Northumbria University
B.Sc. (Hons) Nursing Studies
Transition to Accountable Practitioner
Does working shift rotation adversely affect nurses’ wellbeing and
patient’s health?
Millie O’Neill
20019665
September 2020: Adult Nursing PT18
Sue Tiplady
Submitted via eLP as an electronic submission
Words: 5969
,Table of Contents
1.0 Project rationale, aims and objective………………………………………………………3
2.0 Literature Review………………………………………………………………………….9
2.1 Introduction……………………. …………………………………………………9
2.2 Search Strategies…………………………………………………………………..9
2.3 PIO model….………………………...…………………………………………..10
2.4 Impact of night shifts…………………………………………………………….17
2.5 Effects of shift rotation on nurses and patients……………….………………….17
2.6 Shift rotation and this impact on health…………………….……………………18
2.7 Advantages/Disadvantages of work patterns……………….……………………18
3.0 Research Proposal……………………………………………….……………………….19
3.1 Method…………………………………….…………….……………………….19
3.2 Design……………………………………………………………………………19
3.3 Participants……………………………………………………………………….20
3.4 Ethics………………………………………….………………………………….21
3.5 Materials and equipment…………………………………………………………21
3.6 Procedure…………………………………………………………………………22
3.7 Data Collection…………………………………………………….……………..22
3.8 Data Analysis…………………………………………………………….……….24
4.0 Personal Reflection………………………………………………………………………24
4.1 Critical reflection of the project planning process………………………………24
4.2 Reflection on professional learning…………………………………………….25
4.3 Self-reflection using SWOT self-assessment tool……………………………..26
4.3.1 Strengths……………………………………………………………26
4.3.2 Weaknesses…………………………………………………………27
4.3.3 Opportunities……………………………………………………….27
4.3.4 Threats……………………………………………………………..27
5.0 Conclusion…………………………………………………………………………….27
6.0 References…………………………………………………………………………….28
2
,Chapter 1 - Introduction
The goal of this project is to investigate how nurses working long shifts and rotating shift
patterns, such as day shift to night shift within a 24-hour period, may affect nurses' well-
being, job satisfaction, and job turnover. The purpose of this study is to investigate the
relationship between working long shifts/shift rotation and job discontent, burnout,
unhappiness with work schedule flexibility, and intention to leave present employment
among hospital nurses.
NHS nurse employee turnover
The NHS employ a greater number of individuals than any other organisation in Europe or
the world as a whole. In England's healthcare system, 1.3 million people work professionally
to care for others. A third of the population in working age is female, or one in every twenty-
five. However, during the last ten years, staffing has lagged behind demand, and work
support has failed to keep up with patients' changing needs. There will always be a limited
amount of vacancies as employees change businesses and advance in their careers, but the
current level is unsustainable, with the nursing field experiencing the greatest shortage.
(NHS-No date)
Health accessibility for nurses
Quick and straightforward accessibility to health services is essential for people who are
employed in order to maintain working. The two most common reasons for absences
associated with sickness continue to be mental health and musculoskeletal issues. NHS
services for each are becoming more widely offered. The availability of mental health support
via digital methods is also growing, offering clients more flexibility in scheduling
appointments around their work. Increasing the quantity of physiotherapists engaged in
3
, primary care networks is one strategy for ensuring that patients consult an appropriate
healthcare practitioner the first time. People who miss more than four weeks of work have a
greater chance to be fired permanently. Individualised care plans that assist people in
managing their conditions at work while implementing appropriate changes will help to
reduce this. NO DATE (NHS) The NHS has a higher rate of sick leave than equivalent public
sector businesses (2.9% in 2016) and the private sector (1.9% in 2016), at 4% in 2017.
RCN shift patterns
Previous placement experience has highlighted the impact on nurses and healthcare staff in
regard to shift rotation and working, According to the RCN, "regulations generally require
that there should be a break of 11 consecutive hours between each 12 hour shift" and if this is
not attainable, employees must be given "equivalent compensatory periods of rest" or
"appropriate protection" (RCN, 2023) Although this may not be always practical since travel
time must be factored in—for example, if it takes over an hour to get from home to a
placement and back—this still leaves fewer than nine hours for placement. This can be
damaging to physical and psychological health. Nurses and healthcare staff may also have
this which leaves a short amount of time when the shifts can be demanding and could then
have the potential to impact on the quality and safety of patient care. It may also cause
burnout and intention to leave.
Effects of night shift on nurses
The risk of many disorders and errors becomes greater for nurses working the night shift as it
disrupts circadian rhythm. These disorders and accidents include:
- Higher probability of obesity
- Greater likelihood of cardiovascular disease
- Increased likelihood of mood swings
4
B.Sc. (Hons) Nursing Studies
Transition to Accountable Practitioner
Does working shift rotation adversely affect nurses’ wellbeing and
patient’s health?
