Shift work and hospital employees: A descriptive multi-site study

Int J Nurs Stud. 2020 Dec:112:103746. doi: 10.1016/j.ijnurstu.2020.103746. Epub 2020 Aug 12.

Abstract

Background: Hospitals staff with 12-hour and other shift work patterns to account for daily and seasonal workload requirements. Research in healthcare and industries requiring shift work suggests there may be negative health consequences to the workers related to fatigue and other factors. Due to the 24/7 nature of healthcare, it is important to understand the impact of shift work on employees.

Objectives: The objectives of this study were to investigate how shift work impacts satisfaction with time for social and home activities, based on the Social and Domestic Survey, and chronic fatigue. In addition, an exploration of drowsy driving was undertaken.

Design and setting: This study was a multi-site, descriptive survey study, conducted in 4 acute care hospitals in one metropolitan area in the central United States.

Participants: Participants included healthcare workers in five 24/7 departments: nursing, respiratory therapy, laboratory, radiology and pharmacy.

Methods: Measures included demographics, work characteristics, and scales including the: Social and Domestic Survey, Circadian Type Inventory, and Chronic Fatigue Scale along with data regarding drowsy driving and automobile accidents/near misses. Data were analyzed using descriptive statistics for sample characteristics. An exploratory factor analysis was conducted on the Social and Domestic Survey. Group differences were tested using Mann-Whitney U tests and regression analyses.

Results: The sample included 1563 subjects (24% RR). The mean age was 40 years. Nursing comprised 77% of the sample, 88% were female, 85% were in a direct patient care role, 67% worked day shift, and 49% worked 12-hour shifts. Pay was important for working night shift, but home life was important for day shift. Night shift (p<0.001) and 12-hour shift workers (p<0.001) had higher chronic fatigue. However, after controlling for other factors, working night shift remained a significant predictor of chronic fatigue and lower satisfaction with time for daily tasks and family/social life, whereas working 12-hour shifts predicted higher satisfaction with daily tasks and periodic life activities. Thirty-five percent of workers reported altering their driving behavior at least half the time due to drowsy driving and 19% had an automobile accident or near miss due to drowsy driving.

Conclusions: Findings suggest that night and long shifts can have negative effects on fatigue, family, and social life. Drowsy driving and accidents/near misses frequently occur due to drowsy driving. Leaders should continue to study the 24/7 work environment and test measures to improve the safety of shift workers.

Keywords: Circadian rhythm; Drowsy driving; Fatigue; Hospital workers; Satisfaction; Shift work.

MeSH terms

  • Accidents, Traffic
  • Adult
  • Automobile Driving*
  • Female
  • Hospitals
  • Humans
  • Male
  • Shift Work Schedule* / adverse effects
  • Work Schedule Tolerance*