Nurses' Long Shifts May Have Downside: Study

Meant as a work flexibility option, extended shifts might promote job burnout and affect patient care

MONDAY, Nov. 26 (HealthDay News) -- Nurses who work long shifts are more likely to experience job dissatisfaction and burnout, and their patients' care may suffer, according to a new study.

The research included nearly 23,000 registered nurses in California, New Jersey, Pennsylvania and Florida. Sixty-five percent of the nurses worked shifts of 12 to 13 hours.

The three-year study found that nurses who worked shifts of 10 hours or longer were up to 2.5 times more likely than nurses who worked shorter shifts to report job dissatisfaction and burnout.

In addition, seven of 10 patient outcomes assessed in the study were significantly worse when nurses worked the longest shifts, the University of Pennsylvania School of Nursing researchers found.

In hospitals with more nurses working longer shifts, a greater percentage of patients reported that nurses sometimes or never communicated well, pain was sometimes or never well controlled, and they sometimes or never received help as soon as they wanted.

The study was published in the November issue of the journal Health Affairs.

"Traditional eight-hour shifts for hospital nurses are becoming a thing of the past," Amy Witkoski Stimpfel, a registered nurse and postdoctoral fellow at Penn Nursing's Center for Health Outcomes and Policy Research, said in a school news release. "Bedside nurses increasingly work 12-hour shifts. This schedule gives nurses a three-day work week, potentially providing better work-life balance and flexibility."

However, when "long shifts are combined with overtime, shifts that rotate between day and night duty, and consecutive shifts, nurses are at risk for fatigue and burnout, which may compromise patient care," she added.

The researchers recommended that the number of consecutive hours worked by nurses should be restricted, nurse management should monitor nurses' hours worked (including second jobs) and state boards of nursing should consider possible restrictions on nurse shift length and voluntary overtime.

"Nursing leadership should also encourage a workplace culture that respects nurses' days off and vacation time, promotes nurses' prompt departure at the end of a scheduled shift and allows nurses to refuse to work overtime without retribution," Witkoski Stimpfel said.

"These types of policies that facilitate manageable work hours can contribute to the development of a healthier nursing workforce, prepared to manage the complex care needs of patients and their families," she added.

More information

The American Nurses Association has more about nursing.

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