Extended Work Shifts Research Articles

Sleep Disorders Linked to Quality of Life in a Sample of Egyptian Policemen a Comparative Study between Shift Workers and Non-Shift Workers

Abstract Background Poor sleep is associated with bad health outcomes, worse wellbeing and decreases in performance, productivity and safety at work. Police officers are exposed to several risk factors including extended work schedules, shift work, occupational stress, dangerous and traumatic events and can, as such, develop sleep problems. Aim and Objectives To compare quality of life, occupational stress level, between shift &non shift workers policemen working at El-Agouza Police Hospital. Subjects and Methods This was a cross-sectional comparative study conducted on 64 policemen working in 6 different Police department recruited from sleep clinic neuropsychiatry department at EL-Agouza Police Hospital serving police officers in El-Nile street, Giza, Egypt. Result Occurrence of sleep disorders was significantly higher in the shift workers compared to the non-shift worker group (p < 0.01). Conclusion In the current population-based study of police officers, poor sleep quality was more prevalent among officers who were engaged in shift work. The findings are consistent with prior evidence that night shift carried the greatest risk of poor sleep quality because night-shift officers have to make some adaptations that compensate for their natural circadian patterns.

The Occurrence of Anxiety, Depression, and Distress among Professionals Working in Emergency Care.

Maintaining mental health is essential for professions with higher stress levels and challenging environments, including emergency specializations. In this study, the occurrence of distress, anxiety, and depression among a group of ambulance and hospital emergency care professionals was assessed (n = 202). A cross-sectional, quantitative, descriptive online survey was conducted, including the internationally validated Beck depression inventory (BDI), the perceived stress scale (PSS-14), and the State-Trait Anxiety Inventory (STAI). Statistical analyses involved descriptive statistics, the χ2-test, Mann-Whitney U test, Kruskal-Wallis test, Dunn-Bonferroni test, logistic regression (LR), Cramer coefficient (Cramer's V), Kolmogorov-Smirnov test, and Spearman's rank correlation coefficient (rs). Based on the results, female professionals are more likely to have depressive symptoms (OR = 2.6, 95% CI = 1.3-5.1), perceived stress (OR = 1.2, 95% CI = 1.2-4.1), and anxiety (OR = 2.1, 95% CI = 1.0-4.1) than male professionals. Perceived stress levels decreased proportionally with increasing years spent working in healthcare (OR = 7.4, 95% CI = 7.1-8.3). Extended work shifts of 12 or 24 h increase the risk of perceived stress and anxiety in emergency care workers (p = 0.02). Customized stress management interventions are needed to mitigate the amplified mental strain associated with gender, working years, and longer shifts in the emergency care sector to sustain their mental health and well-being.

Nurses' Knowledge Regarding Medication Errors in Government Hospitals

Background: Nursing knowledge regarding medication error can be caused by various things, including personal causes (stress, exhaustion), predisposing conditions (extended work shifts, busy environmental settings), and a lack of experience and awareness regarding medication error. The most frequent medical errors in hospital settings involve the administration of medications. Objective: This study aims to assess nurses‟ knowledge regarding medication errors and to identify the relationship between nurses' knowledge and their demographic characteristics. Methods: This study is a descriptive cross-sectional quantitative carried out from 1 December 2022 to 1 February 2023 on the three Al Najaf Al-Ashraf Province hospitals. A non-probability sampling technique (convenience sample) accidentally. The study sample includes (200) nurses who work in Al-Sadr Medical City, Al-Hakim General Hospital, and Al-Zahraa Hospital. A questionnaire specifically designed to achieve the study's goals serves as the research instrument. The validity and reliability of the questionnaire were validated using an expert panel and Cronbach's Alpha, respectively. Result: showed that (54%) of nurses were males and (41%) were aged (25-29) years old. Overall, nurses’ knowledge regarding medication errors was moderate. The nurse’s knowledge was found to be significantly associated with (workplace, qualification, years of experience and continuing nursing education courses). Conclusion: The study concluded that the nurses' general understanding of medication errors was moderate. The most knowledgeable nurses are those who participate in continuing nursing education programs. The nurses with greater levels of education have the most expertise in medication errors. The nurses with the greatest depth of knowledge about medication errors are those with the greatest number of years of experience.

