A comparison of scheduling, work hours, overtime, and work preferences across four cohorts of newly licensed Registered Nurses

Psychological detachment from work during nonwork time as a moderator and mediator of the relationship of workload with fatigue and sleep in hospital nurses

OBJECTIVES

To examine differences in psychological detachment from work during nonwork time by nurses' personal and work-related characteristics, and to examine the moderating and mediating effects of psychological detachment on the relationships between nursing workload and fatigue and sleep.

METHODS

This study employed a cross-sectional design with a self-administered online survey. Survey data from 827 hospital nurses providing direct patient care in the United States were used. Moderating and mediating effects of psychological detachment between workload and fatigue/sleep relationships were assessed using Hayes' PROCESS macro in SPSS.

RESULTS

There were significant differences in psychological detachment from work based on age, highest nursing degree, work experience, shift length, weekly work hours, and frequency of providing care to patients with COVID-19. The associations of workload with physical fatigue, mental fatigue, and sleep quality were weakened when psychological detachment was high. Psychological detachment statistically mediated the associations between workload and fatigue and sleep problems.

CONCLUSION

Healthcare organizations are encouraged to facilitate nurses' psychological detachment during time-off to protect them from fatigue and sleep problems.

Association between work fatigue and cognitive function among Lebanese health-care professionals: the moderating effect of emotional intelligence

The aim of this study was to assess the association between work-related fatigue and cognitive impairment among Lebanese health-care professionals with a closer look into the moderating role of emotional intelligence. This cross-sectional study was conducted between November 2021 and January 2022; 406 Lebanese health-care professionals were recruited through convenience sampling. Moderate analysis showed that with low levels of emotional intelligence, more physical, mental, or emotional work fatigue was significantly associated with lower cognitive function scores. These scores get better in people with moderate and high emotional intelligence for the same levels of work fatigue. Health-care workers, especially in Lebanon, are subject to a decline in their cognitive function when faced to high work fatigue loads in all its types, physical, mental, and emotional, along with the country's stressors. Here comes the role of emotional intelligence, where for the same level of fatigue, professionals with high emotional intelligence tend to have better cognitive functioning.

Secondary traumatic stress and posttraumatic growth in newly graduated nurses: the mediating role of compassion satisfaction

BACKGROUND

Nurses' secondary traumatic stress, compassion satisfaction and posttraumatic growth are closely related, but for newly graduated nurses, there are few reports to evaluate the specific path between these three. The aim of this study was to investigate examine the mediating role of compassion satisfaction in secondary traumatic stress and posttraumatic growth among newly graduated nurses.

METHODS

From March 2021 to May 2021, a total of 330 newly graduated nurses from five tertiary hospitals in China were enrolled, and asked to complete questionnaires regarding secondary traumatic stress, compassion satisfaction and posttraumatic growth. Descriptive statistics, independent-samples T-test, one-way analysis of variance (ANOVA), Pearson correlation analysis and structural equation model were used in this study. A STROBE checklist was used to report findings.

RESULTS

The scores of secondary traumatic stress, compassion satisfaction and posttraumatic growth of newly graduated nurses were 27.11 ± 4.94 (score range: 10-50), 31.89 ± 6.22 (score range: 10-50) and 56.47 ± 20.41 (score range: 0-100), respectively. Additionally, structural equation modeling showed that compassion satisfaction mediated the relationship between secondary traumatic stress and posttraumatic growth with the partial mediating effect of 0.089.

CONCLUSIONS

Newly graduated nurses may experience moderate secondary traumatic stress, but their posttraumatic growth is at a low level, and compassion satisfaction significantly affects the relationship between the two. Nursing managers should strengthen psychological evaluation, and promote their posttraumatic growth by improving their level of compassion satisfaction.

