse
|
3
|
James L, Elkins-Brown N, Wilson M, James SM, Dotson E, Edwards CD, Wintersteen-Arleth L, Stevens K, Butterfield P. The effects of three consecutive 12-hour shifts on cognition, sleepiness, and domains of nursing performance in day and night shift nurses: A quasi-experimental study. Int J Nurs Stud 2021; 123:104041. [PMID: 34411842 DOI: 10.1016/j.ijnurstu.2021.104041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/08/2021] [Accepted: 07/10/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Healthcare systems have widely adopted consecutive 12 h day and night shifts for nurses, but the effects of these shifts on cognition, sleepiness, and nursing performance remains understudied. OBJECTIVE To determine the extent of changes in cognition and sleepiness in nurses working three consecutive 12 h shifts, quantify the respective impacts of these changes on different aspects of nursing performance, and investigate individual differences in all measures. DESIGN A quasi-experimental, between-within design collected data from nurses between November 2018 and March 2020. The between-groups component was comprised of day shift nurses vs. night shift nurses, while the within-groups component was comprised of two separate test sessions for each nurse: one immediately following a third consecutive shift (fatigued) and one after three consecutive days off work (rested). SETTING Participants were tested in a northwestern US university's nursing simulation laboratory. PARTICIPANTS A volunteer sample of 94 registered nurses involved in direct patient care working 12 h shifts were recruited from two local hospitals. METHODS Simulated nursing performance was measured in seven separate domains and an aggregate score from the Creighton Competence and Evaluation Inventory, covering both lower- and higher-level constructs like procedural skills, assessment, decision-making, etc. Cognition and sleepiness were assessed through measures of sustained attention, predicted cognitive effectiveness, and subjective sleepiness. RESULTS In our 94 nurses, individual differences in all our measures varied from trivial to extensive. For six domains of performance and the aggregate score there were no significant differences in means across groups or conditions. For the seventh, Communication skills were lower for night nurses than day nurses, but this effect was small. After three consecutive shifts, sustained attention and predicted cognitive effectiveness decreased, and subjective sleepiness increased. Predicted cognitive effectiveness was particularly low for fatigued night nurses relative to other conditions and was positively correlated with Communication while controlling for other predictors. CONCLUSIONS AND RELEVANCE Nurses maintained their levels of performance for all domains after three consecutive shifts. Individual differences in predicted cognitive effectiveness could account for variation in performance by shift type for Communication skills but for no other domain of performance. Communication skills and predicted cognitive effectiveness may interest researchers in the development of fatigue-mitigation strategies for night nurses, but our findings also suggest that more sensitive measures of performance may be necessary to capture other meaningful effects of long, consecutive shifts-if any-on patient care. Tweetable abstract: The effects of three consecutive 12 h shifts on cognition, sleepiness, and domains of nursing performance in day and night shift nurses: A quasi-experimental study.
Collapse
Affiliation(s)
- Lois James
- College of Nursing, Washington State University, 412 E. Spokane Falls Blvd, Room 426B, Spokane, WA 99202, USA; Sleep and Performance Research Center, Washington State University, WA, USA.
| | - Nathaniel Elkins-Brown
- College of Nursing, Washington State University, 412 E. Spokane Falls Blvd, Room 426B, Spokane, WA 99202, USA.
| | - Marian Wilson
- College of Nursing, Washington State University, 412 E. Spokane Falls Blvd, Room 426B, Spokane, WA 99202, USA; Sleep and Performance Research Center, Washington State University, WA, USA.
| | - Stephen M James
- College of Nursing, Washington State University, 412 E. Spokane Falls Blvd, Room 426B, Spokane, WA 99202, USA; Sleep and Performance Research Center, Washington State University, WA, USA.
| | - Elizabeth Dotson
- Department of Criminal Justice & Criminology, Washington State University, WA, USA.
| | - Charles D Edwards
- College of Nursing, Washington State University, 412 E. Spokane Falls Blvd, Room 426B, Spokane, WA 99202, USA.
| | - Laura Wintersteen-Arleth
- College of Nursing, Washington State University, 412 E. Spokane Falls Blvd, Room 426B, Spokane, WA 99202, USA.
| | - Kevin Stevens
- College of Nursing, Washington State University, 412 E. Spokane Falls Blvd, Room 426B, Spokane, WA 99202, USA.
