November 09, 2012 | | Comments 1
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Nurse burnout and patient dissatisfaction linked to longer shifts

The longer a nurse’s shift, the more dissatisfied the patient, according to a recent study from researchers at the University of Pennsylvania School of Nursing. Researchers found that nurses who worked shifts of 10 hours or longer were more likely to experience burnout and job dissatisfaction than nurses who worked shorter shifts. Of the nearly 23,000 nurses involved in the three-year study, 65% worked shifts of 12-13 hours; the percentage of nurses who reported burnout and/or intention to leave their job increased incrementally with the shift length.

Longer shifts not only had a negative impact on nurses, but also affected patients and patient outcomes. According to researchers, seven out of 10 patient outcomes were significantly and adversely affected by the longest nursing shifts. Additionally, higher percentages of patients reported that the sometimes or never received help as soon as they wanted, and nurses sometimes or never communicated well, in hospitals with higher proportions of nurses working longer shifts.

Researchers recommended that nurse management monitor the hours nurses worked, including second jobs, and consider restricting the number of consecutive hours worked. Nurse leadership should also “encourage a workplace culture that respects nurses’ days off and vacation time, promotes nurses’ prompt departure at the end of a scheduled shift, and allows nurses to refuse to work overtime without retribution,” according to researchers.

While this may all seem like common-sense advice, it is far easier said than done. There are so many factors that could prevent a nurse from leaving the moment a scheduled shift ends, and it would be difficult to enforce a policy for “prompt departure.” Likewise, if an organization is already facing nursing shortages, it’s unlikely that nurses will feel comfortable refusing overtime or taking adequate time off. However, these are issues that must be addressed to prevent nurse fatigue and job dissatisfaction that could put patients at risk. Researchers are correct in that change must come from the top, and nursing leadership must initiate the cultural shifts necessary to prevent burnout and ensure safe, high quality patient care.

What is the average length of nursing shifts at your organization? Have you ever noticed a correlation between the length of a shift and nursing fatigue? Does your organization have any policies in place to address these issues? Share your thoughts in the comments section!

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Filed Under: patient satisfaction

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About the Author: Katrina Gravel is an editor for the Education division of HCPro.

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  1. I think we need to carefully consider the results of one study. Are there other studies that support or refute these findings? Many years ago, 12 hour shifts were instituted at the request of nurses. Nurse satisfaction is an NDNQI measure and is certainly an important consideration for retention of nurses and is certainly a balancing act for organizations; however, patient safety should always come first.

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