The impact of 12-hour shifts on nurses’ health, wellbeing, and job satisfaction: A systematic review

Abstract

Objective: This review was conducted to investigate the impact of applying 12-hour shifts in comparison to 8-hour shifts on nurses' health wellbeing and job satisfaction. Methods: MEDLINE, CINHALE, PsycINFO, EMBASE, Web of Science, and SCOPUS databases were searched, covering the period between 1980 to 2017. Studies were included if they concerned nurses working for 12-hour shifts in comparison to 8-hour shifts in hospital settings, based on observational/surveys studies. Results: In the yielded 12 studies, 3 studies reported that 12-hour shifts had an impact on nurses' health and wellbeing, such as cognitive anxiety, musculo-skeletal disorders, sleep disturbance, and role stress; however, there was no significant difference between 12-and 8-hour shifts with digestive and cardiovascular disorders, psychological ill health, and somatic anxiety. Of the 4 studies measuring the impact of 12-hour shifts on fatigue, three studies showed that the nurses experienced more fatigue in the 12-hour shifts in comparison to 8-hour shifts; nevertheless, one study did not find a significant difference in fatigue and critical thinking performances between 12-and 8-hour shifts. Nine of the 12 studies measured job satisfaction in 12-and 8-hour shifts, 5 studies showed a greater dissatisfaction regarding 12-hour shifts, while 3 studies found that the nurses were more satisfied with 12-hour shifts than with 8-hour shifts; but one study pointed out that there was a difference between the two shifts considering pay and professional status. Conclusions: The findings of the review suggest that 12-hour shifts resulted in negative health concerns and job dissatisfaction; however, there is a need for more empirical evidence to support this.

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“…According to Thompson [22], nurses working longer than 12-hour shifts are at higher risk for fatigue and burnout, leading to compromised quality patient care. Banakhar [23] stated that nurses working for 12 h affects their well-being, and increases stress, fatigue, and anxiety compared to an 8 h shift. One study among European nurses working more than 12 h describes the quality of nursing care provided to patients on their unit as poor, assesses patient safety as fair, and accounts additional care instruments and equipment left uncompleted on their last shift in comparison with nurses working ≤ 8 h and no more than their contracted hours.…”

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“…14 A systematic review of the literature found that nurses had expressed concerns re the health and wellbeing issues as well as dissatisfaction with working 12 hour shifts which they felt led to more stress, anxiety and high emotional exhaustion and many intended to leave their job. 13 This contradicts the assertion that they are a more cost effective way of providing 24 hour care because costs are lower and there is more continuity of staffing. Having a high staff turnover because of stress and burn out is costly and leaves clinical areas understaffed leading to increased costs of temporary staff to cover the vacant posts inbetween recruiting new staff as well as covering the sickness absences which inevitably follow as workload and stress increase.…”

“…The fatigue of working 12 hour shifts has also been linked to poorer care and errors which endanger patients and staff themselves. Fatigue and lack of sleep impacts on mood, motivation, job performance and a person's cognitive skills which increase depression and irritability and stress . Ball et al looked at studies done in the UK and Europe and reported that many had linked fatigue with a rise in occupational hazards such as increased needle stick injuries and musculoskeletal problems.…”

“…Fatigue and lack of sleep impacts on mood, motivation, job performance and a person's cognitive skills which increase depression and irritability and stress. 13 Ball et al 12 looked at studies done in the UK and Europe and reported that many had linked fatigue with a rise in occupational hazards such as increased needle stick injuries and musculoskeletal problems. Interestingly they report that overall working the longer shifts mean less job satisfaction for nurses and that they are also dissatisfied with the care they give and patient safety.…”