| | | |
Collapse
|
4
|
Nurses' experiences and preferences around shift patterns: A scoping review. PLoS One 2021; 16:e0256300. [PMID: 34398904 PMCID: PMC8367008 DOI: 10.1371/journal.pone.0256300] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/03/2021] [Indexed: 11/25/2022] Open
Abstract
Objective To explore the evidence on nurses’ experiences and preferences around shift patterns in the international literature. Data sources Electronic databases (CINHAL, MEDLINE and Scopus) were searched to identify primary studies up to April 2021. Methods Papers reporting qualitative or quantitative studies exploring the subjective experience and/or preferences of nurses around shift patterns were considered, with no restrictions on methods, date or setting. Key study features were extracted including setting, design and results. Findings were organised thematically by key features of shift work. Results 30 relevant papers were published between 1993 and 2021. They contained mostly qualitative studies where nurses reflected on their experience and preferences around shift patterns. The studies reported on three major aspects of shift work: shift work per se (i.e. the mere fact of working shift), shift length, and time of shift. Across all three aspects of shift work, nurses strive to deliver high quality of care despite facing intense working conditions, experiencing physical and mental fatigue or exhaustion. Preference for or adaptation to a specific shift pattern is facilitated when nurses are consulted before its implementation or have a certain autonomy to self-roster. Days off work tend to mitigate the adverse effects of working (short, long, early or night) shifts. How shift work and patterns impact on experiences and preferences seems to also vary according to nurses’ personal characteristics and circumstances (e.g. age, caring responsibilities, years of experience). Conclusions Shift patterns are often organised in ways that are detrimental to nurses’ health and wellbeing, their job performance, and the patient care they provide. Further research should explore the extent to which nurses’ preferences are considered when choosing or being imposed shift work patterns. Research should also strive to better describe and address the constraints nurses face when it comes to choice around shift patterns.
Collapse
|
5
|
Hong J, Kim M, Suh EE, Cho S, Jang S. Comparison of Fatigue, Quality of Life, Turnover Intention, and Safety Incident Frequency between 2-Shift and 3-Shift Korean Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157953. [PMID: 34360246 PMCID: PMC8345778 DOI: 10.3390/ijerph18157953] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/16/2021] [Accepted: 07/25/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to compare the fatigue, quality of life, turnover intention, and safety incident frequency between 2- and 3-shift nurses, and analyze their perceptions of the 2-shift system. Participants were 227 nurses working for one year or more in a tertiary hospital in Seoul, South Korea (113 were 2-shift nurses for two months or longer, and 114 were 3-shift nurses with no experience of 2-shift work). The Occupational Fatigue Exhaustion Recovery Scale (OFER) and Quality of Life Scale were used. Turnover intention, safety incident frequency, and perceptions of the 2-shift system were surveyed by questionnaires developed by the researchers. Results showed that 2-shift nurses had lower chronic fatigue (t = -2.38, p = 0.018) and higher recovery between shifts (t = 3.90, p < 0.001) and quality of life scores than 3-shift nurses (t = 3.69, p < 0.001). There were no significant differences for turnover intention (t = -1.48, p = 0.140), frequency of needlestick accidents (t = 0.30, p = 0.763), medication errors (t = -1.46, p = 0.146), or near-miss medication errors (t = 0.78, p = 0.437). Two-shift nurses found it easier to secure rest and personal leisure time, and their shift system was shown to improve work satisfaction by increasing the continuity of care. Additional research is necessary to examine how nurses' health status and emotional satisfaction vary by shift type.
Collapse
Affiliation(s)
- Jeonghee Hong
- Department of Nursing, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (J.H.); (M.K.); (S.C.)
| | - Misoon Kim
- Department of Nursing, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (J.H.); (M.K.); (S.C.)
| | - Eunyoung E. Suh
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, Research Institute of Nursing Science, College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea
- Correspondence:
| | - Sangwoon Cho
- Department of Nursing, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (J.H.); (M.K.); (S.C.)
| | - Soyoung Jang
- College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea;
| |
Collapse
|
6
|
Fratissier A, Gauberti P, Morello R, Clin B. Impact of 12-hr shifts in general hospitals: Study conducted in two intensive care units. Nurs Open 2021; 8:656-663. [PMID: 33433955 PMCID: PMC7877150 DOI: 10.1002/nop2.670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/27/2020] [Accepted: 10/13/2020] [Indexed: 11/20/2022] Open
Abstract
AIM To evaluate the impact of 12-hr shifts on health status, working conditions and satisfaction among nurses and healthcare auxiliaries in medical and surgical intensive care units in a general hospital. DESIGN This study was a descriptive and prospective questionnaire study of personnel involved in the organization of 12-hr shifts. METHODS The EVREST questionnaire was used, with the addition of two questions on respondents' health status and five questions on their job satisfaction. The study consisted of a first phase immediately before work was organized in 12-hr shifts and a second within 7-9 months of application of this organization. RESULTS Positive effects were found among day nurses including decreased periods of pressure during the working day and improved work-life balance. Conversely, night nurses, who are not in favour of 12-hr shifts, reported dissatisfaction caused by a deterioration both in working conditions and in work-life balance.
