Occupational Stress and Burnout in Nurses Working Extended Shifts: A Systematic Review

Abstract

Background: Extended nursing work hours have become common internationally, due to inadequate staffing levels and increasing population demands. Extended work hours can have adverse effects on the psychological well-being of nurses, including the manifestation of occupational stress and burnout.Aim: This review aims to explore if and how nurses working extended duty hours experience occupational stress and/or burnout.Methodology: A systematic search was conducted on four electronic databases: CINAHL Plus, MEDLINE, PubMed, and PsycINFO. A methodical search strategy was developed in collaboration with an expert librarian. Medical subject headings, keywords, and synonyms were utilised. Reference lists of papers eligible for inclusion in the review were also hand searched. The quality of each study was evaluated using the Joanna Briggs Institute's quality appraisal tool for cross-sectional studies. Meta-analyses were not possible; thus, findings were synthesised narratively.Results: Five studies were included, all focusing on the impact of extended shifts. One study focused on the nurses’ experience of occupational stress mainly; one study focused on the nurses’ experience of burnout; and two studies focused on the contributing factors of stress and burnout. The methodological quality of these studies was deemed satisfactory. The prevalence of 12-hour shifts was high, and evident across various countries. Long working hours and other variables such as inadequate rests, break-times, and fatigue contributed to the nurses’ experience of occupational stress and burnout. Conclusions: Extended shifts in nursing are a widely observed practise internationally. This systematic review sheds light on the effects of extended shift patterns and the prevalence of occupational stress and burnout among nurses. A better understanding of these concepts may help in building organisational initiatives and strategies to support nurses who work long shifts.