A classification of nursing and midwifery shift systems

Abstract

A classification of 122 shift systems worked by nurses and midwives in the larger general hospitals (400 + beds) in England and Wales was made. The systems were classified along two main dimensions: the degree of flexibility for shift rostering (either regular, irregular or flexible); and the speed of rotation between night and day work (either a permanent night shift or systems of fast or slow internal rotation). This resulted in nine possible categories of shift systems. The most common shift system was a flexible day shift with a permanent night shift. Other features of the systems are discussed, e.g. the start times and durations of shifts, and the relative influence of flexible rostering on these features. This classification is a prerequisite for a further research project aimed at identifying those features of shift systems which are likely to cause the least detrimental effects for the individual nurses concerned.