The Length of a Nurse's Hours - Essay Example

The provision of high-quality care nursing services that primarily focus on the health and safety of patients is a growing concern globally. The contemporary 8-hour shift in the nursing profession is gradually becoming an old norm. Formerly, nurses work in a 12-hour shift that changes according to different schedules in a week. This is aimed to give an improved work-life balance and flexibility. The nursing shifts are often unpredictable and change according to the needs of patients and resulting in a shortage of nursing staff. Hence, nurses suffer unexpected overtime when they are scheduled for an extension of their shift, exposing nurses to burnout and fatigue, which affects their ability to deliver patient-centered care. Longer working hours, primarily, twelve hours or prolonged work shifts are a common phenomenon among nurses, however little is well-known concerning the effect of the extension on the quality of care issued to patients as well as the well-being of nurses.

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Therefore, this bibliography contains peer-reviewed articles that examine the effect of the long working hours and its effect on the quality of care among nurses. in the past few years, the various hospitals started to implement the 12-hour working shift since it was more cost-effective and a better way of providing 24-hour’ patient care. However, there are varying views concerning working hours and the number of daily shifts to the quality of care. Shortage in nurses and the blurred distinction between mandatory and voluntary overtime has resulted in nurses working for longer hours. Nurse staffing is a critical factor in the health delivery system, and it has a direct effect on patient safety.

Harris, R., Sims, S., Parr, J., & Davies, N. (2015). Impact of 12h shift patterns in nursing: A scoping review. International Journal of Nursing Studies, 52(2), 605–634. DOI: 10.1016/ j.ijnurstu.2014.10.014

The authors of this article aimed to give a detailed overview of the effectiveness and the impact of the twelve-hour shift patterns in various countries globally. The paper established that the 12-hour shifts are budget-saving and nurses often like working within that time. Some studies underscore positive impacts, while others in this article indicated a negative impact on the quality of care or no effect. However, it was inconclusive evidence of the benefits and risks to the nursing staff as well as the impact on patient care. After reviewing this study, I established that longer working hours for hospital nurses results in increased levels of burnout and quality of care among patients. This article will be often used as a reference to the impact of longer working hours for nurses and risk to patients and staff as well as their experiences.

Rogers, A. E., Hwang, W.-T., Scott, L. D., Aiken, L. H., & Dinges, D. F. (2004). The Working Hours of Hospital Staff Nurses and Patient Safety. Health Affairs, 23(4), 202–212. DOI: 10.1377/hlthaff.23.4.202

This research provides a strong foundation for the association between longer working shifts and fatigue, poor quality outcomes, and related medical errors. The author aimed to highlight the effect of extended work shifts on the quality of care and safety of patients, primarily caused by the shortage of nursing staff in hospitals. The research established that the risk of making an error increases with overtime and extended work shifts of more than 12 hours of working time. The research was conducted among 393 members of the American Nursing Association (ANA) and established that the occurrence of errors and near errors increased when an extension of the working duration surpassed 12.5 hours in a single shift, while risks to patient care. However, the research lacked sufficient evidence to identify the impact of working hours on errors among nurses who worked in less than 12-hour shifts since errors are relatively rare. This research will form the basis of my paper in quantifying the working hours and patterns of nurses and ascertain if the extension of work shifts and overtime add to the errors and near errors, hence compromising the quality of care to patients. It will give a good balance of information concerning the unpredictability of nurse working schedules and its impact on giving patient-centered care.

Estabrooks, C. A., Cummings, G. G., Olivo, S. A., Squires, J. E., Giblin, C., & Simpson, N. (2009). Effects of shift length on quality of patient care and health provider outcomes: a systematic review. BMJ Quality & Safety, 18(3), 181-188. DOI: 10.1136/qshc.2007.024232

This article aims to give a comparison of nursing shift length (8 hours versus 12-hour shifts) and the impact on the quality of care given to patients. The researcher conducted a systematic review of academic literature in 12 journals. Two journals established a correlation between longer working hour shifts and near errors and errors, others underscored a decline in the number of complications with longer nurse shifts. I can link this article to other research conducted on the topic, however, the author failed to conclude the effect of lengthy nurse shift since few studies examined the well-being of nurses, health complaints, and job satisfaction levels. However, this research will provide an overview of what future research can address.

