12 Hour Shifts May Increase Nursing Burnout

Chiara Dall'Ora MSc Nursing and Midwifery Sciences University of SouthamptonMedicalResearch.com Interview with:
Chiara Dall’Ora MSc
Nursing and Midwifery Sciences
University of Southampton 

Medical Research: What is the background for this study? What are the main findings?

Response: There is a trend for healthcare employers to adopt longer shifts, typically 2 shifts per day each lasting 12 hours. This allows nurses to work fewer shifts each week. Changes are driven by perceived efficiencies for the employer, and anecdotal reports of improved work life balance for employees because they work fewer days per week. However, it is unclear whether these longer shits adversely affect nurses’ wellbeing, in terms of burnout, job dissatisfaction, dissatisfaction with work schedule flexibility and intention to leave the job.

We found that when nurses work 12 h shifts or longer they are more likely to experience high burnout, dissatisfaction with work schedule flexibility and intention to leave their job, compared to nurses working 8 h or less. All shifts longer than 8 hours are associated with nurses’ job dissatisfaction.

Medical Research: What should clinicians and patients take away from your report?

Response: This study adds to a growing body of evidence showing that the organization of shift work in many hospitals may be putting both patients and staff at risk. Nurses may be choosing to work 12 h shifts and sacrifice work satisfaction for benefits in other spheres of life. However, this type of choice is likely to compromise nurses’ recovery sleep, physical and psychological well-being: the stress of those long work days and the recovery time needed may counterbalance any perceived benefit. Our results provide the basis for managers and nurses alike to question routine implementation of shifts longer than 8 h. In the context of austerity measures leading to cuts in spending on public services in Europe, it is particularly important for policymakers and managers to have good evidence on which to base decisions on hospital nurse work hours to ensure that the well-being of workers and the quality of care is maintained and nurses are retained in practice.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: We recommend that future research on shift work is carried out using techniques that can identify further intervening variables that impact on nurses’ wellbeing and performance. It would be valuable to investigate the impact of shift length and other variables such as the number of hours overtime, mode of overtime, the possibility of taking breaks during shifts and opportunity to rest between shifts, sleep patterns and total hours worked per week on nurse and patient outcomes. This is required to advance knowledge on the complex contextual and multivariate influences of shift work and its impact on nurses’ performance and well-being.


Chiara Dall’Ora, Peter Griffiths, Jane Ball, Michael Simon, Linda H Aiken.Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ Open, 2015; 5 (9): e008331 DOI:10.1136/bmjopen-2015-008331

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Chiara Dall’Ora MSc (2015). 12 Hour Shifts May Increase Nursing Burnout 

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