Psychological capital and organizational citizenship behavior among nurses during the COVID-19 epidemic: mediation of organizational commitment

BACKGROUND

Nurses' organizational citizenship behavior, a spontaneous "altruistic work behavior", may be affected by psychological capital and organizational commitment, but its mechanism is not clear. The aim of this study was to investigate the characteristics and distribution of psychological capital, organizational commitment and organizational citizenship behavior among nurses during the COVID-19 epidemic, and explore the mediating role of organizational commitment in psychological capital and organizational citizenship behavior.

METHODS

A cross-sectional survey was conducted among 746 nurses from 6 designated hospitals for COVID-19 treatment in China. Descriptive statistics, Pearson correlation analysis, and structural equation model were used in this study.

RESULTS

Nurses' psychological capital, organizational commitment and organizational citizenship behavior scores were 103.12 ± 15.57, 46.53 ± 7.14 and 101.47 ± 12.14, respectively. Additionally, organizational commitment partially mediates between psychological capital and organizational citizenship behavior.

CONCLUSIONS

During the COVID-19 pandemic, nurses' psychological capital, organizational commitment, and organizational citizenship behavior were found to be at an upper-middle level, influenced by various social-demographic factors. Furthermore, the results illustrated that psychological capital can affect organizational citizenship behavior through the mediating role of organizational commitment. Therefore, the findings emphasize the importance of nursing administration to monitor and prioritize the mental health and organizational behavior of nurses during the ongoing COVID-19 crisis. It is crucial to focus on developing and nurturing nurses' psychological capital, strengthening their organizational commitment, and ultimately promoting their organizational citizenship behavior.

Health occupations salary outcomes: intersections of student race, gender, and first-generation status

Greater diversity in the healthcare workforce has been identified as a critical need in serving an increasingly diverse population. Higher education institutions have been tasked with increasing the number of underrepresented students in the health occupations pipeline to better align with the demographics of the general population and meet the need for a diverse health occupations workforce. This study used the National Science Foundation's National Survey of College Graduates dataset to capture data across time, examining the intersectionality of race, gender, and first-generation status on the salary outcomes of students who earn degrees related to health occupations. Results indicate that the intersecting identities of students who earn a bachelor's degree or higher in the health professions impact salary outcomes. Results of this study have implications for higher education policies that can impact increased diversity in the health occupations workforce pipeline.

Three good things: Promote work-life balance, reduce burnout, enhance reflection among newly licensed RNs

AIMS

This study assessed the feasibility of delivering three good things (3GTs) practice as part of professional nurse residency program, measured the degree to which it influenced work-life balance, resilience, and burnout, and explored what newly licensed nurses (NLRNs) identified as good things.

BACKGROUND

Burnout occurs in response to chronic work-related emotional and interpersonal stress, negatively impacting nurses and patients. However, research shows that 3GT practice can increase positive emotions, enhance resilience, and reduce burnout.

METHODS

In this study, 3GT was introduced to a convenience sample of 115 NLRNs during their professional residency program. For 14 days, participants received daily 3GT prompts. Individualized survey links were sent via SMS message at baseline, postsurvey (T1), and 6 months (T2). Survey data were collected about work-life balance, burnout, and resilience, and text data from participants' daily 3GT notations from March through November 2021.

RESULTS

Seventy-one participants were recruited. T1 survey results indicated significant improvements in survey measures but only emotional recovery improvement was sustained at T2. Burnout was the only variable that correlated to participants' number of 3GT days practice. Simple joys, reflections about work, self-care activities, and relationships were major identified themes.

CONCLUSIONS

The results demonstrate the generalizability, value, and feasibility of implementing a web-based 3GT intervention in a nurse residency program. Additional benefits may be those gained by the reflection that is prompted, thereby facilitating professional development among NLRNs.

Research priorities to reduce risks from work hours and fatigue in the healthcare and social assistance sector

BACKGROUND

The services of Healthcare and Social Assistance (HCSA) workers are needed by society around the clock. As a result, these workers are exposed to shift work and long work hours. The combination of demanding work schedules and other hazards in the HCSA work environment increases the health and safety risks to these workers, as well as to their patients/clients and the public.

