Essay on Working Hours and Shift Work

With regard to sleepiness, several studies indicated that the average of sleep duration in 1910 to 2002 have decreased from 9 to 6 hours on workdays (National sleep foundation, 2002; Groger et al., 2004). Recently, a survey study of Roger et al. (2004) shows that an American Nurses have an average of 84 minutes more sleep on non workdays. Thus, shift work suggested as a cause of sleeping disorder among nurses where they feel of sleep during the shift. Considering the contributing factors of sleepiness, the literature identified that long working hours and rotating shifts are causing sleeping disorder. In the night and rotating shifts, the nurses are rarely obtained adequate amount of sleep. In fact, the nurses experiencing less sleeping hours (1 to 4 hour) than normal sleeping (Zeisler et al.,1980). Nevertheless, insufficient sleep is a significant reason of damaging planning, decision-making, and integration of information (Krueger, 1994; Harrison and Horne, 2000). More recent studies have revealed that long hour shifts and overtime are strongly linked to the difficulties of being a wake through the shift which leads to increase the risk of making an error (Scott et al., 2006; Roger et al., 2004).

West, Ahern, Byrnes and Kwanten (2007) indicate that the new graduate nurses may have not worked full-time in the past; given that graduate nurses begin their career with a full-time job can lead to exhaustion. It was discovered that shift work leads to desynchronisation of physiologically determined circadian rhythms which has a major psychobiology effect and it is commonly perceived the effects of shift work contribute to graduate nurses attrition rate. The NGNs often have a high level of stress due to disturbed sleeping patterns, as they find to adaption to shift work or rotating work hours difficult. Eventually, it leads to feelings of lack of job satisfaction, exhaustion and spending of less time with their friends and family, which can eventually could lead to burnout (West et al., 2007).

Moreover, most shifts run into each other with day shifts extending into the night and night shifts extending into the day. This means that their circadian rhythms are distorted. Extended shift work for nurses eventually lead to them finding it difficult to adapt to normal life or any activities outside work.

In the nursing profession, especially when working in a hospital, it is not uncommon to have 12-hour nursing shifts,

The Merriam-Webster online dictionary (2015) defines fatigue as “a state of being very tired” (Merriam-Webster Dictionary, 2015). Stedman’s concise medical dictionary for the health professions (2001) further defines

Mandatory overtime in health professions generally is likely high, although no reliable data regarding its extent are available. In the Institute for Workplace Studies (1999) report, health sector workers averaged a little over three hours of overtime per week - not particularly high. In a survey on mandatory overtime, the journal Nursing2000 reported that 36% said they never worked mandatory overtime. One quarter of the respondents worked mandatory overtime once or twice a month, while another quarter worked it once or twice a week. However, about 14% worked

Nurses spend most of their time taking care of their patients that they forget to be mindful of their own wellbeing. It is very important for nurses to take care of themselves because it is reflected through the care they provide to their patients. Sleep deprivation can increase the chances of a nurse miscalculating a dosage, which can be fatal to a patient’s life or injure themselves by forgetting proper body mechanics. Not having enough sleep and overworking themselves can be the cause for this simple mistake that could have been avoided through self-care. Having at least 8 hours a sleep a night is just one of the few ways a nurse can manage healthy living. A nurse’s work schedule can consists of mainly over

In 2006 a survey sample of 2,274 Registered Nurses were questioned regarding their work schedule for all jobs during a 6 month period. The conclusion was that a quarter of registered nurses worked 12 hours or more a day and a third of the total sample worked more than 40 hours per week in all jobs held. (Bae, 2013)

Evidence also supports that bedside shift reporting is financially beneficial for staff nurses and nursing management. The average report time is significantly decreased from an average of 45 minutes to 29 minutes (Gregory, et al., 2014). This reduces overtime and saves hospitals money. Nurses’ satisfaction is improved because they get to end their shift on time. They get to proceed with shift report more quickly, with fewer distractions and in real time (when compared with writing or recording report). Increase in nursing satisfaction reduces turn over and, once again, saves hospitals money (Gregory, et al., 2014).

Within the recent years, hospitals and medical facilities have been experiencing nursing shortages that necessitate more nurses to be present to compensate for the care needed to be given. This requires nurses to be dealt with imperative extended work hours along with their normal shifts with no denial or excuse accepted. Working extra hours are accompanied with negative effects that have an impact on the nurse, coworkers, and patients. A major concern that occurs with overtime is that nurses become fatigued or burnout. Fatigue that is experienced is a result of sleep deprivation from working overtime that is associated with arduousness neurobehavioral functioning

Throughout the years there has been more attention directed towards healthcare worker fatigue. More specifically, fatigue associated among night-shift nurses. The Joint Commission has found that lack of sleep from night shifts has contributed to increased errors, leading to poor patient outcomes (Gardner, Dubeck, 2016).

Patients in a hospital and/or healthcare facilities have to be cared for all day and all night, everyday of the week by nurses. The usual way to fulfill this need is to divide up the day into three 8-hour shifts. Different shifts have been put into place to help improve nurse satisfaction, decrease the nursing shortage and save the hospital money. The 24-hour day is made up of two 12-hour shifts; 12 hours in the day and 12 hours at night. There has been quite an ongoing debate over the years regarding this issue of nurses working over 8 hours in a single day. Many people, such as hospital nursing administrators, have reason to believe that working long hour shifts causes more errors in

Limited attention has been paid to the hours worked by nurses, or the effects of these hours on patient safety (Rogers, 2008). Even though most nurses favor 12- hour shifts and overtime, it is associated with difficulties staying awake during times of duty, reduced sleep times, and triple the risk of making an error (Rogers, 2008). The most significant risk of making an error occurred when nurses were scheduled to work 12.5 hours or more.

173). For many workers the schedule was an outlet for discontent; this is because many were forced to work six days a week, some weeks without a day off (Lynaugh, 2000). Nowadays, “60% of U.S. nurses surveyed work at least one type of overtime […] 54% work less than 12 hours a week overtime and 46% work 12 hours or more per week” (Wheatley, 2017, p.213). In addition, traditionally nurse’s shifts were eight hours long; however, in 1980’s -1990’s when structural changes in healthcare occurred and cost containment was put in, nurses started working 12-hour shifts. Because it was less expensive to work 12-hours shifts, instead of 8-hours, this became prevalent in most hospitals in the United States (Weathley, 2017).

The risks of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week. (Trossman, 2009). Working longer hours in a high stress area will always increase the error rate. Designating an adequate number of RN positions to ensure nurses work an appropriate schedule without overtime and that their workload allows for breaks. Managerial staff must work to develop specific policies about the length of work times based on the setting, patient and provider needs. Those policies should limit nurses from working more than 12.5 consecutive hours. Provide education for all care providers on the hazards and causes of fatigue. Continue to document unsafe staffing conditions and work with others to change the current work culture so that it recognizes the effects of fatigue on patient safety, as well as the nurse. (Berger, et al. 2006)