Shiftwork, Long Work Hours, Fatigue

Shiftwork and long work hours can result in stress, fatigue, negative mood, discomfort, physiologic dysfunction, and poor health behaviors like overeating, smoking, and lack of exercise. Shiftwork is any schedule outside the period of 7 a.m. to 6 p.m. (National Institute for Occupational Safety and Health, 2015). Shift workers may be at higher risk for cardiovascular disease, gastrointestinal disorders, psychological disorders, cancer, diabetes mellitus, adverse reproductive outcomes, and difficulty managing chronic health conditions.

• Increases health and safety risks by disturbing sleep and circadian rhythms and reducing time for family and non-work responsibilities.
• Can cause risks to employers that include reduced productivity and increased patient care errors, which negatively affect patients.
• Compared with regular day shifts starting after 7:00 a.m., risks for accidents and errors increase by 28% for night shifts and by 15% for evening shifts.
• Night shift nurses report inadequate sleep 60% more than day shift nurses.

• Increases exposures to hazards at work and reduces recovery times (e.g., working long work hours, particularly for musculoskeletal work, does not give the body time to recover from fatigue and can lead to musculoskeletal disorders).
• Linked to patient care errors and dissatisfaction because of inadequate communication, poor pain control management, limited staffing.

• Fatigue is the daily lack of energy and motivation (both physical and mental) and whole-body tiredness not relieved by sleep (Wedro, 2019).
• Healthy sleep, as recommended by the National Sleep Foundation, is 7 to 9 hours per night for adults, and is linked to feelings of wellness, good mental health and body weight, safety, and preventing infections and many types of chronic illnesses (Hirshkowitz et al., 2015).
• CDC recommends that adults aged 18-60 years sleep 7 or more hours per night; those aged 61-64 years sleep 7 – 9 hours per night; and those aged 65 and older sleep 7 – 8 hours per night.
• Getting less sleep than needed is called sleep deprivation, which can lead to fatigue. Sleep deprivation causes people to feel tired and sleepy. It can also cause a decline in brain functioning such as cognitive slowing, thinking, remembering, and concentration.
• Mistakes by fatigued healthcare workers can have broad-reaching negative effects ranging from care errors and irritability, to motor vehicle crashes during the work commute.

When fatigued, health effects can include:

• Unbalanced appetite hormones promoting overeating and obesity
• Impaired mental functioning, errors, and vehicle crashes
• Irritability, anxiety, depression, and poor communication
• Heart disease and cancer
• Disrupted insulin/blood glucose system (i.e., metabolism) promoting insulin resistance, diabetes
• Compromised immune functioning