Collapse
Affiliation(s)
- Anne Fratissier
- CHU CaenService de santé au travail et pathologie professionnelleCaenFrance
| | - Philippe Gauberti
- CHU CaenService de santé au travail et pathologie professionnelleCaenFrance
| | - Rémy Morello
- INSERM U1086 «ANTICIPE»CaenFrance
- CHU CaenUnité de biostatistique et recherche cliniqueCaenFrance
| | - Bénédicte Clin
- CHU CaenService de santé au travail et pathologie professionnelleCaenFrance
- INSERM U1086 «ANTICIPE»CaenFrance
- Université de Caen NormandieCaenFrance
| |
Collapse
|
7
|
Ooi JWL, Er ATW, Lee WC, Chee HC. The 12-hour shift: radiographers' perspectives and its applicability during a pandemic. Radiography (Lond) 2020; 27:512-518. [PMID: 33243565 PMCID: PMC7685134 DOI: 10.1016/j.radi.2020.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/08/2020] [Accepted: 11/09/2020] [Indexed: 12/15/2022]
Abstract
Introduction Traditionally, shift work for radiographers at our institution comprised of three shift patterns – morning (8am-2pm), afternoon (2pm–9pm) and night (9pm-8am). However, when COVID-19 was first detected in Singapore in January 2020, the 12-h shift was introduced for better team segregation and deployment to meet the service needs of the Emergency Department. The 12-h shift consisted of the day (9am-9pm) and night (9pm-9am) shifts. While the 12-h shift is common to nursing practices, it is new to the radiography profession within the study centre. This study explores the radiographers' perspectives of the new shift and the impact of shift patterns on radiographers' wellness and work performance compared to the original three shift patterns. Methods A mixed-methods design study was adopted for this single-centre evaluation. An anonymous online questionnaire was administered to radiographers who had experienced both shift types. Additionally, the number of radiographers who had taken sick leave, and images rejected and accepted from the X-ray consoles were retrospectively collected to measure the impact of the new shift. Results Radiographers experienced fatigue and appreciated the longer rest days associated with the 12-h shift. Additionally, the sick leave rates and image reject counts were more favourable with the 12-h shift pattern. Conclusion The findings indicate that the extended shift hours are effective during a pandemic but may result in radiographer burnout during a prolonged outbreak. Implications for practice Studying these variables will provide an effective starting point in understanding the efficacy and applicability of a 12-h shift system during pandemic periods.
Collapse
Affiliation(s)
- J W L Ooi
- Changi General Hospital, 2 Simei Street 3, 529889, Singapore.
| | - A T W Er
- Changi General Hospital, 2 Simei Street 3, 529889, Singapore.
| | - W C Lee
- Changi General Hospital, 2 Simei Street 3, 529889, Singapore.
| | - H C Chee
- Changi General Hospital, 2 Simei Street 3, 529889, Singapore.
| |
Collapse
|
8
|
Shift length and working practices in UK hospital settings: An online survey of heads of midwifery. Midwifery 2020; 87:102709. [PMID: 32348897 DOI: 10.1016/j.midw.2020.102709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/09/2020] [Accepted: 03/23/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE There is currently a lack of data that records how midwives are expected to work in hospital settings. The aim of this study was to determine the prevalence of 12-h shifts and current working practices of hospital-based midwives. DESIGN An online survey conducted between December 2018 and March 2019. Descriptive data are summarised regionally and nationally. SETTING NHS Trusts providing maternity services in hospital settings in the UK PARTICIPANTS: The link to the survey was emailed to Heads of Midwifery in 155 NHS Trusts FINDINGS: Responses were received from 94 of the 155 NHS Trusts (60.65%). Some responses included data for more than one hospital, so results are summarised for 97 hospitals. 12-h shifts were the most prevalent shift length, with only 4.1% of hospitals still routinely operating shorter shifts. 55% of hospitals limit the maximum number of consecutive shifts to three, but this can be influenced by different factors. More than half of midwives (55.67%) will be rostered to start a day shift within 24-h of finishing a night shift. 70% of hospitals do not currently record the number of midwives working beyond their contracted hours but 68% report formal methods of recording missed rest breaks. Regional differences were seen in the use of other personnel to support the midwifery workforce. CONCLUSIONS Shift schedules and the lack of formal methods to record the number of midwives working beyond their contracted hours may be a cause for concern due to the potential impact on recovery times. Further research is required to explore how working practices may affect midwives and their ability to provide care for women and their babies.
Collapse
|
9
|
Dall'Ora C, Griffiths P, Emmanuel T, Rafferty AM, Ewings S. 12-hr shifts in nursing: Do they remove unproductive time and information loss or do they reduce education and discussion opportunities for nurses? A cross-sectional study in 12 European countries. J Clin Nurs 2019; 29:53-59. [PMID: 31241794 PMCID: PMC6916398 DOI: 10.1111/jocn.14977] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/03/2019] [Accepted: 06/16/2019] [Indexed: 11/27/2022]
Abstract
Aims and objectives To examine the association between registered nurses' (referred to as “nurses” for brevity) shifts of 12 hr or more and presence of continuing educational programmes; ability to discuss patient care with other nurses; assignments that foster continuity of care; and patient care information being lost during handovers. Background The introduction of long shifts (i.e., shifts of 12 hr or more) remains controversial. While there are claims of efficiency, studies have shown long shifts to be associated with adverse effects on quality of care. Efficiency claims are predicated on the assumption that long shifts reduce overlaps between shifts; these overlaps are believed to be unproductive and dangerous. However, there are potentially valuable educational and communication activities that occur during these overlaps. Design Cross‐sectional survey of 31,627 nurses within 487 hospitals in 12 European countries. Methods The associations were measured through generalised linear mixed models. The study methods were compliant with the STROBE checklist. Results When nurses worked shifts of 12 hr or more, they were less likely to report having continuing educational programmes; and time to discuss patient care with other nurses, compared to nurses working 8 hr or less. Nurses working shifts of 12 hr or more were less likely to report assignments that foster continuity of care, albeit the association was not significant. Similarly, working long shifts was associated with reports of patient care information being lost during handovers, although association was not significant. Conclusion Working shifts of 12 hr or more is associated with reduced educational activities and fewer opportunities to discuss patient care, with potential negative consequences for safe and effective care. Relevance to clinical practice Implementation of long shifts should be questioned, as reduced opportunity to discuss care or participate in educational activities may jeopardise the quality and safety of care for patients.
