Changes in the Work Schedule of Nurses Related to the COVID-19 Pandemic and Its Relationship with Sleep and Turnover Intention

Abstract

Background: This study aimed to investigate whether different types of changes in the work schedule of nurses working rotating shifts during the COVID-19 pandemic were associated with sleep duration, sleep quality, and turnover intention. Methods: Cross-sectional questionnaire data from 694 nurses participating in the SUrvey of Shift work, Sleep and Health (SUSSH) were collected between the first and the second wave of the COVID-19 pandemic in Norway. A total of 89.9% were female, and mean age was 44.6 years (SD = 8.6 years). Changes in the shift work schedule related to the pandemic comprised reports of more long workdays (>8 h), less days off between work periods, more night shifts, more quick returns (i.e., 11 h or less between two consecutive shifts), more day shifts, and more evening shifts compared to no change in the respective shift characteristics. Change in sleep duration, sleep quality, and turnover intention as well as demographics were also assessed. Logistic regression analyses were performed to investigate whether changes in the specific work schedules were associated with sleep duration, sleep quality, and turnover intention, controlling for sex, age, cohabitation, children living in household, percentage of full time equivalent and other changes in the work schedule. Results: A total of 17% reported experiencing one or more changes in their work schedule during the pandemic. Experiencing any change in the work schedule predicted worse sleep quality (OR = 2.68, p < 0.001), reduced sleep duration (OR = 4.56, p < 0.001), and higher turnover intention (OR = 1.96, p = 0.006) compared to experiencing no change in work schedule. Among the specific changes in work schedules, experiencing an increase in quick returns had the highest odds ratio for worse sleep quality (OR = 10.34, p = 0.007) and higher turnover intention (OR = 8.49, p = 0.014) compared to those who reported no change in quick returns. Nurses experiencing an increase in long workdays were more likely to report higher turnover intention (OR = 4.37, p = 0.003) compared to those experiencing no change in long workdays. Conclusions: Change in work schedule related to the pandemic was associated with worse sleep quality, reduced sleep duration, and higher turnover intention. Increase in quick returns emerged as especially problematic in terms of sleep quality and turnover intention, along with long workdays, which were associated with higher turnover intention.

Working Hour and Schedule Characteristics among Nurses: A Retrospective Study

“…The schedule and work hour characteristics for the year 2021, as compared to those for 2019, showed that nurses worked more long shifts in the former. This finding was consistent with Djupedal [32] and Tabrizi et al [33], who found that approximately 17% of nurses reported experiencing changes in their work schedules due to the COVID-19 pandemic, mostly in an increased number of long workdays. It is known that long work hours increase fatigue, the risk for reduced performance on the job, obesity, injuries, and a wide range of chronic diseases [34][35][36].…”

The Impact of the Working Hours Among Malaysian Nurses on Their Ill-Being, Intention to Leave, and the Perceived Quality of Care: A Cross-Sectional Study During the COVID-19 Pandemic

“…Several studies have demonstrated that overtime negatively affects the health and well-being of caregivers’ quality of care. 22 , 23 Before the pandemic, Ball et al survey of nurses reported that shifts of more than 12 hours were associated with poor quality of care ratings, higher rates of care left undone, and the longer the shift, the higher the dissatisfaction level. 24 Jarrar et al examined the associations between nursing duty hour length on nurses’ reported quality and safety in Malaysian hospitals.…”

“… 26 , 27 During the pandemic, frequent changes in nurses’ schedules and the extension of the world emergency to combat COVID‐19 were associated with increased intent to leave and resign from their jobs. 22 A recent study demonstrated that nurses who provided treatment for COVID‐19 patients had higher intent to leave their jobs. 28 …”

Assessing the impacts of nurse staffing and work schedules on nurse turnover: A systematic review

“…Nurse turnover significantly contributes to nurse shortages (Xu et al., 2021). During the COVID‐19 pandemic, changes in work environments for nurses affected their psychological and physical health and well‐being, which led to increased turnover intention (Djupedal et al., 2022; Labrague & de Los Santos, 2021). Nurse turnover adversely affects nurse and patient outcomes, which can harm the quality of care and patient safety (Bae, 2022).…”