Sleep disorders linked to quality of life in a sample of Egyptian policemen a comparative study between shift workers and non-shift workers

BackgroundPoor sleep is associated with bad health outcomes, worse well-being and decreases in performance, productivity and safety at work. Police officers are exposed to several risk factors including extended work schedules, shift work, occupational stress, dangerous and traumatic events and can, as such, develop sleep problems.So, this study aimed to compare quality of life, occupational stress level, between shift and non-shift workers’ policemen working at El-Agouza Police Hospital.This was a cross-sectional comparative study conducted on 64 policemen working in 6 different Police department recruited from sleep clinic neuropsychiatry department at EL-Agouza Police Hospital serving police officers in El-Nile Street, Giza, Egypt. The total included cases were classified to two groups: group I (shift workers) included 32 of shift workers who provide service across, all 24 h of the clock each day of the week (often abbreviated as 24/7), group II (non-shift workers): included 32 of non-shift workers.ResultsOccurrence of sleep disorders was significantly higher in the shift workers compared to the non-shift worker group (p < 0.01).ConclusionsIn the current population-based study of police officers, poor sleep quality was more prevalent among officers who were engaged in shift work. The findings are consistent with prior evidence that night shift carried the greatest risk of poor sleep quality because night-shift officers have to make some adaptations that compensate for their natural circadian patterns.

Extended Work Shifts Increase Subjective Pain Complaints Among Cabin Crewmembers, but Not Among Airline Pilots or Healthcare Workers: A Repeated-Measures Study.

To determine whether four consecutive extended work shifts are associated with an increased risk of subjective pain complaints, sleep duration, and sleep disturbances. Forty-three healthcare workers, 41 cabin crewmembers, and 18 airline pilots working 4 consecutive extended workdays reported subjective pain complaints and sleep after the 1st and 4th workday. The risk of headache (odds ratio [OR] 21.4, 95% confidence interval [CI] 1.85 to 246.5) and pain in the hands, arms, or wrists (OR 3.78, 95% CI 1.84 to 7.76) increased after workday 4 versus workday 1 in cabin crewmembers. Sleep duration was longer (0.6 to 1.1 hours), and sleep disturbances fewer, the night before the fourth extended workday, compared with before the first workday, in all occupations. We found no general support for an association between extended work shifts and subjective pain, whereas sleep duration was improved, and sleep disturbances reduced after 4 consecutive extended workdays.

Effects of COVID-19 pandemic on mental health

The COVID-19 pandemic and its resulting economic and social consequences have significantly affected the mental health of the individuals.1Nevertheless, related literature on the effects of COVID-19 pandemic on mental health is scarce.2 Moreover, COVID-19 pandemic has profound effects on public mental health and their routine activities. Anxiety, sleep disturbance and overall lower perceived state of health are among some of the adverse effects.3 It has been reported that health organizations across the globe are working in coordination to cope with the mental health issues associated with the COVID-19 pandemic.4 The mental state of individuals vary based on their health, profession and status.5 Most importantly, mental health issues are common in quarantined and self-isolated individuals. It might be due to loneliness, fear of death and separation from their family members.6 Similarly, children, who have less interaction with their school friends on daily basis, may suffer from psychological problems. Additionally, separation from parents and friends can cause grief in children. They may encounter distress, anxiety, and loneliness; all of which affects their psychological health.7 Elderly people are highly susceptible to the COVID-19 outbreak as they are already prone to autoimmune, neurovascular, cardiovascular and psychological disorders. Social isolation among the elderly may cause irritating and shouting behaviour and emotional anger.8 Health care professionals are at the forefront of the battle to tackle the COVID-19. Therefore, fear of getting infection, extended work shifts, dealing with COVID-19 patients, inaccessibility to COVID-19 medicine, deaths of their colleagues at line of work, exposure to COVID-19, self-isolation, and keeping distance from friends and family can adversely affect their mental health.2 In general, individuals who recover from COVID-19 disease may face social stigma and get emotional disturbance. Each of us have a different attitude towards people who recovered from COVID-19. Health care workers who try to save people’s lives and limit the spread of COVID-19 can also face stigmatization for potentially being carriers of the COVID-19.2 The COVID-19 is a world problem, so concrete efforts are needed to address this pandemic at a global level. In the case of Pakistan, it is the responsibility of the Pakistani government to implement effective strategies to fight the Covid-19, as per the guidelines set by the World Health Organization (WHO).