Millie O’Neill
20019665
September 2020: Adult Nursing PT18
Sue Tiplady
Submitted via eLP as an electronic submission
Words: 5969
,Table of Contents
1.0 Project rationale, aims and objective………………………………………………………3
2.0 Literature Review………………………………………………………………………….9
2.1 Introduction……………………. …………………………………………………9
2.2 Search Strategies…………………………………………………………………..9
2.3 PIO model….………………………...…………………………………………..10
2.4 Impact of night shifts…………………………………………………………….17
2.5 Effects of shift rotation on nurses and patients……………….………………….17
2.6 Shift rotation and this impact on health…………………….……………………18
2.7 Advantages/Disadvantages of work patterns……………….……………………18
3.0 Research Proposal……………………………………………….……………………….19
3.1 Method…………………………………….…………….……………………….19
3.2 Design……………………………………………………………………………19
3.3 Participants……………………………………………………………………….20
3.4 Ethics………………………………………….………………………………….21
3.5 Materials and equipment…………………………………………………………21
3.6 Procedure…………………………………………………………………………22
3.7 Data Collection…………………………………………………….……………..22
3.8 Data Analysis…………………………………………………………….……….24
4.0 Personal Reflection………………………………………………………………………24
4.1 Critical reflection of the project planning process………………………………24
4.2 Reflection on professional learning…………………………………………….25
4.3 Self-reflection using SWOT self-assessment tool……………………………..26
4.3.1 Strengths……………………………………………………………26
4.3.2 Weaknesses…………………………………………………………27
4.3.3 Opportunities……………………………………………………….27
4.3.4 Threats……………………………………………………………..27
5.0 Conclusion…………………………………………………………………………….27
6.0 References…………………………………………………………………………….28
2
,Chapter 1 - Introduction
The goal of this project is to investigate how nurses working long shifts and rotating shift
patterns, such as day shift to night shift within a 24-hour period, may affect nurses' well-
being, job satisfaction, and job turnover. The purpose of this study is to investigate the
relationship between working long shifts/shift rotation and job discontent, burnout,
unhappiness with work schedule flexibility, and intention to leave present employment
among hospital nurses.
NHS nurse employee turnover
The NHS employ a greater number of individuals than any other organisation in Europe or
the world as a whole. In England's healthcare system, 1.3 million people work professionally
to care for others. A third of the population in working age is female, or one in every twenty-
five. However, during the last ten years, staffing has lagged behind demand, and work
support has failed to keep up with patients' changing needs. There will always be a limited
amount of vacancies as employees change businesses and advance in their careers, but the
current level is unsustainable, with the nursing field experiencing the greatest shortage.
(NHS-No date)
Health accessibility for nurses
Quick and straightforward accessibility to health services is essential for people who are
employed in order to maintain working. The two most common reasons for absences
associated with sickness continue to be mental health and musculoskeletal issues. NHS
services for each are becoming more widely offered. The availability of mental health support
via digital methods is also growing, offering clients more flexibility in scheduling
appointments around their work. Increasing the quantity of physiotherapists engaged in
3
, primary care networks is one strategy for ensuring that patients consult an appropriate
healthcare practitioner the first time. People who miss more than four weeks of work have a
greater chance to be fired permanently. Individualised care plans that assist people in
managing their conditions at work while implementing appropriate changes will help to
reduce this. NO DATE (NHS) The NHS has a higher rate of sick leave than equivalent public
sector businesses (2.9% in 2016) and the private sector (1.9% in 2016), at 4% in 2017.
RCN shift patterns
Previous placement experience has highlighted the impact on nurses and healthcare staff in
regard to shift rotation and working, According to the RCN, "regulations generally require
that there should be a break of 11 consecutive hours between each 12 hour shift" and if this is
not attainable, employees must be given "equivalent compensatory periods of rest" or
"appropriate protection" (RCN, 2023) Although this may not be always practical since travel
time must be factored in—for example, if it takes over an hour to get from home to a
placement and back—this still leaves fewer than nine hours for placement. This can be
damaging to physical and psychological health. Nurses and healthcare staff may also have
this which leaves a short amount of time when the shifts can be demanding and could then
have the potential to impact on the quality and safety of patient care. It may also cause
burnout and intention to leave.
Effects of night shift on nurses
The risk of many disorders and errors becomes greater for nurses working the night shift as it
disrupts circadian rhythm. These disorders and accidents include:
- Higher probability of obesity
- Greater likelihood of cardiovascular disease
- Increased likelihood of mood swings
4