METHODS

This paper has three aims: (1) provide an overview of the burden of shift work, long hours, and related sleep and fatigue problems in this sector; (2) suggest research priorities that would improve these; and (3) discuss potential positive impacts of addressing these research priorities for the health and safety of workers and the public. The authors used a modified Delphi approach to anonymously rank-order priorities for improving HCSA worker health and safety and public safety. Input was also obtained from attendees at the 2019 National Institute for Occupational Safety and Health (NIOSH) Work Hours, Sleep, and Fatigue Forum.

RESULTS

The highest rated research priorities were developing better designs for work schedules, and improving the HCSA culture and leadership approaches to shift work and long work hours. Additional priorities are identified.

CONCLUSION

Research in these priority areas has the potential to benefit HCSA workers as well as their patients/clients, employers, and society.

A Comparison of Shift Length and Nursing and Quality Outcomes in Acute Inpatient Mental Health Units

OBJECTIVE

This study compared outcomes between units that used either 8-hour or 12-hour shifts in acute inpatient mental health units.

BACKGROUND

Most hospitals continue to use 12-hour shifts despite research suggesting safety concerns with longer shifts. There is a gap in the literature on effects of shift lengths on nursing and patient outcomes in acute mental health units.

METHODS

This study is a retrospective comparative analysis of cross-sectional data between 32 inpatient mental health units that used 8-hour versus 12-hour shifts. Independent samples t test was used to examine differences on several staffing, quality, and safety measures.

RESULTS

A moderate effect size was found between the groups in quality and safety measures involving patient disruptive behaviors, with the 8-hour group having more desirable outcomes.

CONCLUSIONS

Nurse leaders in acute mental health units should consider the impacts of shift length on quality and safety when determining staffing patterns. More research is needed to evaluate correlations or causality.

Prevalence and influencing factors of posttraumatic growth among nurses suffering from workplace violence: A cross-sectional study

The purpose of this study was to (i) identify the level of posttraumatic growth among nurses suffering from workplace violence, (ii) clarify the relationship between nurses' posttraumatic growth and compassion satisfaction, burnout, secondary traumatic stress, and (iii) determine the influencing factors for posttraumatic growth among nurses suffering from workplace violence. A cross-sectional study was conducted to investigate 726 nurses suffering from workplace violence in 10 tertiary hospitals by using demographic, work-related information, lifestyle questionnaire, simplified Chinese version of the Posttraumatic Growth Inventory, and professional quality of life scale. In the findings, (i) the participants' posttraumatic growth scores were 57.29 ± 21.56, while the compassion satisfaction, burnout, and secondary traumatic stress scores were 32.82 ± 6.80, 27.17 ± 5.53, and 26.67 ± 5.29, respectively, (ii) posttraumatic growth was positively correlated with compassion satisfaction and secondary traumatic stress, and negatively correlated with burnout, and (iii) compassion satisfaction, sleep hours per day, department, scheduling, alcohol, secondary traumatic stress, children, and work hours per day were influencing factors of posttraumatic growth, which explained 36.3% of the total variance. Our study indicates that Chinese nurses may experience moderate levels of compassionate satisfaction, burnout, secondary traumatic stress, and low levels of posttraumatic growth after suffering from workplace violence, while the posttraumatic growth of nurses suffering from workplace violence is more affected by work-related variables and lifestyle-related variables, but less affected by other sociodemographic variables. Therefore, it is necessary to strengthen the psychological evaluation of nurses and adopt targeted strategies to promote nurses' posttraumatic growth.

Original Research: Losing the Art and Failing the Science of Nursing: The Experiences of Nurses Working During the COVID-19 Pandemic

PURPOSE

RNs have served as the bedrock of the response to the COVID-19 pandemic, working under unprecedented and difficult conditions. In this study, we sought to understand the experiences of nurses working across a range of care settings in the United States during the first six months of the pandemic, and to learn more about barriers to and facilitators of their work.

