Comparison of Fatigue, Quality of Life, Turnover Intention, and Safety Incident Frequency between 2-Shift and 3-Shift Korean Nurses

Abstract

This study aimed to compare the fatigue, quality of life, turnover intention, and safety incident frequency between 2- and 3-shift nurses, and analyze their perceptions of the 2-shift system. Participants were 227 nurses working for one year or more in a tertiary hospital in Seoul, South Korea (113 were 2-shift nurses for two months or longer, and 114 were 3-shift nurses with no experience of 2-shift work). The Occupational Fatigue Exhaustion Recovery Scale (OFER) and Quality of Life Scale were used. Turnover intention, safety incident frequency, and perceptions of the 2-shift system were surveyed by questionnaires developed by the researchers. Results showed that 2-shift nurses had lower chronic fatigue (t = −2.38, p = 0.018) and higher recovery between shifts (t = 3.90, p < 0.001) and quality of life scores than 3-shift nurses (t = 3.69, p < 0.001). There were no significant differences for turnover intention (t = −1.48, p = 0.140), frequency of needlestick accidents (t = 0.30, p = 0.763), medication errors (t = −1.46, p = 0.146), or near-miss medication errors (t = 0.78, p = 0.437). Two-shift nurses found it easier to secure rest and personal leisure time, and their shift system was shown to improve work satisfaction by increasing the continuity of care. Additional research is necessary to examine how nurses’ health status and emotional satisfaction vary by shift type.

Fatigue in nurses and medication administration errors: A scoping review

“…Of interest, authors from the same study (Jarrar et al, 2019) found that shift length indirectly affects nurses' perceived medication error. Planned longer shifts, such as 12‐h shifts, appear to have less significance on the incidence of MAEs than unplanned overtime (Hong et al, 2021; Liu et al, 2012, Olds & Clarke, 2010; Wilkins & Shields, 2008). This has implications for nurse managers when developing rosters, as RNs working overtime is a factor which can be prevented and warrants further study.…”

Relationship quality of nursing work life and burnout among nurses: A systematic review

“…Environmental factors include role conflict, workload, lack of social support, control, community, rewards, fairness, values, and the level of flexibility of working time, while personal factors are gender, age, marital status, personality, and expectations (10,18,26). However, the different levels of fatigue across the included studies could be explained by different work environments such as different units/wards, shift work (28), and different workloads (10). Women suffer from higher burnout rates than men.…”

“…Shift work has been shown to cause circadian rhythm disturbances. As a result of sleep deprivation, shift workers are likely to experience disruption of daily life, which can lead to chronic illness, higher levels of fatigue harm to job satisfaction and quality of life (28).…”

“…The study found explaining the factors associated is the most significant variable that harms QNWL and affects burnout as well, namely workload, control, community, rewards, fairness, values, and work environment (1,4,(9)(10)(11)(12)22,23), is also determined by the interaction between risk factors (e.g., symptoms of depression/ bullying and anxiety) and protective factors (e.g., good social support) (10,13,24). The sociodemographic variables associated with QNWL and Burnout are age, finances, education, gender, marital status, having children, personality, and expectations and shift work (10,14,21,22,(25)(26)(27)(28).…”

Shift Happens: Emergency Physician Perspectives on Fatigue and Shift Work

“…Studies have shown that more and more employees are experiencing longer work hours, shorter recovery periods, and more unpredictability in terms of scheduling [ 7 ]. Organizational research has shown that these changes in work schedules have been accompanied by increases in employee fatigue, burnout, turnover, and other negative outcomes [ 8 ]. In addition, research on shiftwork over the past century has shown that shiftworkers experience higher levels of fatigue due to the non-circadian nature of their schedules [ 1 ].…”