Nature and Prevalence of Extended Work Schedules for Nurses

A well-rested nursing staff is essential to providing quality care. However, dramatic changes in the healthcare industry have significantly increased the demands on nursing staff, the largest segment of the healthcare work force.

Although current evidence indicates that extended schedules have a negative effect on nurses’ health and patient care, little is known about the frequency of extended work schedules across all nursing settings.

In a recent paper published in the American Journal of Nursing, CAMH’s Dr. Carles Muntaner, Chair in Psychiatry and Addiction Nursing Research, and colleagues sought to fill this research gap by describing the nature and prevalence of extended work schedules across the nursing profession.

The researchers analyzed quantitative survey data from 2, 273 registered nurses in two U.S states. This study analyzed hospital staff nurses, those working more than one job, single parents and those over the age of 50. Researchers reviewed demographic data, information about the respondents’ primary jobs, and work schedule variables including data on breaks, overtime, on-call requirements, time off between shifts and how often respondents worked more than 13 hours per day on scheduled days off and vacation days.

More than one quarter of the sample reported that they typically worked 12 or more hours per day. One third of the total sample worked more than 40 hours per week and more than one third had worked six or more days in a row at least once in the preceding six months. A quarter of the nurses with more than one job worked 50 or more hours per week, and they were more likely to work many days consecutively, without sufficient rest between shifts, and during scheduled time off. Single parents were as likely as those with more than one job to work 13 to 15 hours per day and many days consecutively.

The study reveals that a substantial portion of nurses reported working schedules that compromised their health and patient care, demonstrating that there should be industry-wide concern about this issue. The authors suggest that health care providers and legislators need to recognize the limits within which nurses can safely practice. They further suggest that promoting optimal working conditions could create loyalty and stability in a workforce that continually strives to maintain these qualities.

While anecdotal information has been widely available, this work of Dr. Muntaner and colleagues’ quantifies the adverse working conditions of nurses. The next step will be to use this information to implement solutions to protect the health of nurses and patients, and evaluate these measures to help inform policy.

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