Nurse Fatigue and Shift Length: A Pilot Study

Deborah Maust Martin, DNP, MBA, RN, NE-BC, FACHE

Nurs Econ. 2015;33(2):81-87.

Introduction

Nurse fatigue in the United States is recognized as a source of adverse patient events as well as negative impacts on nurse safety. The Occupational Safety and Health Administration (2013) cautions people against working more than 8-hour shifts as longer shifts may result in reduced alertness. Shift length was a focus of the Joint Commission (2011) recommendations to mitigate fatigue in health care workers.

In the United States, nurses who provide direct patient care routinely work 12-hour shifts. In a study of about 23,000 nurses, Stimpfel, Sloane, and Aiken (2012) reported 65% worked 12-hour shifts or longer. Nationwide there are 1,617,200 nurses working in hospitals (American Nurses Association, 2011). If 65% worked 12-hour shifts, then there could be well over one million nurses scheduled and working shifts with long hours.

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Table 1. Demographics and Characteristics
Sex	Female: 57%	Male: 43%
Marital status	Married: 57%	Divorced: 14%	Never married: 29%
Children at home	29%
Elders at home	0
Age	20–39: 57%	40–59: 43%
Years of experience	1 or less: 57%	3–8: 43%
Educational degree	Bachelor: 57%	Associate: 43%

Table 2. Average Hours of Sleep per Night
	n	Minimum	Maximum	Mean (SD)	Median	p*
12-hour shift average sleep per night	7	6.0	8.5	6.9 (0.85)	7.0
8-hour shift average sleep per night	7	6.0	8.5	7.2 (0.99)	7.0
The median of differences between average sleep time in hours while working 12-hour shifts and average sleep time in hours while working 8-hour shifts is 0.						0.059

* Related Samples Wilcoxon Signed Rank Test p<0.10

Table 3. Average Hours Worked per Week
	n	Minimum	Maximum	Mean (SD)	Median	p*
12-hour shift average hours worked per night	7	36	40	36.71 (1.5)	36
8-hour shift average hours per week	7	36	42	37.57 (2.4)	36
The median of differences between average hours worked while working 12-hour shifts and average hours worked while working 8-hour shirts is 0.						0.180

* Related Samples Wilcoxon Signed Rank Test p<0.10

Table 4. Acute Fatigue
	12-Hour Shifts	8-Hour Shifts	p*
Mean acute fatigue scores	55.28	51
Median acute fatigue scores	60.00	50
The median differences between working 12-hour shifts and 8-hour shifts for acute fatigue is 0.			0.157

* Related Samples Wilcoxon Signed Rank Test p<0.10

Table 5. Chronic Fatigue
	12-Hour Shifts	8-Hour Shifts	p*
Mean chronic fatigue scores	37.71	33.28
Median chronic fatigue scores	33.00	26.00
The median differences between working 12-hour shifts and 8-hour shifts for chronic fatigue is 0.			0.157

* Related Samples Wilcoxon Signed Rank Test p<0.10

Table 6. Inter-Shift Recovery
	12-Hour Shifts	8-Hour Shifts	p*
Mean inter-shift recovery scores	52.42	45.71
Median inter-shift recovery scores	53.00	43.00
The median differences between working 12-hour shifts and 8-hour shifts for inter-shift recovery is 0.			0.027