Collapse
Affiliation(s)
- Chiara Dall'Ora
- School of Health Sciences, University of Southampton, Southampton, UK.,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, Southampton, UK
| | - Peter Griffiths
- School of Health Sciences, University of Southampton, Southampton, UK.,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, Southampton, UK.,Department of Learning, Informatics, Management and Ethics, Division of Innovative Care Research, Karolinska Institutet, Stockholm, Sweden
| | - Talia Emmanuel
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Anne Marie Rafferty
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Sean Ewings
- School of Health Sciences, University of Southampton, Southampton, UK
| | | |
Collapse
|
10
|
|
11
|
Dent J. Is it shift length or working practices that most affect midwives' wellbeing and ability to safely deliver care? ACTA ACUST UNITED AC 2018. [DOI: 10.12968/bjom.2018.26.12.812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jackie Dent
- Senior midwifery lecturer, Department of Health and Social Work, University of Hertfordshire
| |
Collapse
|
12
|
Baillie L, Thomas N. Changing from 12‐hr to 8‐hr day shifts: A qualitative exploration of effects on organising nursing care and staffing. J Clin Nurs 2018; 28:148-158. [DOI: 10.1111/jocn.14674] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/31/2018] [Accepted: 09/13/2018] [Indexed: 11/29/2022]
|
13
|
Webster J, McLeod K, O'Sullivan J, Bird L. Eight-hour versus 12-h shifts in an ICU: Comparison of nursing responses and patient outcomes. Aust Crit Care 2018; 32:391-396. [PMID: 30262179 DOI: 10.1016/j.aucc.2018.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 08/06/2018] [Accepted: 08/09/2018] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Controversy remains about the impact of 12-h shift patterns on staff satisfaction and health and on patient outcomes. Consequently, the objective of the study was to investigate the effect on nurses and patients of 8-h rostering compared with 12-h rostering. METHODS We conducted a two-phase survey. Intensive care nurses completed a purposefully designed 49-item questionnaire, which included open- and closed-ended questions. Phase 1 was conducted during 2015, while the 8-h shift pattern was in place. Data for phase 2 were collected in 2017, approximately 6 months after the trial of 12-h shifts began. We extracted data from the hospital's adverse event register to compare patient outcomes between the two phases. RESULTS A total of 152/193 (78.8%) surveys were returned in phase 1. In phase 2, the response rate was 114/188 (60.6%). The proportion of nurses satisfied with the roster increased 3-fold after the introduction of 12-h shifts; risk ratios 3.36 (95% confidence intervals 2.62 to 4.28). Communication with all levels of senior staff improved, and the number of hours of professional development leave increased with the 12-h roster phase 1, 358 h versus 538 h in phase 2 (p = <0.0001). Most respondents believed that 12-h shifts would be beneficial for their health, and this belief was validated by official leave records; there was a reduction of 69 days for sick leave and 216 days for family leave. Adverse outcomes for patients were similar in the two periods. CONCLUSION Twelve-hour shifts are popular with ICU nurses, days lost to sick and family leave are reduced, and patient outcomes are not compromised.
Collapse
Affiliation(s)
- Joan Webster
- Royal Brisbane and Women's Hospital, Herston, QLD 4006, Australia; Nursing & Midwifery Research Centre, School of Nursing & Midwifery, Griffith University, Nathan, QLD, 4111 Australia; National Centre of Research Excellence in Nursing, Griffith University, Nathan QLD 411, Australia.
| | - Kerri McLeod
- Royal Brisbane and Women's Hospital, Herston, QLD 4006, Australia.
| | - Judy O'Sullivan
- Royal Brisbane and Women's Hospital, Herston, QLD 4006, Australia.
| | - Laura Bird
- Royal Brisbane and Women's Hospital, Herston, QLD 4006, Australia.
| |
Collapse
|
14
|
Battle C, Temblett P. 12-Hour nursing shifts in critical care: A service evaluation. J Intensive Care Soc 2018; 19:214-218. [PMID: 30159013 PMCID: PMC6110020 DOI: 10.1177/1751143717748094] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this single-centre study was to investigate the impact of the introduction of 12-h critical care nursing shifts on healthcare provider and patient care outcomes. A single-centre, prospective service evaluation was completed over a two-year period, comparing the 8-h and 12-h shifts. Outcomes included number of clinical incidents, levels of burn-out, sick rates, personal injuries and training. There were no significant differences between the clinical incidents, sickness rates, personal injuries and staff training between the two data collection periods. The results of the burn-out analysis demonstrate that emotional exhaustion and depersonalisation improved, from the 8-h to 12-h shifts (both p < 0.05). In conclusion, the results of this service evaluation have demonstrated that 12-h nursing shifts can be introduced safely into the critical care environment, without any detriment to patient or healthcare provider outcomes.
