NIOSH Training for Nurses on Shift Work and Long Work Hours

Workload Level Analysis

Workload level analysis can determine historical trends in patient care workloads across the 24 hour day, the days of the week, and the seasons. Knowing these predicted patterns, you can design proportional staffing schedules to fit staffing levels with workload peaks. This may help reduce the need to call nurses on short notice to work unplanned work shifts.

Consider developing policies to reduce risks, minimize buildup of fatigue, and maximize recovery that address these topics:

• Procedures to follow when a worker is too fatigued to work
• A backup staffing plan when people are unable to continue working
• Restrictions on shift length and how much and when overtime can be worked
• Protecting recovery days
• Identifying and modifying policies that encourage excessive overtime
• Exploring flexible scheduling options and shorter shifts.

Several studies report shift work and long work hours increase the risk for drowsy driving crashes and near misses.^27-29 Consider instituting organizational strategies to reduce this risk:

• Targeted education campaigns for managers and nurses
• Procedures to identify nurses at risk and possible action steps
• Procedures to arrange transportation home for nurses who are excessively fatigued after a work shift (a small fund for transportation can save a life)
• Off-duty sleeping rooms close to the worksite.