METHODS

This is a qualitative descriptive study. We recruited participants online through regional professional nursing membership listservs, program directors of occupational health nursing training programs, and social media. After completing a survey, potential participants were invited to complete an individual semistructured interview via the Zoom platform. From June through August 2020, we conducted 34 interviews. Content analysis was performed using ATLAS.ti software.

RESULTS

The overarching theme-"Losing the art and failing the science of nursing"-underscored the barriers nurses faced in the early months of this pandemic. It reflected the deeply painful disruptions in the care nurses were accustomed to providing their patients. Themes that reflected barriers included disrupted nurse-patient connection, lack of personal protective equipment and fear of infection, lack of evidence-based guidance, and understaffing, all of which drastically altered the delivery of nursing care. Themes that reflected facilitators to nurses' work included camaraderie and strength and resourcefulness.

CONCLUSIONS

The study findings give important direction to nurse leaders, researchers, and organizations concerning potential areas of support that nurses need during and after this pandemic. Future research should investigate the long-term impact of COVID-19 and similar public health crises on nurses, as well as interventions that could support the workforce after an extended crisis.

Self-Care in Nurses

The health of nurses impacts the care of patients in healthcare settings today both inside and outside of hospitals. Many papers are written about nurses' burnout, depression, poor physical and mental health, weight gain, unhealthy eating patterns, back injury, moral negativity, and lack of job satisfaction. However, little attention has been paid to self-care in nurses. The goal of this paper is to discuss the importance of nurses caring for themselves as they work under stressful conditions regularly. Job satisfaction is necessary for nurses to have a healthy work-life balance and a desire to go to work. There are evidence-based interventions that can make a difference in a nurse's quality of life that can be implemented independently or within the work setting. Suggestions made by researchers include working less than 40 hr/week in a clinical setting, working a consistent time of day without rotations, expressing emotions, taking time to exercise, participating in a support group, and incorporating a place designated as a sanctuary in the clinical setting. Personal ways to improve health include preparing healthy meals before working a shift, getting proper sleep, utilizing cognitive behavioral therapy, participating in mindfulness training, and practicing stress reduction techniques.

Associations Among Nurses' Mental/Physical Health, Lifestyle Behaviors, Shift Length, and Workplace Wellness Support During COVID-19: Important Implications for Health Care Systems

Work cultures supportive of wellness and shorter shift length have been associated with better mental/physical health outcomes in nurses, but how the coronavirus disease-19 (COVID-19) pandemic impacted such outcomes is not known. This study's aims were to (1) describe the mental/physical health, well-being, and healthy lifestyle behaviors of nurses during the pandemic; (2) explore the pandemic's impact on their health and healthy lifestyle behaviors; and (3) determine the associations of perceived workplace wellness support and shift length with nurses' health, well-being, and healthy lifestyle behaviors. A cross-sectional descriptive design was used with 264 nurses associated with Trusted Health. Nurses completed a survey containing valid and reliable scales measuring depression, anxiety, burnout and quality of life, perceived wellness culture, and healthy lifestyle behaviors. Results indicated that more than 50% of nurses had worsening mental/physical health relating to the pandemic. Compared with nurses whose workplaces provided little/no wellness support, nurses with workplaces that supported their wellness were 3 to 9 times as likely to have better mental/physical health, no/little stress, no burnout, and high quality of life. Nurses who worked longer shifts had poorer health outcomes. These findings indicate that workplace wellness support and shorter shifts positively impacted nurse mental/physical health and professional quality of life amidst the pandemic.

