According to research published in BMJ Open, working 12+ hour shifts is linked to a heightened risk of burnout, job dissatisfaction, and intention to leave among hospital nurses.
Working long shifts is very common in England, Ireland and Poland but this research reveals that job satisfaction and burnout are issues that are already of concern in the nursing workforce as they can have a negative impact on not only the quality and safety of patient care but also on retention.
Longer shifts are based on the perception that they would result in an increase in efficiency and productivity and also provide workers the flexibility to have more full days off by working longer hours. However, the researchers believe that this perception has not been comprehensively evaluated.
A survey of 31,627 registered hospital nurses in 488 hospitals in Belgium, England, Finland, Germany, Greece, Ireland, The Netherlands, Norway, Poland, Spain, Switzerland and Sweden was conducted between 2009 and 2010. The respondents were asked to answer 118 questions related to their job experience and demands as well as the most recent shift worked. The researchers assessed burnout using an internationally validated three-dimensional measure (MBI).
Nurses working in intensive or long term care units were not included. Two thirds of the respondents worked in hi-tech and/or teaching hospitals and over half of them worked in medical units. 50 percent of the respondents had a shift length of 8 or fewer hours; 31 percent worked 8-10 hours; 4 percent worked 10 to less than 12 hours; and 14 percent worked 12-13 hours. Only about 1 percent worked more than 13 hours.
12+ hour shifts were more common in Poland (99% of respondents) followed by Ireland (79%) and England (39%). More than one in four of the sample population had worked overtime in their last shift. In terms of their work experience, 27 percent reported that they suffered form high emotional exhaustion. 10 percent reported that they experienced high depersonalisation while 17 percent indicated a feeling of low personal accomplishment. Approximately one in four of the respondents expressed dissatisfaction with their job and a similar proportion indicated dissatisfaction with their work schedule flexibility. A third of the respondents revealed that they planned to quit their job.
The findings of the survey clearly show that 12+ hour shifts were associated with greater levels of burnout on all three dimensions: job dissatisfaction; working schedule dissatisfaction; and intention to leave. Working 8 hour shifts was also found to be associated with poorer job satisfaction and working overtime was also found to be associated with unfavourable outcomes.
"Current literature tends to report that 12 h shifts represent a way to retain nurses in hospital clinical practice because it is believed to be the preferred shift length and that nurses are more satisfied with their jobs: our results suggest the opposite," they write. "Therefore, our findings pose substantial questions for managers, most notably because job satisfaction is a consistent and robust predictor of remaining in a job," they say.
The researchers also point out that it is important for employers to take the effects of burnout seriously as they increase chances of making a mistake, can have an impact on the quality of care, can increase turnover and absenteeism and can compromise the wellbeing of all involved.
Source: BMJ Open
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