Nurses' perceptions of night shifts: A qualitative study

Nurses' level of sleepiness during night shift

AIMS

This study aimed to determine the peak hours of sleepiness and the factors affecting the sleepiness levels of nurses.

BACKGROUND

Sleepiness is commonly seen in individuals working night shifts. However, in case of nurses, this sleepiness can be a major threat to patient and staff safety.

METHOD

This was a prospective cross-sectional study. Data were collected between July and September 2023, and a stratified sampling method was used according to the departments in which the nurses worked. Data were collected using the Personal Information Form and Visual Analog Scale. Nurses reported their sleepiness levels at the beginning of each hour between midnight and 8:00 am.

EQUATOR CHECKLIST

The study adhered to the STROBE checklist for reporting.

RESULTS

The mean sleepiness levels of emergency department nurses, intensive care nurses, internal or surgical clinic nurses, and all nurses were 59.75 ± 15.50, 43.53 ± 20.49, 44.67 ± 18.88, and 49.15 ± 19.67, respectively. The highest sleepiness level of the nurses was at 05:00 am. A significant correlation was found between the variables of age, gender, marital status, sleep quality, number of patients cared, working style and satisfaction with working in the department, and sleepiness level (P < 0.05).

CONCLUSION

Nurses working night shifts experience sleepiness (highest at 5:00 am). In addition, the sleepiness levels of nurses are affected by some personal and clinical factors.

IMPLICATIONS FOR NURSING AND NURSING POLICY

Based on the results, there is a need for necessary policies regarding nurses' working hours and working conditions. To protect patient and employee safety, necessary strategies should be devised regarding the hours when nurses experience the highest sleepiness and the factors affecting sleepiness levels.

Turnover intention of nurses in public hospitals and its association with quality of working life: a cross-sectional survey in six provinces in China

Objectives

High turnover intention can exacerbate the workforce shortage of nurses. This study aimed to determine the level of turnover intention of public hospital nurses in China and its associated factors.

Methods

A cross-sectional questionnaire survey of 2,863 nurses was conducted in 48 public hospitals across six provinces in mainland China, measuring the sociodemographic (gender, age, marital status, and monthly basic salary) and work characteristics (professional title, workload, night sleep deprivation, and workplace violence) of respondents, their quality of working life (QWL), and turnover intention. Multivariate logistic regression models were established to determine the association between QWL and turnover intention after adjustment for variations of the sociodemographic and work characteristics.

Results

Overall, 42.8% of respondents reported turnover intention. Higher QWL scores (AOR = 0.824 for job and career satisfaction, p < 0.001; AOR = 0.894 for professional pride, p < 0.001; AOR = 0.911 for balance between work and family, p < 0.05) were associated with lower turnover intention. Workplace violence was the strongest predictor of higher turnover intention (AOR = 3.003-4.767) amongst the sociodemographic and work characteristics, followed by an age between 30 and 40 years (AOR = 1.457 relative to <30 years), and night sleep deprivation (AOR = 1.391-1.808). Senior professional title had a protective effect (AOR = 0.417 relative to no title) on turnover intention.

Conclusion

High levels of turnover intention are evident across China in nurses employed by public hospitals, in particular in those aged between 30 and 40 years. Low QWL and poor work environment are significant predictors of turnover intention.