The Seniority Swoop: Young Nurse Burnout, Violence, and Turnover Intention in an 11-Hospital Sample

We sought to understand whether nurses aged 20 to 29 years burnout and intend to turnover in higher proportions than more senior nurses, and if so, why. Guided by Maslow's hierarchy, we used brief inventories to assess hospital-based bedside nurses at 11 hospitals in Pennsylvania and Rhode Island (n = 3549/9520) prior to the pandemic. In a second study, we compared scheduling policies, bargaining, and Magnet status to see whether these variables predicted worsened burnout rates in young nurses. In a pattern that appears like a swooping line when graphed, nurses aged 20 to 29 years reported higher burnout and intention to leave than more senior nurses. They also reported being punched, bitten, spit on, kicked, or otherwise physically struck more often, worked more long shifts, worked more nights, and reported more dehydration and poorer sleep. Notably, age alone was not a strong predictor of turnover until burnout was added to the model, indicating that there is no inherent millennial trait resulting in higher turnover. Instead, preventing and addressing burnout is key to retention. When comparing hospital characteristics, only scheduling perks for senior nurses predicted the seniority swoop pattern. We offer 9 recommendations to reduce burnout and turnover in young nurses.

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

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.

Nurses' experiences and preferences around shift patterns: A scoping review

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.

Technical considerations for evaluating clinical prediction indices: a case study for predicting code blue events with MEWS

Objective.There have been many efforts to develop tools predictive of health deterioration in hospitalized patients, but comprehensive evaluation of their predictive ability is often lacking to guide implementation in clinical practice. In this work, we propose new techniques and metrics for evaluating the performance of predictive alert algorithms and illustrate the advantage of capturing the timeliness and the clinical burden of alerts through the example of the modified early warning score (MEWS) applied to the prediction of in-hospital code blue events.Approach. Different implementations of MEWS were calculated from available physiological parameter measurements collected from the electronic health records of ICU adult patients. The performance of MEWS was evaluated using conventional and a set of non-conventional metrics and approaches that take into account the timeliness and practicality of alarms as well as the false alarm burden.Main results. MEWS calculated using the worst-case measurement (i.e. values scoring 3 points in the MEWS definition) over 2 h intervals significantly reduced the false alarm rate by over 50% (from 0.19/h to 0.08/h) while maintaining similar sensitivity levels as MEWS calculated from raw measurements (∼80%). By considering a prediction horizon of 12 h preceding a code blue event, a significant improvement in the specificity (∼60%), the precision (∼155%), and the work-up to detection ratio (∼50%) could be achieved, at the cost of a relatively marginal decrease in sensitivity (∼10%).Significance. Performance aspects pertaining to the timeliness and burden of alarms can aid in understanding the potential utility of a predictive alarm algorithm in clinical settings.

Impact of 12-hr shifts in general hospitals: Study conducted in two intensive care units

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.

Patient safety. Factors for and perceived consequences of nursing errors by nursing staff in home care services

AIM

To identify factors for and perceived consequences of nursing errors by nursing staff in home care services in correlation with qualification, work experience, working hours and trainings.

BACKGROUND

Patient safety has increasingly been brought into focus of politics and care practices over the past few years. However, little evidence has been provided yet on nursing errors in out-of-hospital settings.

DESIGN

A cross-sectional study.

METHODS

Randomized sample of 107 home care services and 656 nurses and nursing assistants recruited from all 16 federal states in Germany.

RESULTS

Missing trainings on error management within the past 2 years were identified to be an important factor for mistakes regarding hygienic measures and medication administration. However, most errors arose in documentation without any significant differences in qualification, work experience, training and working hours.

