Journal of Advanced Practice Nursing

Survey of 6,100 Nurses: Longer Working Hours Impact on Quality Care


                                                                BY ASRN Staff

Results of a survey of more than 6,100 registered nurses across the US in September, show that nurses who work longer shifts and more overtime are more likely to rate the standard of care delivered on their ward as poor, give a negative rating of their hospitals safety and omit necessary patient care.

Results showed that nearly a third of nurses in the country are working shifts of more than 8-9 hours, something which is becoming more common in U.S. hospitals. Hospitals are adopting long shifts to reduce the number of shifts between nurses and to save costs. Some nurses seem to prefer them because they work fewer days in a week.

Nurses working these long shifts were 30 per cent more likely to report poor quality of care compared to nurses working traditional eight hour shifts. They were also 41 per cent more likely to report failing or poor standards of safety and reported leaving more necessary nursing care undone than nurses working shifts lasting eight hours. Nurses working overtime in their last shift were also likely to report lower standards of care, safety and care left undone.

Tina Montclair, who conducted the survey of registered nurses for ASRN in September, comments: "These findings raise questions for healthcare organizations, especially in the current economic climate, where employers are aiming to use the existing workforce more efficiently, either to reduce expenditure or because of nursing shortages. Moving from three shorter shifts per day to two longer ones has been claimed to save up to 18 percent of salary costs. But at what cost to the patient? This strategy needs to be looked at in much more detail. If nurses perform less effectively and less safely, what's the point?"

"This is compelling evidence that policy makers need to take note of," Tina adds. "Although eight hour shifts are still common, a lot of nurses are working these longer shifts, but this study shows that this could be counterproductive. Additionally, the increased flexibility associated with working overtime may not deliver the desired goals for employers."


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