Long shift patterns lead to higher sickness absence risk for hospital-based Registered Nurses and Healthcare Assistants
A new study has found that consistently working long shifts on hospital wards can lead to a higher risk of sickness absence for Registered Nurses (RNs) and Healthcare Assistants (HCAs).
The study, led by researchers at the University of Southampton and published in the Journal of Nursing Management, also concludes that higher sickness absence rates associated with long shifts could result in additional costs or loss of productivity for hospitals and calls for the routine implementation of long shifts to be avoided.
Whilst surveys have suggested negative impacts from nurses working 12-hour shifts for nurses and patients, this is the first longitudinal study to interrogate the issue and demonstrate the impact on nurses' sickness rates. Researchers from Southampton, the University of Portsmouth, Portsmouth Hospitals NHS Trust, and Italy's Libera Università Maria Ss Assunta, reached their conclusions after analysing routinely collected data from over 600,000 shifts worked by 1,944 staff members across 32 general inpatient wards at an acute hospital in England. The data covered a three-year period from April 2012 to March 2015.
Of the overall total reviewed were 38,051 shifts lost due to sickness absence corresponding to 8,090 distinct episodes. The study was funded by NIHR CLAHRC Wessex and the NIHR HS&DR programme.
"The aim of this study was to examine the extent to which shift patterns are associated with sickness absence within a sample of nursing staff working on hospital wards," said lead author Dr. Chiara Dall'Ora, Research Fellow in Nursing Workforce at the University of Southampton. "Research into this issue in the past relied mostly on surveys of nurses to report their opinions of job satisfaction and quality but this study shows objectively what happens after nurses have worked more long shifts."
"We found that staff scheduled to work a shift of 12 hours or more were 24% more likely to miss the shift due to sickness absence, compared to staff who were scheduled to work shifts of eight hours or less," Dr. Dall'Ora continued. "While occasional shifts of 12 hours or more (<25%) in the past 7 days were not significantly associated with more sickness absence, when staff worked a higher proportion of shifts of 12 hours or more, sickness rates increased, with the highest odds for those working more than three quarters of their shifts as 12 hours or more shifts."
Professor Peter Griffiths, a co-author on the paper and Chair of Health Services Research at the University of Southampton, added: "Working more long shifts was associated with both long and short-term sickness. As well as being bad for employees, such increases in sickness rates are likely to be costly and may undermine a key motivation for introducing the 12-hour shift pattern – organisational efficiency."
Dr. Dall'Ora concluded: "In the current context and in light of previous findings from our work and that of others, our research suggests that, while occasional 12-hour shift work may not have adverse consequences, working higher proportions may lead to higher sickness absence. Therefore, nurse managers should question routine implementation of long shift patterns, especially if this is based on assumed cost savings."
More information: Chiara Dall'Ora et al. Are long nursing shifts on hospital wards associated with sickness absence? A longitudinal retrospective observational study, Journal of Nursing Management (2018). DOI: 10.1111/jonm.12643