A National Survey of Motor Vehicle Crashes Among General Surgery Residents.

Evaluate the frequency of self-reported, post-call hazardous driving events in a national cohort of general surgery residents and determine the associations between duty hour policy violations, psychiatric well-being, and hazardous driving events. MVCs are a leading cause of resident mortality. Extended work shifts and poor psychiatric well-being are risk factors for MVCs, placing general surgery residents at risk. General surgery residents from US programs were surveyed after the 2017 American Board of Surgery In-Training Examination. Outcomes included self-reported nodding off while driving, near-miss MVCs, and MVCs. Group-adjusted cluster Chi-square and hierarchical regression models with program-level intercepts measured associations between resident- and program-level factors and outcomes. Among 7391 general surgery residents from 260 programs (response rate 99.3%), 34.7% reported nodding off while driving, 26.6% a near-miss MVC, and 5.0% an MVC over the preceding 6 months. More frequent 80-hour rule violations were associated with all hazardous driving events: nodding off while driving {59.8% with ≥5 months with violations vs 27.2% with 0, adjusted odds ratio (AOR) 2.86 [95% confidence interval (CI) 2.21-3.69]}, near-miss MVCs, [53.6% vs 19.2%, AOR 3.28 (95% CI 2.53-4.24)], and MVCs [14.0% vs 3.5%, AOR 2.46 (95% CI 1.65-3.67)]. Similarly, poor psychiatric well-being was associated with all 3 outcomes [eg, 8.0% with poor psychiatric well-being reported MVCs vs 2.6% without, odds ratio 2.55 (95% CI 2.00-3.24)]. Hazardous driving events are prevalent among general surgery residents and associated with frequent duty hour violations and poor psychiatric well-being. Greater adherence to duty hour standards and efforts to improve well-being may improve driving safety.

Educational challenges of postgraduate neonatal intensive care nursing students: A qualitative study.

INTRODUCTION:Despite the progress of health care and the application of new technology in the care of patients, the need to train highly skilled and specialized nurses is inevitable. Given that a master's degree in neonatal intensive care nursing has been recently established in Iran, the aim of the study was to explain the educational challenges of neonatal intensive care postgraduate nursing students in their perspective.MATERIALS AND METHODS:This conventional content analysis was performed by conducting semi-structured interviews with 18 students of neonatal intensive care in X University of Medical Sciences from 2018 to 2019. Data were analyzed using conventional content analysis. To establish the reliability and validity of findings, Graneheim and Landman criteria were considered.RESULTS:Following the data analysis, two main categories were extracted: “theoretical education challenges” and “clinical education challenges.” The first main category was comprised of the following subcategories: “detachment of nursing department and hospital,” “defects in weekly scheduling,” “combination of care and treatment approaches in education,” “inconsistency between the content of theoretical courses,” “limited collaboration between basic science and medical departments,” “low number of lecturers,” “lecturers’ unrealistic expectations,” and “the importance of the scoring system.” “Extended work shifts,” “a large number of students,” “lack of opportunity to do clinical practices,” “lack of training classes,” and “limited amenities in the hospital” were recognized as subcategories of the second category.CONCLUSION:Managers can address some of the students’ challenges and provide the opportunity to enhance the quality of education through being familiar with, considering and meetings the needs and expectations of these students.