Collapse
Affiliation(s)
- Ceri Battle
- Ed Major Critical Care Unit, Morriston Hospital,
Swansea, UK
| | - Paul Temblett
- Ed Major Critical Care Unit, Morriston Hospital,
Swansea, UK
| |
Collapse
|
15
|
|
16
|
Ball J, Day T, Murrells T, Dall'Ora C, Rafferty AM, Griffiths P, Maben J. Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures. BMC Nurs 2017; 16:26. [PMID: 28559745 PMCID: PMC5445490 DOI: 10.1186/s12912-017-0221-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/16/2017] [Indexed: 01/20/2023] Open
Abstract
Background Twenty-four hour nursing care involves shift work including 12-h shifts. England is unusual in deploying a mix of shift patterns. International evidence on the effects of such shifts is growing. A secondary analysis of data collected in England exploring outcomes with 12-h shifts examined the association between shift length, job satisfaction, scheduling flexibility, care quality, patient safety, and care left undone. Methods Data were collected from a questionnaire survey of nurses in a sample of English hospitals, conducted as part of the RN4CAST study, an EU 7th Framework funded study. The sample comprised 31 NHS acute hospital Trusts from 401 wards, in 46 acute hospital sites. Descriptive analysis included frequencies, percentages and mean scores by shift length, working beyond contracted hours and day or night shift. Multi-level regression models established statistical associations between shift length and nurse self-reported measures. Results Seventy-four percent (1898) of nurses worked a day shift and 26% (670) a night shift. Most Trusts had a mixture of shifts lengths. Self-reported quality of care was higher amongst nurses working ≤8 h (15.9%) compared to those working longer hours (20.0 to 21.1%). The odds of poor quality care were 1.64 times higher for nurses working ≥12 h (OR = 1.64, 95% CI 1.18–2.28, p = 0.003). Mean ‘care left undone’ scores varied by shift length: 3.85 (≤8 h), 3.72 (8.01–10.00 h), 3.80 (10.01–11.99 h) and were highest amongst those working ≥12 h (4.23) (p < 0.001). The rate of care left undone was 1.13 times higher for nurses working ≥12 h (RR = 1.13, 95% CI 1.06–1.20, p < 0.001). Job dissatisfaction was higher the longer the shift length: 42.9% (≥12 h (OR = 1.51, 95% CI 1.17–1.95, p = .001); 35.1% (≤8 h) 45.0% (8.01–10.00 h), 39.5% (10.01–11.99 h). Conclusions Our findings add to the growing international body of evidence reporting that ≥12 shifts are associated with poor ratings of quality of care and higher rates of care left undone. Future research should focus on how 12-h shifts can be optimised to minimise potential risks.
Collapse
Affiliation(s)
- Jane Ball
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC), Wessex, Southampton, UK.,University of Southampton, Southampton, UK.,Medical Management Centre (MMC), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet (KI), Stockholm, Sweden
| | - Tina Day
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA UK
| | - Trevor Murrells
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA UK
| | - Chiara Dall'Ora
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC), Wessex, Southampton, UK.,University of Southampton, Southampton, UK
| | - Anne Marie Rafferty
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA UK
| | - Peter Griffiths
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC), Wessex, Southampton, UK.,University of Southampton, Southampton, UK
| | - Jill Maben
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA UK
| |
Collapse
|
17
|
Ferri P, Guadi M, Marcheselli L, Balduzzi S, Magnani D, Di Lorenzo R. The impact of shift work on the psychological and physical health of nurses in a general hospital: a comparison between rotating night shifts and day shifts. Risk Manag Healthc Policy 2016; 9:203-211. [PMID: 27695372 PMCID: PMC5028173 DOI: 10.2147/rmhp.s115326] [Citation(s) in RCA: 180] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Shift work is considered necessary to ensure continuity of care in hospitals and residential facilities. In particular, the night shift is one of the most frequent reasons for the disruption of circadian rhythms, causing significant alterations of sleep and biological functions that can affect physical and psychological well-being and negatively impact work performance. OBJECTIVES The aim of this study was to highlight if shift work with nights, as compared with day work only, is associated with risk factors predisposing nurses to poorer health conditions and lower job satisfaction. METHODS This cross-sectional study was conducted from June 1, 2015 to July 31, 2015 in 17 wards of a general hospital and a residential facility of a northern Italian city. This study involved 213 nurses working in rotating night shifts and 65 in day shifts. The instrument used for data collection was the "Standard Shift Work Index," validated in Italian. Data were statistically analyzed. RESULTS The response rate was 86%. The nurses engaged in rotating night shifts were statistically significantly younger, more frequently single, and had Bachelors and Masters degrees in nursing. They reported the lowest mean score in the items of job satisfaction, quality and quantity of sleep, with more frequent chronic fatigue, psychological, and cardiovascular symptoms in comparison with the day shift workers, in a statistically significant way. CONCLUSION Our results suggest that nurses with rotating night schedule need special attention due to the higher risk for both job dissatisfaction and undesirable health effects.
