The aim of this study was to design ergonomically improved shift schedules for nurses in primary health care shift work in order to enhance their health and well-being. The main change made was the reduction of quick returns (i.e., no more morning shifts immediately after an evening shift) in order to ensure more recovery time between work shifts. Six municipal hospital units participated in the intervention. Our aim was to maintain or improve the well-being and work ability of aged workers. The subjects (n=75) were divided into three age groups: 20-40, 41-52, and 53-62 yr. The introduction of more recovery time between evening and morning shifts significantly improved the subjects' sleep and alertness, well-being at work, perceived health, and leisure-time activities independently of their age. The effect on social and family life was also positive. Working in shifts was the most disruptive for the youngest group of nurses. The Work Ability Index score depended on the age group: it was lowest among the oldest age group, and did not change during the intervention. Ergonomic working time arrangements show positive effects on the well-being of health care workers of all ages.

Effects of Implementing an Ergonomic Work Schedule on Heart Rate Variability in Shift working Nurses: Susanna JÄRVELIN‐PASANEN, et al. Ergonomics, Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland— Objectives The aim of this study was to compare the psychophysiological strain related to a conventional shift schedule and new ergonomically improved two‐ and three‐shift schedules using heart rate variability (HRV) analysis. The specific aim was to determine whether the introduced ergonomic shift arrangement had any positive effects on the psychophysiological strain such as increased HRV or decrease in the sympathovagal balance of the autonomic nervous system (ANS). Methods Questionnaire data and 24‐hour HRV recordings were gathered from 48 female shift‐working nurses once while working the conventional shift schedule (baseline) and again after one year working an ergonomic shift schedule during the morning shift. Results Comparisons between conventional and ergonomic shift schedules (baseline and follow‐up, respectively) revealed significant differences in frequency‐domain parameters. Implementing an ergonomic shift schedule resulted in decreased normalized low frequency (LF) power, increased normalized high frequency (HF) power, and decreased LF/HF ratio at the beginning of the shift. Furthermore, at baseline, mean RR interval, root mean square of successive RR interval differences (RMSSD) and normalized HF power were increased at the end of the shift compared with the values at the beginning of the morning shift. In contrast, at the follow‐up, LF power was increased between the end and beginning of the morning shift. Conclusions The psychophysiological strain measured by HRV analysis was lower at the beginning of the work shift for the ergonomic shift schedules compared with the conventional schedule. This indicates that an ergonomic shift schedule may have a positive effect on the ANS recovery occurring between successive work shifts.

Introduction: Shift work is one of the most serious occupational risk factors for health problems such as cardiovascular diseases. Furthermore, shift work disturbs sleep and alertness and impairs recovery from work, especially if the time between work shifts is insufficient. The aim of this study was to evaluate if a reduced number of short intervals (i.e., less than 11 hours) between work-shifts would result in better recovery indicated by sleep time heart rate variability reflecting the psychophysiological recovery. Methods: Participants were 39 female shift-working nurses with the mean age of 45 years. The study design was a prospective within-subject study with a one year follow-up. The 24-hour heart rate variability recordings supplemented with questionnaires were performed twice. First, while working in the old shift schedule with frequent short intervals between work shifts, and again after one year of a working schedule with a reduced number of short intervals between work shifts. Statistical analyses were conducted using liner mixed models. Results: The comparison between the initial shift system and the schedule with the reduced number of short intervals between work shifts caused an increase in heart rate variability parameters reflecting mainly parasympathetic activation of the autonomic nervous system (i.e., RMSSD, HF power and HF power in normalized units) (p < .001). Conclusions: In conclusion, our results suggest that reducing the number of short intervals between work shifts is an effective way to enhance the physiological recovery during the sleep. This study demonstrated that the recovery of autonomic nervous system from shift work can be promoted by implementation of ergonomic recommendations.

BackgroundIn the city of Helsinki, employees report thousands of threatening situations at work every year. Two thirds of victims typically cope on their own after a critical incident but one third needs help to manage. If not handled shortly, incidents may cause excessive stress or absence from work. Occupational health care organises debriefing after severe incidents but many minor incidents are left unhandled.Description of the problemThere was a need for mental first aid” at workplaces, so that personnel facing incidents could unload the mental burden right away. How to handle incidents quickly, during the workday, with a colleague? After the incident, the manager is usually responsible for examining the facts whereas colleagues could support with the mental process.ResultsA short training based on Critical Incident Stress Management (CISM) was organised for some employees and leaders. The training included e.g. lecture and discussion of safety culture at work and of human reactions during and after incidents. A discussion model of mental first aid (in Finnish hetipurku) and practical tools to support it were presented and practiced. According to the participants’ experience, the model turned out to be useful in many ways. Leaders felt that they got a valuable tool to handle different kinds of problematic situations at work. The model was also utilised within concerns about an organisational change.ConclusionsMental first aid model was aimed to help work communities handle workplace incidents quickly on the spot. In addition to that, the model appeared to be more versatile instrument. It can be used to encourage discussing and solving challenging cases at work. It brings help easily available and strengthens work communities’ own competence to deal with stressful situations. Inspired by positive experiences, a further use of the model is developed and more support persons are trained.