Work-Related Fatigue Factors among Hospital Nurses: An Integrative Literature Review

Background: Due to the demanding nature of nurses’ work and the current shortage of nurses, hospital nurses often find themselves working extra shifts, extended hours, and taking on more responsibilities. However, this added pressure on the body and mind results in fatigue which adversely affects nurses' health status as well as their ability to provide optimal health care procedures. Preventing fatigue and reducing its adverse consequences requires comprehensive awareness about its diverse contributing factors.Purpose: Examine factors that influence fatigue among nurses employed in a hospital setting.Methods: An integrative review to assess the quality of the research evidence, to find minor and major gaps in current research and the main issues in the area of the research and finally to bridge the research gaps. This integrative review identified a total of 12 relevant research studies from Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase, PsycINFO, and a manual search were used in this review. Data were reviewed in May 2017, using an integrative review then interpreted, analyzed and synthesized to identify key contributing factors that influence fatigue among hospital nurses.Results: The 12 studies in this review revealed that significant factors such as organizational factors, nursing work characteristics, psychosocial factors as well as individual characteristics and demand influence nurse fatigue. Work shifts, specifically night- shifts and extended work shifts without sufficient inter-shift recovery were linked to higher levels of fatigue.Conclusion: This review identified the significant associations between work schedules, work environments, demographics and fatigue among nurses in hospital settings located in various countries all around the world.Impact: Increased physical and psychological job demands combined with the lack of social support at work leads to a heightened degree of job dissatisfaction, which results in acute and chronic fatigue. Findings from this study may help healthcare organizations and policymaker to introduce strategies that mitigate fatigue among nurses in hospital settings.

Sleep Quality among Police Officers: Implications and Insights from a Systematic Review and Meta-Analysis of the Literature.

Poor sleep is associated with bad health outcomes, worse wellbeing and decreases in performance, productivity and safety at work. Police officers are exposed to several risk factors including extended work schedules, shift work, occupational stress, dangerous and traumatic events and can, as such, develop sleep problems. The aim of the present study was to analyze the sleep quality among police officers. A systematic literature search, in PubMed/MEDLINE, PsycINFO, Scopus, ISI/Web of Science (WoS) and the Cochrane Library was conducted. Original articles, published in English, French, Italian, Spanish and Portuguese, the primary objective of which was the evaluation of the quality of sleep through the Pittsburgh Sleep Quality Index (PSQI) in Police Forces, were selected. From an initial sample of 1,149 studies, 13 articles were included in the meta-analysis (3,722 police officers). The pooled prevalence of bad sleep quality in police officers was 51% [95%CI 42–60%]. The pooled global score of the PSQI was 5.6 [95%CI 5.0–6.3], corresponding to a low average quality. At the meta-regressions, statistically significant associations could be found for work seniority (in terms of years of service) and being on shift. The poor quality of sleep in police officers could have negative consequences for workers’ health and for the safety of third parts. The implementation of health and sleep hygiene promotion programs in police forces is strongly recommended.

Urinary 1-hydroxypyrene and Skin Contamination in Firefighters Deployed to the Fort McMurray Fire.

BackgroundIn May 2016, firefighters from the province of Alberta, Canada deployed to a fire that engulfed the urban area of Fort McMurray. During the first days of the fire, firefighters experienced heavy smoke exposures during greatly extended work shifts. Urinary samples were collected post-deployment from three fire services for estimation of 1-hydroxypyrene (1-HP) concentration, reflecting exposure to polycyclic aromatic hydrocarbons (PAHs), to determine the effects of respiratory protective equipment (RPE) and skin hygiene in reducing internal doseMethodsUrine samples from one fire service (n = 62) were analyzed for 1-HP by two laboratories, using different assays (LC-MS/MS: GC-MS): remaining samples were analyzed just by LC-MS/MS. A Skin Exposure Mitigation Index (SEMI) was computed from questions on opportunities for changing clothing, showering, and washing during breaks. Regression analyses, using 1-HP ng/g creatinine as the dependent variable, assessed the effect of RPE and skin factors on PAH absorption, allowing for environmental exposure and potential confounders. Stratification identified key groups with equal delay in sample collection.Results1-HP was detected in 71.0% of 62 samples by LC-MS/MS and 98.4% by GC-MS, with good mutual agreement between the methods. In 171 post-fire samples, 1-HP corrected for creatinine was related to current cigarette smoking and recent barbeque. Among those with samples collected within 48 h, urinary 1-HP was correlated with estimated exposure(r = 0.53, P < 0.001). In those with only one rotation before urine sample collection, no effect was seen of RPE use but I-HP was significantly lower (P = 0.003) in those with those with a high score on the SEMI scale, indicating better access to factors mitigating skin absorption.ConclusionSkin exposure to PAHs is an important route of absorption in firefighters, which can be mitigated by good skin hygiene.