Collapse
Affiliation(s)
- Paola Ferri
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia
| | - Matteo Guadi
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia
| | - Luigi Marcheselli
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia
| | - Sara Balduzzi
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia
| | - Daniela Magnani
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia
| | - Rosaria Di Lorenzo
- Department of Mental Health, AUSL di Modena, Service of Psychiatric Diagnosis and Treatment, Modena, Italy
| |
Collapse
|
18
|
Conner BJ, Behar-Horenstein LS, Su Y. Comparison of Two Clinical Teaching Models for Veterinary Emergency and Critical Care Instruction. JOURNAL OF VETERINARY MEDICAL EDUCATION 2016; 43:58-63. [PMID: 26751912 DOI: 10.3138/jvme.0415-069r1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Standards to oversee the implementation and assessment of clinical teaching of emergency and critical care for veterinary students do not exist. The purpose of this study was to assess differences in the learning environment between two veterinary emergency and critical care clinical rotations (one required, one elective) with respect to caseload, technical/procedural opportunities, direct faculty contact time, client communication opportunities, and students' perception of practice readiness. The authors designed a 22-item survey to assess differences in the learning environment between the two rotations. It was sent electronically to 35 third- and fourth-year veterinary medicine students. Bivariate analysis, including the Wilcoxon signed-rank test and the t-test, were used to compare differences between pre-test and post-test scores among students. Twenty-six students' responses were included from the required rotation and nine from the elective rotation. Findings showed that students preferred the elective community emergency department setting to the required academic setting and that there were statistically significantly more positive experiences related to the variables of interest. Students saw significantly more cases at the community emergency department setting. Findings from this study offer guidance to assess students' emergency department rotations, suggest how teaching interactions can be modified for optimal learning experiences, and ensure that students receive maximal opportunities to treat patients that are representative of what they would encounter in practice.
Collapse
|
19
|
Scholtz S, Nel EW, Poggenpoel M, Myburgh CPH. The Culture of Nurses in a Critical Care Unit. Glob Qual Nurs Res 2016; 3:2333393615625996. [PMID: 28462324 PMCID: PMC5342286 DOI: 10.1177/2333393615625996] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 12/01/2015] [Accepted: 12/07/2015] [Indexed: 01/12/2023] Open
Abstract
Critical care nurses have to adapt to a fast-paced and stressful environment by functioning within their own culture. The objective of this study was to explore and describe the culture of critical care nurses with the purpose of facilitating recognition of wholeness in critical care nurses. The study had a qualitative, exploratory, descriptive, and contextual design. The ethnographic study included data triangulation of field notes written during 12 months of ethnographic observations, 13 interviews from registered nurses, and three completed diaries. Coding and analysis of data revealed patterns of behavior and interaction. The culture of critical care nurses was identified through patterns of patient adoption, armor display, despondency because of the demands to adjust, sibling-like teamwork, and non-support from management and medical doctors. An understanding of the complexity of these patterns of behavior and interaction within the critical care nursing culture is essential for transformation in the practice of critical care nursing.
Collapse
Affiliation(s)
| | - Elsabe W. Nel
- University of Johannesburg, Johannesburg, South Africa
| | | | | |
Collapse
|
20
|
The effect of chronotype on sleepiness, fatigue, and psychomotor vigilance of ICU nurses during the night shift. Intensive Care Med 2015; 41:657-66. [PMID: 25672276 PMCID: PMC4392115 DOI: 10.1007/s00134-015-3667-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/14/2015] [Indexed: 11/01/2022]
Abstract
PURPOSE In general, sleeping and activity patterns vary between individuals. This attribute, known as chronotype, may affect night shift performance. In the intensive care unit (ICR), night shift performance may impact patient safety. We have investigated the effect of chronotype and social demographics on sleepiness, fatigue, and night shift on the performance of nurses. METHODS This was a prospective observational cohort study which assessed the performance of 96 ICU night shift nurses during the day and night shifts in a mixed medical-surgical ICU in the Netherlands. We determined chronotype and assessed sleeping behaviour for each nurse prior to starting shift work and before free days. The level of sleepiness and fatigue of nurses during the day and night shifts was determined, as was the effect of these conditions on psychomotor vigilance and mathematical problem-solving. RESULTS The majority of ICU nurses had a preference for early activity (morning chronotype). Compared to their counterparts (i.e. evening chronotypes), they were more likely to nap before commencing night shifts and more likely to have young children living at home. Despite increased sleepiness and fatigue during night shifts, no effect on psychomotor vigilance was observed during night shifts. Problem-solving accuracy remained high during night shifts, at the cost of productivity. CONCLUSIONS Most of the ICU night shift nurses assessed here appeared to have adapted well to night shift work, despite the high percentage of morning chronotypes, possibly due to their 8-h shift duration. Parental responsibilities may, however, influence shift work tolerance.
