The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction

Health Affairs (Impact Factor: 4.97). 11/2012; 31(11):2501-9. DOI: 10.1377/hlthaff.2011.1377
Source: PubMed


Extended work shifts of twelve hours or longer are common and even popular with hospital staff nurses, but little is known about how such extended hours affect the care that patients receive or the well-being of nurses. Survey data from nurses in four states showed that more than 80 percent of the nurses were satisfied with scheduling practices at their hospital. However, as the proportion of hospital nurses working shifts of more than thirteen hours increased, patients' dissatisfaction with care increased. Furthermore, nurses working shifts of ten hours or longer were up to two and a half times more likely than nurses working shorter shifts to experience burnout and job dissatisfaction and to intend to leave the job. Extended shifts undermine nurses' well-being, may result in expensive job turnover, and can negatively affect patient care. Policies regulating work hours for nurses, similar to those set for resident physicians, may be warranted. Nursing leaders should also encourage workplace cultures that respect nurses' days off and vacation time, promote nurses' prompt departure at the end of a shift, and allow nurses to refuse to work overtime without retribution.

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    • "While findings from the Polish RN4CAST study are currently helping to inform this committee's work, few changes have been seen to date. Thus, despite what the international evidence has demonstrated about the relationships between staffing, patient outcomes and nurses' care (Klopper et al. 2012; McHugh et al. 2013; Rogers et al. 2004; Stimpfel et al. 2012; You et al. 2013), overall domestic nursing workforce policies in Poland do not reflect the research findings nor account for the domestic nursing labour market realities. The combination of the aforementioned factors meant that in 2009, Poland was ripe for a national nursing workforce study that would create the evidence needed to make better national and organizational policy for nurses. "
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    ABSTRACT: National nursing workforce studies are important for evidence-based policymaking to improve nursing human resources globally. Survey instrument translation and contextual adaptation along with level of experience of the research team are key factors that will influence study implementation and results in countries new to health workforce studies. This study's aim was to describe the pre-data collection instrument adaptation challenges when designing the first national nursing workforce study in Poland while participating in the Nurse Forecasting: Human Resources Planning in Nursing project. A descriptive analysis of the pre-data collection phase of the study. Instrument adaptation was conducted through a two-phase content validity indexing process and pilot testing from 2009 to September 2010 in preparation for primary study implementation in December 2010. Means of both content validation phases were compared with pilot study results to assess for significant patterns in the data. The initial review demonstrated that the instrument had poor level of cross-cultural relevance and multiple translation issues. After revising the translation and re-evaluating using the same process, instrument scores improved significantly. Pilot study results showed floor and ceiling effects on relevance score correlations in each phase of the study. The cross-cultural adaptation process was developed specifically for this study and is, therefore, new. It may require additional replication to further enhance the method. The approach used by the Polish team helped identify potential problems early in the study. The critical step improved the rigour of the results and improved comparability for between countries analyses, conserving both money and resources. This approach is advised for cross-cultural adaptation of instruments to be used in national nursing workforce studies. Countries seeking to conduct national nursing workforce surveys to improve nursing human resources policies may find the insights provided by this paper useful to guide national level nursing workforce study implementation. © 2015 International Council of Nurses.
    International Nursing Review 04/2015; 62(3). DOI:10.1111/inr.12191 · 0.95 Impact Factor
    • "The authors found that increases in the proportion of nurses working shifts of more than 13 h were associated with increases in patient dissatisfaction. Having higher proportions of nurses working shorter shifts of less than 11 h also resulted in significant decreases in patient dissatisfaction (Stimpfel et al., 2012). In comparison, another study found that patients rate the quality and quantity of nursing service higher on 12 than 8 h shift wards (Ganong et al., 1976). "
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    ABSTRACT: Objectives: To provide a comprehensive scoping review of evidence of the impact and effectiveness of 12. h shifts in the international nursing literature, supplemented by a review of evidence in other, non-nursing related industries. Data sources: A search of the academic literature was undertaken in electronic databases (AMED, MEDLINE, CINAHL, PsychInfo, Scopus, HMIC, the Cochrane Library, Business Source Premier, Econ Lit, ASSIA and Social Policy and Practice). Review methods: A total of 158 potentially relevant nursing research papers and reviews were published between 1973 and 2014. Two reviewers independently reviewed the articles, leaving 85 primary research studies and 10 review papers in the nursing field to be included in the scoping review. Thirty-one relevant primary research papers and reviews were also identified in the non-nursing related industries literature. Results: Research into 12. h nursing shifts fell within five broad themes: 'risks to patients', 'patient experience', 'risks to staff', 'staff experience' and 'impact on the organisation of work'. There was inconclusive evidence of the effects of 12. h shift patterns in all five themes, with some studies demonstrating positive impacts and others negative or no impacts. This also mirrors the evidence in other, non-nursing related industries. The quality of research reviewed is generally weak and most studies focus on the risks, experience and work/life balance for staff, with few addressing the impact on patient outcomes and experience of care or work productivity. Conclusions: There is insufficient evidence to justify the widespread implementation or withdrawal of 12. h shifts in nursing. It is not clearly understood where there are real benefits and where there are real and unacceptable risks to patients and staff. More research focusing on the impact of 12. h nursing shifts on patient safety and experience of care and on the long term impact on staff and work organisation is required.
    International Journal of Nursing Studies 11/2014; 52(2). DOI:10.1016/j.ijnurstu.2014.10.014 · 2.90 Impact Factor
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    • "Working more than 12 h has negative effects on performances of nurses in addition to increase in consumption of cigarettes and alcohol, fatigue, musculoskeletal disorders, needlestick injuries and sleep deprivation (Geiger-Brown & Trinkoff 2010). Stimpfel et al. (2012) stated that nurses who work more than 10 h experience fatigue, have less work "
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    ABSTRACT: For the majority of newly graduated nurses, the transition to professional roles in their lives may be stressful. Common reasons for this include feelings of insufficiency with regard to clinical skills, fears of making mistakes, increased responsibilities and insufficient guidance. To identify the factors affecting the transition period of newly graduated nurses. This study was designed and carried out as a descriptive and a cross-sectional study of three cohorts of newly graduated students. The study was implemented at a military education and research hospital in Ankara, Turkey. The population consisted of 234 (89%) of newly graduated nurses. For evaluating data, the SPSS 15.0 program was used. The paired samples t-test and the Mann-Whitney U-test were employed to compare the participants' perceptions about the transition period based on certain variables. It is found that 54.7% of nurses surveyed have the intent to quit the profession. More than half of the participants stated that their expectations were met through working with a preceptor nurse (58.73%). Furthermore, almost half of the newly graduated nurses experienced and expressed disappointment in the first year of their professional lives. The findings indicate that newly graduated nurses experience some difficulty during this period of transition, but assistance from experienced nurses facilitates the transition period. In order to increase work quality and satisfaction levels of new graduates, support programs must be initialized and their effectiveness must be evaluated regularly by clinical administrators and educators.
    International Nursing Review 09/2013; 60(3):405-12. DOI:10.1111/inr.12026 · 0.95 Impact Factor
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