Nursing is notoriously known as a profession with erratic scheduling and constant fatigue from a lack of or inconsistent sleep. This is largely due to shifting work which forces nurses to work long hours to meet the staffing needs of a hospital. There is a myriad of negative effects on the health and performance of nurses due to shifting work which results in ineffectiveness, cognitive fatigue, and low job retention rates in the long run.
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Nurses commonly work in rotating shifts each week, covering all times of the day, including regular daytime and nighttime shifts. This is in order for a medical professional to be present in case of emergencies with hospitalized patients and any other instances that may arise and require a nurse. Night shifts are traditionally considered the longest, officially lasting 12 hours, but in practice, they can be up to 14 hours by the time a full transition occurs with the next rotation.
Furthermore, the mental stress of the nursing profession and considerable workload add to the impact of such long shifts. Shift work leads to a disrupted circadian cycle and negatively affects the work-life balance (Dall’Ora, Ball, Recio-Saucedo, & Griffiths, 2016). However, there is currently no viable alternative to ensure hospital and patient needs are met consistently without shift rotations.
Shift work has been associated with a decreased quality of sleep, lack of alertness, and poor cognitive performance, with both long- and short-term effects. According to Ferri et al. (2016), nurses working rotating shifts, which include night shifts, are more likely to demonstrate low quality and quantity of sleep. Despite being younger in age on average, they statistically experience more common chronic fatigue and physical symptoms of cardiovascular issues. In a study of long hours, Ferri et al. (2016) found that disruptions to the circadian rhythm and sleep cycles induce a drop in cognitive performances towards the end of shift. The physical fatigue experienced by nurses is detrimental and can have severe health consequences as well as impact their professional abilities.
Sleep deprivation and chronic fatigue caused by shift work will eventually begin to impact the professional competency of a nurse. Kaliyaperumal, Elango, Alagesan, and Santhanakrishanan (2017) conducted a comprehensive study on poor sleep quality in nurses and found decreased cognitive performance on standardized tests. Other aspects such as attention, vigilance, and memory were impaired as well, with night shift nurses demonstrating the lowest scores. As nurses struggle with cognitive performance, this poses a danger to their alertness and competency. There is an increased risk of error or lack of an appropriate reaction to an emergency which could lead to adverse outcomes with a patient.
Shift work on a continuous basis leads to widespread job dissatisfaction and severely decreases retention rates among the nursing staff. The impact of long hours on health and work-life balance results in negative attitudes towards the job and its scheduling. A comprehensive multinational study by Dall’ora, Griffiths, and Ball (2015) found the effects of nurse shift work to be exemplified by increased burnout, severe job dissatisfaction, and a possible intention to leave. Particularly, 12-hour shifts which have profoundly negative psychological effects which accumulate and eventually erupt into nurses quitting their jobs. This suggests the long-term effects of shift work and the impact it may have on administrative aspects of healthcare delivery since nurse retention is a critical issue in light of the shortness of nursing staff.
Shift work is demonstrated to have a number of negative effects on nurses, ranging from psychological and physical health to their job satisfaction and employment. Over the long term, nurses experience burnout on all levels, physical and emotional, which severely hinders them in their professional and personal lives. Unfortunately, shift work is ultimately a necessity in current healthcare realities, but strategies such as shorter shifts and staff rotations for breaks could be introduced to mitigate the effects.
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Dall’Ora, C., Ball, J., Recio-Saucedo, A., & Griffiths, P. (2016). Characteristics of shift work and their impact on employee performance and wellbeing: A literature review. International Journal of Nursing Studies, 57, 12-27. Web.
Dall’ora, C., Griffiths, P., & Ball, J. (2015) 12 hour shifts: Nurse burnout, job satisfaction & intention to leave. Evidence Brief, 3, 1-2. Web.
Ferri, P., Guadi, M., Marcheselli, L., Balduzzi, S., Magnani, D., & Di Lorenzo, R. (2016). 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 Management and Healthcare Policy, 9, 203-211.
Kaliyaperumal, D., Elango, Y., Alagesan, M., & Santhanakrishanan, I. (2017). Effects of sleep deprivation on the cognitive performance of nurses working in shift. Journal of Clinical and Diagnostic Research, 11(8), 1-3.
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