CONCLUSION

Findings indicate that insufficient hygiene and medication administration might be reduced by implementing error management trainings on a regular basis in home care services.

iWash: A smartwatch handwashing quality assessment and reminder system with real-time feedback in the context of infectious disease

Washing hands properly and frequently is the simplest and most cost-effective interventions to prevent the spread of infectious diseases. People are often ignorant about proper handwashing in different situations and do not know if they wash hands properly. Smartwatches are found to be effective for assessing the quality of handwashing. However, the existing smartwatch based systems are not comprehensive enough in terms of achieving accuracy as well as reminding people to handwash and providing feedback to the user about the quality of handwashing. On-device processing is often required to provide real-time feedback to the user, and so it is important to develop a system that runs efficiently on low-resource devices like smartwatches. However, none of the existing systems for handwashing quality assessment are optimized for on-device processing. We present iWash, a comprehensive system for quality assessment and context-aware reminders for handwashing with real-time feedback using smartwatches. iWash is a hybrid deep neural network based system that is optimized for on-device processing to ensure high accuracy with minimal processing time and battery usage. Additionally, it is a context-aware system that detects when the user is entering home using a Bluetooth beacon and provides reminders to wash hands. iWash also offers touch-free interaction between the user and the smartwatch that minimizes the risk of germ transmission. We collected a real-life dataset and conducted extensive evaluations to demonstrate the performance of iWash. Compared to existing handwashing quality assessment systems, we achieve around 12% higher accuracy for quality assessment, as well as we reduce the processing time and battery usage by around 37% and 10%, respectively.

Exploring Perceptions of Shift Length: A State-Based Survey of Registered Nurses

OBJECTIVE

The aim of this study was to explore clinical nurses' perspectives of shift length.

BACKGROUND

Discussions about scheduling practices, work rotations, and shift length are pervasive among nurses and nursing leadership. However, the science surrounding nurse perceptions of longer shifts is limited.

METHODS

A survey instrument was developed and distributed to nurses engaged in the state's professional association.

RESULTS

Data from 190 clinical nurses were included. When working a 40-hour work week, 76.3% reported a preference for 10-hour shifts, whereas 83.5% preferred a 12-hour shift during a 36-hour week. Those who chose longer shifts perceived improved work life balance and better patient care. Those identifying 8-hour shifts also pointed to work life balance as benefit.

CONCLUSIONS

The results capture the voice of the nurse regarding shift length. The preference for the 10-hour shift within the 40-hour work week is novel. These results may assist with efforts to initiate change, improve the work environment and enhance home life.

Shift work and hospital employees: A descriptive multi-site study

BACKGROUND

Hospitals staff with 12-hour and other shift work patterns to account for daily and seasonal workload requirements. Research in healthcare and industries requiring shift work suggests there may be negative health consequences to the workers related to fatigue and other factors. Due to the 24/7 nature of healthcare, it is important to understand the impact of shift work on employees.

OBJECTIVES

The objectives of this study were to investigate how shift work impacts satisfaction with time for social and home activities, based on the Social and Domestic Survey, and chronic fatigue. In addition, an exploration of drowsy driving was undertaken.

DESIGN AND SETTING

This study was a multi-site, descriptive survey study, conducted in 4 acute care hospitals in one metropolitan area in the central United States.

PARTICIPANTS

Participants included healthcare workers in five 24/7 departments: nursing, respiratory therapy, laboratory, radiology and pharmacy.

METHODS

Measures included demographics, work characteristics, and scales including the: Social and Domestic Survey, Circadian Type Inventory, and Chronic Fatigue Scale along with data regarding drowsy driving and automobile accidents/near misses. Data were analyzed using descriptive statistics for sample characteristics. An exploratory factor analysis was conducted on the Social and Domestic Survey. Group differences were tested using Mann-Whitney U tests and regression analyses.

RESULTS

The sample included 1563 subjects (24% RR). The mean age was 40 years. Nursing comprised 77% of the sample, 88% were female, 85% were in a direct patient care role, 67% worked day shift, and 49% worked 12-hour shifts. Pay was important for working night shift, but home life was important for day shift. Night shift (p<0.001) and 12-hour shift workers (p<0.001) had higher chronic fatigue. However, after controlling for other factors, working night shift remained a significant predictor of chronic fatigue and lower satisfaction with time for daily tasks and family/social life, whereas working 12-hour shifts predicted higher satisfaction with daily tasks and periodic life activities. Thirty-five percent of workers reported altering their driving behavior at least half the time due to drowsy driving and 19% had an automobile accident or near miss due to drowsy driving.