Potter, P., Barr, N., McSweeney, M., & Sledge, J. (2003). Identifying nurse staffing and patient outcome relationships: A guide for change in care delivery. Nursing Economics, 21(4), 158-166. Retrieved from https://csuglobal.idm.oclc.org/login?url=https://search-proquest-com. csuglobal.idm.oclc.org/docview/230602641?accountid=38569

The article aimed at examining the association between patient outcomes and nurse staffing. The research was conducted in a university teaching hospital in Missouri, using a prospective correlational study that involved 32 acute inpatients. The research found out that an increased number of nursing in the acute care units improves patient satisfaction with care given during the hospitalization period as well as a capacity for self-care after discharge. The research will be used as a reference to underscore the effect of nurse working hours and outcomes on medication errors. After reviewing this research, it will provide a basis for my research since it encompasses the self-reports of inpatients and satisfaction levels of patients after discharge. This research is related to the article above in linking the working hours of RNs and improvement in the quality of care.

Jarrar, M. T., Abdul Rahman, H., M Zebiany, A., S Abu Madini, M., Sangkala, M., & Amalraj, C. (2018). Nursing duty hours' length and the perceived outcomes of care. Global Journal of Health Science, 10(4), 1-8. DOI: 10.5539/gjhs.v10n4p1

The author aimed to evaluate the effect of the length of nursing working hours and the provision of quality and safe care among patients in the surgical ward. The research was primarily based in private hospitals in Malaysia among 652 nurses. The research established that the length of nursing working hours' does not significantly affect the quality of care and patient safety. Nurses who worked for 10-hour night shifts had a different perceived outcome compared to other schedules. The author established that the 12-hour shift among nurses in the surgical ward does not affect the quality of care. Giving particular attention to the care in the surgical ward, the research will be used to underscore the effect of extended night shifts on the quality of care. I found that when reviewing this article, I was able to revisit my own experience in the nursing practice and take note of the impact of a night shift, which is often resulted in fatigue, mood effects, and burnout. This article is well-researched, up-to-date, and descriptive, therefore, it will be directly impactful to the background of my study.

Ball, J., Day, T., Murrells, T., Dall’Ora, C., Rafferty, A. M., Griffiths, P., & Maben, J. (2017). A cross-sectional examination of the association between shift length and hospital nurses' job satisfaction and nurse reported quality measures. BMC nursing, 16(1), 26. DOI 10.1186/s12912-017-0221-7

The study provides strong evidence of the effect of 12-hour nurse shift on job satisfaction levels, quality of care, and safety of patients. The research was conducted in 46 acute hospitals involving patients in 401 wards. This resource supports the findings of other research reporting that nursing shifts of more than 12 hours are associated with poor quality of care as well as errors. The author gives a concise overview of how more than 12-hour shifts are related to increased fatigue and reduced productivity. The research will be a valuable resource for my essay, it raises the concern of whether the long term effects of 12-hour shifts result in nurses' sickness absenteeism, turnover rates, and missed care. it offers the context of analyzing the scope of my research including a review of the effects and quality evidence.

Haegdorens, F., Van Bogaert, P., De Meester, K., & Monsieurs, K. G. (2019). The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicentre study. BMC health services research, 19(1), 1-9. https://doi.org/10.1186/s12913-019-4688-7

The author of the study aimed to explore the relationship between the level of nursing staff and the mortality rate. This research was done in 28 wards (14 surgical and 14 medical) among seven hospitals in Belgium. The results of the study established that a higher staffing level is associated with reduced mortality rates at the ward level. Subsequently, the authors highlighted that a higher number of nurses with bachelors' degrees, a lower patient mortality rate was experienced. This article provides a strong foundation of the effect of nursing staffing, particularly paying attention to the nursing hours per patient day (NHPPD) methodology used. Hence, this article is a valuable resource that gives a concise analysis and scope of the effects of nursing staff to the quality and level of care given to patients inwards.

Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501-2509. doi: 10.1377/hlthaff.2011.1377

This research aimed to highlight the effect of extended hours on the quality of care that patients receive and the well-being of healthcare staff. The research involved survey data from four states, it established that 80 percent of nurses are comfortable with their shifts in their respective hospitals, however, they expressed significant levels of dissatisfaction and aim to leave the hospital when shifts are increasing to more than 13 hours. The author highlights that extended nursing shifts often result in a turnover and affects nurses' well-being, leading to poor care quality. This study is particularly important to my research to highlight how the extended hours directly correlate with patient care, nurse burnout, and job dissatisfaction. The author associated the job dissatisfaction extended shifts with underestimation of the impact of working for long shifts since working for three days in a week is more appealing than five days.