Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures.

BACKGROUND: Twenty-four hour nursing care involves shift work including 12-h shifts. England is unusual in deploying a mix of shift patterns. International evidence on the effects of such shifts is growing. A secondary analysis of data collected in England exploring outcomes with 12-h shifts examined the association between shift length, job satisfaction, scheduling flexibility, care quality, patient safety, and care left undone. METHODS: Data were collected from a questionnaire survey of nurses in a sample of English hospitals, conducted as part of the RN4CAST study, an EU 7th Framework funded study. The sample comprised 31 NHS acute hospital Trusts from 401 wards, in 46 acute hospital sites. Descriptive analysis included frequencies, percentages and mean scores by shift length, working beyond contracted hours and day or night shift. Multi-level regression models established statistical associations between shift length and nurse self-reported measures. RESULTS: Seventy-four percent (1898) of nurses worked a day shift and 26% (670) a night shift. Most Trusts had a mixture of shifts lengths. Self-reported quality of care was higher amongst nurses working ≤8 h (15.9%) compared to those working longer hours (20.0 to 21.1%). The odds of poor quality care were 1.64 times higher for nurses working ≥12 h (OR = 1.64, 95% CI 1.18-2.28, p = 0.003). Mean 'care left undone' scores varied by shift length: 3.85 (≤8 h), 3.72 (8.01-10.00 h), 3.80 (10.01-11.99 h) and were highest amongst those working ≥12 h (4.23) (p < 0.001). The rate of care left undone was 1.13 times higher for nurses working ≥12 h (RR = 1.13, 95% CI 1.06-1.20, p < 0.001). Job dissatisfaction was higher the longer the shift length: 42.9% (≥12 h (OR = 1.51, 95% CI 1.17-1.95, p = .001); 35.1% (≤8 h) 45.0% (8.01-10.00 h), 39.5% (10.01-11.99 h). CONCLUSIONS: Our findings add to the growing international body of evidence reporting that ≥12 shifts are associated with poor ratings of quality of care and higher rates of care left undone. Future research should focus on how 12-h shifts can be optimised to minimise potential risks.

Experiences of Newly Qualified Nurses in Critical Care: A qualitative systematic review.

Recent nursing shortages have been particularly felt in specialist areas, like Critical Care, which require higher staffing quotas; leading to increased recruitment of Newly Qualified Nurses in an area once reserved for the more experienced. This qualitative systematic review aimed to explore the experiences of Newly Qualified Nurses working in Critical Care, as their first job post-registration. A systematic search was undertaken between December 2017 and May 2018, yielding eight studies for inclusion in this review. Eligibility criteria included a qualitative design; Newly Qualified Nurses with less than two years post-registration experience, working in adult Intensive Care Units. Data were extracted and synthesised using the Thematic Synthesis approach. Five main themes emerged from the data: Intensive Care Unit Readiness; An Emotional Spectrum; Developing Relationships; The Journey to Self-Satisfaction and Intensive Care Unit Commitment. Conclusions are that an undergraduate placement in Critical Care should be facilitated where possible, consistent mentorship enhances Newly Qualified Nurse satisfaction, peer support is an important coping mechanism and opportunities for socialisation should be facilitated.