Collapse
|
21
|
Harris R, Sims S, Parr J, Davies N. Impact of 12h shift patterns in nursing: A scoping review. Int J Nurs Stud 2015; 52:605-34. [DOI: 10.1016/j.ijnurstu.2014.10.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 10/10/2014] [Accepted: 10/28/2014] [Indexed: 10/24/2022]
|
22
|
Abstract
OBJECTIVE The aim of this study was to examine current research related to nurse fatigue and identify effective prevention strategies. BACKGROUND Work-related fatigue negatively affects patient safety and nurses' well-being and increases employer costs. Preventing fatigue and minimizing its negative consequences require knowledge of the contributing factors if effective interventions are to be designed and implemented. METHODS This review targeted original research (2002-2013) examining fatigue among nurses working in acute care settings. RESULTS Nurses experience high rates of fatigue. Shifts longer than 12 hours contribute to increased fatigue and errors, but the evidence was inconsistent with regard to age and fatigue level. Individual lifestyle, unit culture, and organization policies influence the prevalence and intensity of work-related fatigue. CONCLUSIONS Preventing work-related fatigue requires multifaceted approaches involving the organization, the clinical unit, and the individual.
Collapse
|
23
|
Matheson A, O'Brien L, Reid JA. The impact of shiftwork on health: a literature review. J Clin Nurs 2014; 23:3309-20. [PMID: 24460821 DOI: 10.1111/jocn.12524] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2013] [Indexed: 12/27/2022]
Abstract
AIMS AND OBJECTIVES To identify the impact of shiftwork on individuals and their lives and to discuss the implications this has for nurses and nursing. BACKGROUND The context of shiftwork in the early 21st century is changing rapidly, and those involved in or required to work shiftwork are now spread over many different sectors of the community. In the Australian community, 16% of workers regularly work shiftwork. Most nurses undertake shiftwork at some time in their career, and health services could not operate without a shiftworking nursing workforce. DESIGN Narrative literature review. METHODS A narrative review of journal articles was conducted. Databases searched were CINAHL, EBSCO Host, JSTOR, Medline/PubMed and Google Scholar. Search terms used were 'shiftwork' and 'shift work'. Limitations included 'English language', 'published between 1980-2013' and 'human'. RESULTS Reviewed for this paper were 118 studies that met the inclusion criteria. Results were categorised using thematic analysis. Themes that emerged were physical and psychosocial health, and sleep. Findings will be explored under these themes. CONCLUSIONS Shiftwork research has mainly focussed on the physiological and psychosocial health and sleep effects. Absent from the literature are studies focussing on the personal experience of the shiftworker and how workers mediate the effects of shiftwork and how shiftwork fits into the rest of their lives. Therefore, it is difficult to draw conclusions about how people 'manage' their shiftwork, and further research needs to be undertaken in this area. RELEVANCE TO CLINICAL PRACTICE Working shifts for nurses is a reality that comes with the profession. While there is a significant body of research on shiftwork, little of this has been specifically applied to nursing, and the implications for individual nurses needing to care for their own health have not been drawn.
Collapse
Affiliation(s)
- Annabel Matheson
- School of Nursing, Midwifery & Indigenous Health, Charles Sturt University, Bathurst, NSW, Australia
| | | | | |
Collapse
|
24
|
Chen J, Daraiseh NM, Davis KG, Pan W. Sources of work-related acute fatigue in United States hospital nurses. Nurs Health Sci 2014; 16:19-25. [DOI: 10.1111/nhs.12104] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 10/02/2013] [Accepted: 10/04/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Jie Chen
- College of Health and Human Sciences; Northern Illinois University; DeKalb Illinois USA
| | - Nancy M. Daraiseh
- Center for Professional Excellence; Cincinnati Children's Hospital Medical Center; Cincinnati Ohio USA
| | - Kermit G. Davis
- College of Medicine; University of Cincinnati; Cincinnati Ohio USA
| | - Wei Pan
- School of Nursing; Duke University; Durham North Carolina USA
| |
Collapse
|
25
|
Blanca-Gutiérrez JJ, Jiménez-Díaz MDC, Escalera-Franco LF. Intervenciones eficaces para reducir el absentismo del personal de enfermería hospitalario. GACETA SANITARIA 2013; 27:545-51. [DOI: 10.1016/j.gaceta.2012.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 09/14/2012] [Accepted: 09/14/2012] [Indexed: 10/27/2022]
|
26
|
Chen J, Davis KG, Daraiseh NM, Pan W, Davis LS. Fatigue and recovery in 12-hour dayshift hospital nurses. J Nurs Manag 2013; 22:593-603. [DOI: 10.1111/jonm.12062] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Jie Chen
- School of Nursing and Health Studies; Northern Illinois University; DeKalb IL USA
| | - Kermit G. Davis
- College of Medicine; University of Cincinnati; Cincinnati OH USA
| | - Nancy M. Daraiseh
- Research in Patient Services; Cincinnati Children's Hospital Medical Center; Cincinnati OH USA
| | - Wei Pan
- School of Nursing; Duke University; Durham NC USA
| | - Linda S. Davis
- College of Nursing; University of Cincinnati; Cincinnati OH USA
| |
Collapse
|
27
|
