S19 S9 AND S16 Limiters: English-Research Articleġ. Therefore, the aim of this review is to examine and summarise the extent, range and nature of research activity on nurses’ subjective experience and preferences around shift patterns. This review focusses only on nurses because the experience of shift work is specific to the occupation and the context specific. Nursing staff form the largest group in the health workforce, and comprehending their experience and preferences around shift patterns is key to effectively improve nursing working conditions, enhance nurses’ job satisfaction and increase quality of care. Studies where nurses’ perspectives are directly obtained (rather than inferred by the researcher) could shed further light on the contradictions arising from the quantitative body of evidence. Yet, insights from nurses’ perspective are key to better understand mechanisms of preference and choice around shift patterns. The purpose of such quantitative studies is generally not to capture nurses’ perspectives. In these studies, adverse experiences are indirectly inferred from (for example) reported associations between shift patterns and burnout. The evidence on nurses’ subjective experience and preferences around shift patterns has not been summarised, as quantitative studies reporting associations dominate the field. However, the mechanisms explaining such preferences, how nurses experience these shift patterns, and how these shift patterns interact with other aspects of their life remains unclear. Preference for long shifts is also attributed to improved work-life balance, higher number of days off and opportunities for greater continuity of care. ĭespite such adverse outcomes, some literature suggest certain nurses prefer working long shifts, as evidenced by their higher job and schedule satisfaction, as well as their lower emotional exhaustion level. Nurses working long shifts are also more likely to experience burnout and report intention to leave in comparison to their counterparts. Working long shifts is also associated with nurses reporting reduced educational opportunities, fewer opportunities to discuss patient care, increased delayed or missed care and higher (pneumonia) mortality rates in comparison to shorter shifts. Despite a number of claims that a two-shift system is more efficient, there is no evidence of productivity gain when working long shifts and job dissatisfaction is higher among nurses working long shifts. While a three-shift pattern with two 8-hour day shifts and a night shift remains common, long shifts of 12 hours or more as part of a two-shift system have become standard in many countries including Ireland, Poland, the USA and increasingly in the UK. These factors can in turn jeopardise the quality of care. In the same vein, working as part of a rotating schedule is associated with increased levels of acute fatigue, errors and higher risks of alcohol consumption. Working permanent night shifts is associated with higher long-term sickness absence rates in comparison to day-shifts only. Shift work schedules can also have unintended consequences depending on whether they are rotating or permanent. įor instance, shift work may require nurses to work overnight causing adverse health effects, such as increased sleepiness at the end of the shift or disturbed sleep. How shift patterns are organised play a key role in factors influencing nurses’ wellbeing and performance, as well as patient outcomes and health systems’ productivity. Notwithstanding such regulations, shift work can be organised in a variety of ways, in terms of shift length, overtime, weekly hours, rotating and/or permanent schedules. Such directives limits the maximum number of weekly hours or regulate the frequency of work breaks. Several directives and regulations influence how shift work is organised, including the European Working Time Directive of 2003 and the US Fair Labor Standards Act of 1938. Shift work is an established feature of working life for many hospital nurses, who work to provide 24-hour healthcare.
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