The Implact of Working 8 vs. 12 Hour Shifts on Fatigue Among Nurses

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1.2. Literature Review
1.2.1. The impact of working hours (12 vs. 8)
1.2.1.1. Nurse’s fatigue and job performance

A considerable amount of literature has been published on the impact of working hours (8 vs. 12 hour shifts) on fatigue among the nurses. These studies revealed that twelve-hour shifts increase the risk of fatigue, reduce the level of alertness and performance, and therefore reduce the safety aspect compared to eight-hour shifts (Mitchell and Williamson, 1997; Dorrian et al., 2006; Dembe et al., 2009; Tasto et al., 1978). Mills et al. (1982) found that the risk of fatigues and performance errors are associated with the 12-hour shifts. Beside this, Jostone et al. (2002) revealed that nurses who are working for long hours
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In addition, it reported that in 8-hour shifts the nurses are more alert in the establishment of their shift than those in 12-hour shifts, and also after finishing simple performance tasks (Thompson, 1989). Thus, considering the definition of fatigue and its impact on health, and diversity of finding results, it seems that 12-hour shift is much associated with the risk of fatigue and poor performance. Whereas in Saudi Arabia, it can be seen that working under 12-hours shifts is preferred for non-Saudi (immigrant) nurses as a result of fatigue, stress, and the disturbance of their social life.

1.2.1.2. The relationship between working hours and patient’s safety

Moreover, comparing the effect of the two shift systems (12 vs. 8 hour shifts) on patient’s safety are also evaluated by several studies. Beside the effect on fatigue, Todd et al. (1989) and Reid et al. (1993) concluded that there is a variety of results with the effect of 12-hour shifts on quality of care, in which they found that in the later part of the day there was less direct patient’s care that has an influence on the quality of nursing care. Reid et al. (1993) added that the reason of declined the direct patient’s care was found with the increase number of the unofficial breaks during the shift. This finding draws our attention to the importance of having adequate break time for the staff. However, in my

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