How Do Nurses Cope with Shift Work? A Qualitative Analysis of Open-Ended Responses from a Survey of Nurses.

Michael Savic,Megan J. Sechtig,Rowan P. Ogeil,Peta Lee-Tobin,Nyssa Ferguson,Dan I. Lubman

doi:10.3390/ijerph16203821

Michael Savic, Megan J. Sechtig + Show 4 more

Open Access

https://doi.org/10.3390/ijerph16203821

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Abstract

Nurses are frequently required to engage in shift work given the 24/7 nature of modern healthcare provision. Despite the health and wellbeing costs associated with shift work, little is known about the types of coping strategies employed by nurses. It may be important for nurses to adopt strategies to cope with shift work in order to prevent burnout, maintain wellbeing, and ensure high quality care to patients. This paper explores common strategies employed by nurses to cope with shift work. A workforce survey was completed by 449 shift working nurses that were recruited from a major metropolitan health service in Melbourne, Australia. Responses to open-ended questions about coping strategies were analysed using the framework approach to thematic analysis. Four interconnected main themes emerged from the data: (i) health practices, (ii) social and leisure, (iii) cognitive coping strategies, and (iv) work-related coping strategies. Although a range of coping strategies were identified, sleep difficulties often hindered the effective use of coping strategies, potentially exacerbating poor health outcomes. Findings suggest that in addition to improving nurses’ abilities to employ effective coping strategies on an individual level, workplaces also play an important role in facilitating nurses’ wellbeing.

Highlights

Work hours that fall outside the traditional 9am–5pm schedule are increasingly prevalent because of increased demand for services across the 24 hour day [1]
The findings outline a range of strategies employed, emphasising the need to improve and facilitate shift working nurses’ ability to adopt effective coping mechanisms, in order to handle the high stress associated with nursing work and a shift working schedule
In the first theme—health practices—nurses reported using a range of relaxation and sleep, eating, physical activity, and substance use practices to cope with shift work

Summary

Introduction

Work hours that fall outside the traditional 9am–5pm schedule are increasingly prevalent because of increased demand for services across the 24 hour day [1]. 1.4 million Australians are classified as shift workers, and collectively account for. Similar figures are seen internationally, with shift workers comprising approximately 15% of full-time workers in the United States [4] and 17% in the United. Kingdom [5], whereas shift workers account for an estimated 28% of all working adults in Canada [6]. Shift work is associated with a series of potentially negative physical and psychological effects, as human physiology has biologically adapted to synchronise with the light–dark cycle [7]. Underlying homeostatic circadian rhythms are pervasive across many physiological and biochemical outputs [8,9]. Circadian rhythmicity underlies performance and behavioural outputs including sleep–wake states, alertness, and mental performance [10,11,12]

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