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Shift Scheduling Models for Registered Nurses

Purpose of the Study

The primary goal of the study is the evaluation of the traditional 8-hour and longer 12- and 13-hour shift scheduling models, their potential impacts on RNs’ health and productivity, as well as the overall organizational culture and performance. The research findings will support the development of an efficient, evidence-based strategy aimed to reduce multiple negative effects of longer working hours on individual practitioners, nursing teams, and hospitals. The expected long-term result of an evidence-based intervention will be the increase in the quality of patient care.

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Problem Statement and Research Background

Consistently with a traditional work scheduling pattern, RNs’ workday is divided into three 8-hour shifts. The given scheduling model was a standard in nursing for a long time. However, many employers commenced introducing longer working shifts, e.g., two 12- or 13-hour shifts a day, in order to increase staffing and cost efficiency (Griffiths et al., 2014). It is considered that the new form of scheduling may help to reduce organizational issues associated with handovers and shift overlaps, and, additionally, improve nurses’ work-life balance (Griffiths et al., 2014). However, despite their potential positive organizational effects, longer working hours may be detrimental to RNs’ health and may lead to work-related burnouts.

Researchers observe that long working hours contribute to the development of fatigue, excess stress, and decreased alertness in nursing practitioners and, as a result, may be correlated with the increased frequency of adverse and harmful events (Griffiths et al., 2014). At the same time, traditional 8- or 9-hour schedules help healthcare providers maintain a sufficient level of patient safety and service quality, which consequently results in a greater level of patient satisfaction (Griffiths et al., 2014).

According to Stimpfel, Sloane, and Aiken (2012), increased shift length is correlated with greater burnout levels, job dissatisfaction, and intentions to quit the job. The negative effects of burnout on healthcare practitioners are widely investigated in the literature. Burnout is defined as a syndrome of emotional exhaustion; it is associated with reduced motivation and a sense of personal accomplishment (Dewa et al., 2014). The major impacts of burnout on health include depression, psychosomatic complaints, and cardiovascular disorders (Dewa et al., 2014). The common psychological impacts of job-related burnout are increased neuroticism and poor self-esteem (Dewa et al., 2014). In this way, burnout and distress can result in decreased commitment and negative attitudes to work, which, in turn, may also have counterproductive and adverse impacts on organizational performance and the overall working climate.

Taking into account the relevant research evidence, we should promote the education of nursing staff and hospital managers in order to develop their awareness of potentially negative influences of long work hours. By developing evidence-based strategies and policies which would promote sufficient breaks during RNs’ shifts, hospitals will be able not only to improve work schedules but also to eliminate job-related fatigue issues. Although to both employers and employees longer shifts because may at first seem to be preferable because the idea of working three days instead of five is associated with greater flexibility and other organizational and personal benefits, the findings provided in the recent studies reveal that such schedules do not provide nurses with sufficient time for psychological and physical recovery after work. Thus, training nurses and supervisors regarding possible negative influences of longer shifts, e.g., unintentional injuries, decreased alertness, insufficient sleep, and increased incidence of human errors, etc. can be regarded as an effective intervention for the problem.


Dewa, C. S., Loong, D., Bonato, S., Thanh, N. X., & Jacobs, P. (2014). How does burnout affect physician productivity? A systematic literature review. BMC Health Services Research, 14(1). Web.

Griffiths, P., Dall’Ora, C., Simon, M., Ball, J., Lindqvist, R., Rafferty, A.-M., … Aiken, L. H. (2014). Nurses’ shift length and overtime working in 12 European countries: The association with perceived quality of care and patient safety. Medical Care, 52(11), 975–981. Web.

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Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501-2509. Web.

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