Fluctuations in heart rate variability of health care workers during four consecutive extended work shifts and recovery during rest and sleep.

The aim of this study was to investigate fluctuations in heart rate variability (HRV), which reflect autonomic nervous system (ANS) function and potential psychological and physical strain, among 24 health care workers during work and sleep during four consecutive extended work shifts. Data included 24/36/12 h of HRV measurements, two logbooks, and a questionnaire. A cross-shift/cross-week design was applied. HRV was measured during work, leisure time, and sleep. The HRV data included time-domain [mean RR, SD of normal to normal R-R intervals (SDNN), and root mean square of the successive differences (RMSSD)] and frequency-domain [low frequency (LF)/high frequency (HF) ratio] parameters. HRV parameters revealed significant differences among work, leisure time, and sleep. Mean RR, RMSSD, and SDNN values were lower and the LF/HF ratio was higher on the first versus last day of the work period; however, the differences were most prominent in the morning hours. The results indicate higher levels of cardiovascular stress on the first versus fourth day of the working period, and measurements at night indicate a satisfactory recovery from the extended shifts.

0155 SLEEP WHILE ON-CALL OVERNIGHT DOES NOT RESTORE PERFORMANCE AMONG FIRST-YEAR RESIDENT PHYSICIANS

It has recently been reported that providing resident physicians with 3- or 5-hour protected windows for sleep during an on-call night increases the amount of sleep obtained and improves next-day performance relative to an on-call night with no protected window, in contrast to earlier findings. These studies have not reported, however, the relationship between the amount of sleep during this protected window and the degree of improvement in performance, and whether performance is sufficiently restored to warrant such an intervention. Here, we explored the dose-response relationship between amount of sleep during an on-call night and next-day performance. We analyzed data from 34 postgraduate-year 1 resident physicians (23 males; 28.0 ± 1.8 years old) studied for 3 weeks on a Q3 schedule (24-30-hour on-call extended duration work shift [EDWS] every other shift). Resident physicians completed daily sleep/work logs (validated by ambulatory polysomnography) and 10-min psychomotor vigilance tests (PVTs) every ~6 hours during each EDWS. We used a generalized estimating equation to examine the correlation between spontaneous sleep amounts (0, >0–1, >1–2, >2–3, >3–4, and >4 h bins) overnight during the EDWS (23:00-07:00) and next-day (05:00-19:00) PVT attentional failures (reaction time >500 ms). Time of day of PVT and study week were included as covariates. A total of 296 PVTs were analyzed. Compared to no sleep overnight, >4 hours of actual sleep (4.15–6.33 h) was required before a significant reduction in next-day PVT attentional failures was observed (p=0.0237). Sleeping <4 hours did not significantly improve performance (p>0.05). Even following >4 hours of sleep, PVT performance remained impaired, with 2 or more attentional failures on 68% of tests and 5 or more attentional failures on 39% of tests. Our data show that resident physicians need >4 hours of sleep on-call overnight to improve next-day PVT performance. Performance remained suboptimal despite this relative improvement, highlighting the substantial sleep deficiency inherent in EDWS. Given that 3- and 5-hour ‘protected’ windows result in far less than 4 hours of total sleep, our findings challenge reports that such protected time during an on-call shift is sufficient to maintain optimal next-day performance. NHLBI-4U01HL111478/NIOSH-R01OH07567/AHRQ-R01HS12032/NCRR-M01RR02635/UL1-RR025758/NHLBI-T32HL079010/NSBRI-NASA-NCC-9–58.

En ny ro med langturnus

Extended work shifts of 12 hours or more have become a common scheduling strategy for nurses in several countries, though this is not the case in Norway. There, many managers, nurses, and union representatives have expressed concerns about whether nurses can function effectively while working long shifts. This study thus aimed to examine how long shifts influence nursing outcomes such as stress, continuity, and responsibility in Norwegian nursing homes. Data were collected during in-depth interviews with 16 nurses employed at four different nursing homes who have worked 12–14-hour shifts. Results suggest that long shifts actually reduce stress and increase both work continuity and accountability, though these positive impacts of long shifts occur primarily when all departmental staff work long shifts. Furthermore, fewer shift changes mean more time spent with patients and better communication.