Sarna L, Aguinaga Bialous S, Wells MJ, Kotlerman J, Froelicher ES, Wewers ME. Do you need to smoke to get a break?: smoking status and missed work breaks among staff nurses. Am J Prev Med 2009; 37:S165-71. [PMID: 19591757 DOI: 10.1016/j.amepre.2009.05.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 03/03/2009] [Accepted: 05/04/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The prevalence of missed work breaks by smoking status in healthcare settings is unknown. The work routines of nurses (Registered Nurses [RNs] and Licensed Practical Nurses [LPNs]), who smoke at higher rates than other health professionals, may be influenced by smokers who use breaks to avoid nicotine withdrawal. The purpose of this study was to examine the relationship between nurses' smoking status and work breaks and to explore the relationships among personal, professional, and workplace variables associated with missed work breaks. METHODS A web-based survey of 2589 staff nurses from 34 hospitals was conducted in 2006. Each hospital had been designated as a Magnet hospital by the American Nurses Credentialing Center. Data analysis included descriptive statistics, chi-square tests, and multivariate logistic regression. RESULTS The majority (90%) were nonsmokers; 97% were RNs. Missed breaks were common (70%) and differed by smoking status: 59% of smokers and 72% of nonsmokers frequently missed work breaks. Multivariate logistic regression determined that nonsmokers (OR=1.81, 95% CI=1.36, 2.42), LPNs (OR=2.37, 95% CI=1.16, 4.84), older nurses (OR 1.02, 95% CI=1.01, 1.03), those in emergency rooms (OR=1.75, 95% CI=1.25, 2.47), and in intensive care units (OR=1.60, 95% CI=1.22, 2.09) were more likely to miss breaks. CONCLUSIONS Missed work breaks were common among nurses. Those who did not smoke were almost twice as likely to miss their work breaks as compared to smokers. Inequities in breaks, especially by smoking status, may cause dissension in the workplace and negatively affect patient care. Policies that support work breaks for all nurses are needed.
Collapse
Affiliation(s)
- Linda Sarna
- School of Nursing, University of California, Los Angeles, California 90095-6918, USA.
| | | | | | | | | | | |
Collapse
|
28
|
Abstract
Flexible work hours, including 12-hour shifts, have become a common scheduling option for nurses. The author explores whether 12-hour shifts are an ethical scheduling option for nurses because recent research suggests that 12-hour shifts are a potential hazard to patients. A multistep model for ethical decision making, reflecting the concept of procedural justice, is used to examine this issue.
Collapse
|
29
|
Black L, Spetz J, Harrington C. Nurses working outside of nursing: societal trend or workplace crisis? Policy Polit Nurs Pract 2008; 9:143-157. [PMID: 18577598 DOI: 10.1177/1527154408319288] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The phenomenon of career inactivity in professional nursing has been historically portrayed in the literature as a major cause of disequilibrium in the registered nurse labor market. However, there remains a general lack of understanding of the diverse forces that shape the inactive nurse pool and the likelihood that this population will return to nursing. The purpose of this study was to examine the population of registered nurses who are active in the labor market but work in nonnursing employment. Specifically, this study sought to determine the relative importance of nonworkplace- and workplace-related reasons for working outside of nursing. The results demonstrate that dissatisfaction with the nursing workplace is the key reason cited by actively licensed nurses for working outside of nursing employment. These findings suggest that policy and employer remedies are needed to improve the nursing workplace.
Collapse
Affiliation(s)
- Lisa Black
- University of Nevada, Reno, Nevada 89557-0134, USA.
| | | | | |
Collapse
|
30
|
Seki Y. Working Condition Factors Associated with Time Pressure of Nurses in Japanese Hospitals. J Occup Health 2008; 50:181-90. [DOI: 10.1539/joh.l7031] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
31
|
|
32
|
Dwyer T, Jamieson L, Moxham L, Austen D, Smith K. Evaluation of the 12-hour shift trial in a regional intensive care unit. J Nurs Manag 2007; 15:711-20. [PMID: 17897148 DOI: 10.1111/j.1365-2934.2006.00737.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Given the shortage of critical care nurses, emphasis has been placed upon improving their working lives through the implementation of flexible work hours. METHOD This descriptive exploratory study evaluated the effects of the implementation of the 12-hour roster in a regional intensive care unit (ICU). Staff (n = 19) completed a survey 12 weeks following the implementation of the 12-hour roster. RESULTS The study demonstrated widespread acceptance (92%) positive impact on physical and psychological well-being and increased work satisfaction (58%) for the nursing participants. Similarly, nurses working both the 8- and 12-hour rosters (75%), the doctors and allied health care workers all identified increased continuity of patient care as an outcome of the 12-hour shift. Participants strongly agreed that 12-hour rostering was a good recruitment (67%) and retention (75%) strategy. CONCLUSION In an environment with considerable shortages of experienced critical care nurses, the use of flexible shift patterns such as the 12-hour roster was a positive recruitment and recruitment strategy.
Collapse
Affiliation(s)
- Trudy Dwyer
- Nursing and Health Studies, Central Queensland University and Intensive Care Unit, Rockhampton Hospital, Rockhampton, Australia.
| | | | | | | | | |
Collapse
|