NIOSH Training for Nurses on Shift Work and Long Work Hours

Work/Home Demands

Some nurses’ work environments increase the risk for accidents, injuries, or errors during shift work and/or long work hours.

• Physically demanding jobs^a can cause fatigue and may increase the risk for injury with long work hours.^16,17
• Emotionally and socially demanding nursing jobs^b can cause mental fatigue and a desire to leave the profession.¹⁸ Another form of emotional demand in nursing is “emotional labor”: smiling and being friendly in public when this is not what you feel inside.¹⁹
• Cognitively demanding jobs^c. A high level of cognitive demands is difficult to sustain over long work hours or during the early morning hours of night shift, and risk for fatigue will therefore increase.

When shift work or long work hours combine with these additional demands, risks increase for injuries and adverse health outcomes for the nurse, as well as for errors in delivery of nursing care.²⁰

Personal Responsibilities. Nurses with responsibilities outside of the job (such as childcare, caring for an elderly relative, having a second job, or a long commute) may have difficulty arranging enough time to rest and recover between shifts. Housework and other domestic chores also take time away from needed rest.

To promote health and safety, managers and staff nurses can consider the demands of the job and the nurse’s personal life when choosing the length of work shifts.

^aPhysically demanding jobs involve lifting, bending, reaching, working in awkward postures, standing, and static postures.

^bEmotionally and socially demanding nursing jobs involve dealing with grieving, angry, or frustrated patients and families, angry doctors or other personnel, coworkers with “issues,” and unsupportive supervisors.

^cCognitively demanding jobs are those that require intense concentration; are boring but interspersed with emergencies; have frequent interruptions; require keeping facts in memory; or involve complex situations that require sorting out, frequent reordering of priorities, and constant “mind power.”