Sleep disorders among French anaesthesiologists and intensivists working in public hospitals: a self-reported electronic survey.

Sleep disorders can affect the health of physicians and patient outcomes. To determine the prevalence of sleep disorders among French anaesthesiologists and intensivists working in a public hospital. A cross-sectional survey. Anaesthesiologists and intensivists working in French public hospitals. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) was used to assess the degree of excessive daytime sleepiness. Among 1504 responders, 677 (45%) physicians reported sleep disorders. The independent factors associated with sleep disorders were reporting of sleep disorders [odds ratio (OR) 12.04, 95% CI (95% confidence interval) 8.89 to 16.46], sleep time less than 7 h (OR 8.86, 95% CI 6.50 to 12.20), work stress (OR 2.04, 95% CI 1.49 to 2.83), stress at home (OR 1.77, 95% CI 1.24 to 2.53), anxiolytic use (OR 3.69, 95% CI 2.23 to 6.25), psychotropic drug use (OR 3.91, 95% CI 1.51 to 11.52) and excessive daytime sleepiness (OR 1.81, 95% CI 1.34 to 2.45). Six hundred and seventy-six (44%) responders reported excessive daytime sleepiness during their professional activity. The independent factors associated with excessive daytime sleepiness were female sex (OR 1.86, 95% CI 1.49 to 2.34), tea consumption (OR 1.47, 95% CI 1.14 to 1.91), regular practice of nap (OR 1.68, 95% CI 1.34 to 2.09), stress at home (OR 1.31, 95% CI 1.02 to 1.68), more than four extended work shifts monthly (OR 1.25, 95% CI 1.01 to 1.56) and sleep disorders (OR 1.73, 95% CI 1.31 to 2.29). Reporting sleep disorder duration and a sleep time less than 7 h were the two major risk factors for sleep disorders. Female sex was the major risk factor for excessive daytime sleepiness. French anaesthesiologists did not report more sleep disorders than the general population, but their alertness is impaired by a factor of two.

Maximizing time from the constraining European Working Time Directive (EWTD): The Heidelberg New Working Time Model.

BackgroundThe introduction of the European Working Time Directive (EWTD) has greatly reduced training hours of surgical residents, which translates into 30% less surgical and clinical experience. Such a dramatic drop in attendance has serious implications such compromised quality of medical care. As the surgical department of the University of Heidelberg, our goal was to establish a model that was compliant with the EWTD while avoiding reduction in quality of patient care and surgical training.MethodsWe first performed workload analyses and performance statistics for all working areas of our department (operation theater, emergency room, specialized consultations, surgical wards and on-call duties) using personal interviews, time cards, medical documentation software as well as data of the financial- and personnel-controlling sector of our administration. Using that information, we specifically designed an EWTD-compatible work model and implemented it.ResultsSurgical wards and operating rooms (ORs) were not compliant with the EWTD. Between 5 pm and 8 pm, three ORs were still operating two-thirds of the time. By creating an extended work shift (7:30 am-7:30 pm), we effectively reduced the workload to less than 49% from 4 pm and 8 am, allowing the combination of an eight-hour working day with a 16-hour on call duty; thus, maximizing surgical resident training and ensuring patient continuity of care while maintaining EDTW guidelines.ConclusionA precise workload analysis is the key to success. The Heidelberg New Working Time Model provides a legal model, which, by avoiding rotating work shifts, assures quality of patient care and surgical training.