CONCLUSIONS

Findings suggest that night and long shifts can have negative effects on fatigue, family, and social life. Drowsy driving and accidents/near misses frequently occur due to drowsy driving. Leaders should continue to study the 24/7 work environment and test measures to improve the safety of shift workers.

Novice nurses' sleep disturbance trajectories within the first 2 years of work and actual turnover: A prospective longitudinal study

BACKGROUND

Novice nurses experience radical changes in their sleep-wake cycle and sleep difficulties after exposure to a rotating shift work schedule. The link between workplace hardship and employee turnover may be dependent on factors at the individual level, e.g., individual health. Nurses with sleep disturbance are more vulnerable to stressful stimuli and lack resilience at work compared with those without sleep disturbance.

OBJECTIVES

To classify novice nurses according to sleep disturbance trajectories during the first 2 years of work, to compare turnover rates according to trajectory classification, and to compare levels of sleep disturbance between stayers and leavers within each trajectory class.

DESIGN

Prospective longitudinal design.

SETTINGS

A tertiary hospital in Seoul, South Korea.

PARTICIPANTS

A total of 465 newly graduated nurses who started work between September 2014 and December 2015.

METHODS

Data were collected 6 times within the first 2 years of work (on the first day of orientation before ward placement, at 6 weeks after starting work, and at 6, 12, 18, and 24 months of work). Sleep disturbance was assessed using the General Sleep Disturbance Scale. Turnover information was retrieved from the hospital's administrative data system to determine whether anyone had left the hospital at each data collection point. Unconditional latent growth curve analysis was performed to identify latent classes of trajectories of sleep disturbance among novice nurses during the first 2 years of work.

RESULTS

The 2-year trajectories of sleep disturbance were classified into two distinct groups: the high symptomatic group (Class 1: 57.4%) and the low symptomatic group (Class 2: 42.6%). In comparison with Class 2, Class 1 consistently showed a higher turnover in each period. In Class 1, leavers who left the hospital at the next measurement point tended to report more severe sleep disturbance at prior measurements. This pattern was also observed for the overall sample. However, in Class 2, an inconsistent pattern between stayers and leavers was observed.

CONCLUSIONS

This study identified two distinct classes of sleep disturbance among novice nurses during the first 2 years of work. Given that many nurses experience sleep problems at pre-employment and during the early career period, a comprehensive approach to address this issue should be implemented in nursing schools and hospitals. The basic nursing curriculum should include self-care management strategies for sleep difficulties to ensure retention at work. At-risk nurses should receive organizational support and early monitoring to prevent the adverse effects of poor sleep.

How do nurses' work arrangements influence nurse managers' communication? A qualitative study

AIM

To understand how nurses' work arrangements influence nurse managers' communication with their nurses.

BACKGROUND

Transient work relations affect nurse coordination and the way nurse managers work, especially since giving feedback is an important managerial responsibility.

METHOD

Semi-structured interviews conducted between June 2016 and November 2017.

RESULTS

Although professional communication on direct patient care is mostly standardized, nurses' work arrangements influence how nurse managers mentor and provide feedback.

CONCLUSION

Facilities must explore avenues to provide nurse managers with adequate resources so that they can mentor both permanent and temporary nurses to their full professional potential. The implementation of formal mentoring programmes is important to ensure that temporary nurses receive the same information and support that permanent nurses receive and that permanent nurses feel comfortable to critically evaluate information from trusted sources.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers with limited mentoring resources may have to make practical decisions on whom they mentor, but this practical approach becomes a problem when nurses who do not receive adequate mentoring bring their deficiencies to other facilities. The rise in alternative work arrangements requires a shift in thinking about mentoring as a managerial responsibility to improve nursing care delivery universally and not unit specific.