Sleep and cognitive function of crewmembers and mission controllers working 24-h shifts during a simulated 105-day spaceflight mission

The success of long-duration space missions depends on the ability of crewmembers and mission support specialists to be alert and maintain high levels of cognitive function while operating complex, technical equipment. We examined sleep, nocturnal melatonin levels and cognitive function of crewmembers and the sleep and cognitive function of mission controllers who participated in a high-fidelity 105-day simulated spaceflight mission at the Institute of Biomedical Problems (Moscow). Crewmembers were required to perform daily mission duties and work one 24-h extended duration work shift every sixth day. Mission controllers nominally worked 24-h extended duration shifts. Supplemental lighting was provided to crewmembers and mission controllers. Participants' sleep was estimated by wrist-actigraphy recordings. Overall, results show that crewmembers and mission controllers obtained inadequate sleep and exhibited impaired cognitive function, despite countermeasure use, while working extended duration shifts. Crewmembers averaged 7.04±0.92h (mean±SD) and 6.94±1.08h (mean±SD) in the two workdays prior to the extended duration shifts, 1.88±0.40h (mean±SD) during the 24-h work shift, and then slept 10.18±0.96h (mean±SD) the day after the night shift. Although supplemental light was provided, crewmembers’ average nocturnal melatonin levels remained elevated during extended 24-h work shifts. Naps and caffeine use were reported by crewmembers during ∼86% and 45% of extended night work shifts, respectively. Even with reported use of wake-promoting countermeasures, significant impairments in cognitive function were observed. Mission controllers slept 5.63±0.95h (mean±SD) the night prior to their extended duration work shift. On an average, 89% of night shifts included naps with mission controllers sleeping an average of 3.4±1.0h (mean±SD) during the 24-h extended duration work shift. Mission controllers also showed impaired cognitive function during extended duration work shifts.These findings indicate that extended duration work shifts present a significant challenge to crewmembers and mission support specialists during long-duration space mission operations. Future research is needed to evaluate the efficacy of alternative work schedules and the development and implementation of more effective countermeasures will be required to maintain high levels of performance.

Regulating extended work shifts: conflict lines and challenges for trade unions

This article addresses working time schemes with highly concentrated work periods and comparatively extended work-breaks. In Norway illustrations are found in both the private and the public sector. These compressed shifts extend the limits regulated in law and collective agreements, yet they have proved popular among groups of employees. The main arguments for applying compressed shifts are presented. Outcomes are discussed in terms of interest heterogeneity and cross-pressure. Institutional settings and actual regulation practices are also addressed in a Nordic context.

Differences in Heart Rate Variability of Female Nurses between and within Normal and Extended Work Shifts

The aim of this study was to investigate differences in heart rate variability (HRV) reflecting the function of autonomic nervous system (ANS) and psycho-physiological strain associated with normal and extended work shifts in nursing work. Complete data were available from 51 female nurses with a mean age of 40 yr, and based on two comparable 36-h HRV measurements supplemented with a questionnaire. Time-domain (meanRR, SDNN, RMSSD) and frequency-domain (LF power, HF power) parameters represented the HRV data, and were analyzed by linear mixed models. The differences between the compared work shifts were minor, revealing mainly increased sympathetic activity at the beginning of the normal work shift. The HRV parameters detected significant differences between work and leisure-time during the normal and extended work shifts in female nurses. During work shifts, an increase in sympathetic and a decrease in parasympathetic control of HRV was observed when compared to the leisure-time situation. Older subjects had overall lower HRV than younger subjects indicating increased sympathetic activation of ANS, especially during work. HRV parameters revealed significant differences between work, leisure-time and sleep of female nurses, but there were few differences between normal and extended work shifts in HRV parameters. This lack of differences between work shifts may be a consequence of the adaptation of nurses to the extended shifts or the more flexible organization of work duties possible during extended work shifts.

The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction

Extended work shifts of twelve hours or longer are common and even popular with hospital staff nurses, but little is known about how such extended hours affect the care that patients receive or the well-being of nurses. Survey data from nurses in four states showed that more than 80 percent of the nurses were satisfied with scheduling practices at their hospital. However, as the proportion of hospital nurses working shifts of more than thirteen hours increased, patients' dissatisfaction with care increased. Furthermore, nurses working shifts of ten hours or longer were up to two and a half times more likely than nurses working shorter shifts to experience burnout and job dissatisfaction and to intend to leave the job. Extended shifts undermine nurses' well-being, may result in expensive job turnover, and can negatively affect patient care. Policies regulating work hours for nurses, similar to those set for resident physicians, may be warranted. Nursing leaders should also encourage workplace cultures that respect nurses' days off and vacation time, promote nurses' prompt departure at the end of a shift, and allow nurses to refuse to work overtime without retribution.