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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Compressed Work Shifts put Nurses, Patients at Risk

By Gary Evans, AHC Media Senior Staff Writer

Nurses appear to be at higher risk of injury as they suffer a kind of cumulative fatigue and diminishment in balance and reactions working “compressed” shifts, researchers report.1

Regardless of day or night shift, nurses working three 12-hours stints within a four-day period showed measurable diminishment in motor skills and increase in musculoskeletal disorders. The overall effect of this fatigue heightens risk for injury by slips and falls while putting patients at risk of medical errors.

“Evidence is mounting that the more rigorous work schedules yield unfavorable effects on the worker and on the quality of care,” says lead author Brennan J. Thompson, PhD, assistant professor of kinesiology at Utah State University in Logan, UT. “More effort is needed to regulate the volume of work performed within a given time period. Some researchers have put forth evidence that the 12-hour shift schedules are a major part of the problem, and suggest that shorter work shifts would help resolve some of the poor health- and work-related issues of the nurse. If the 12-hour shift schedule is unable to be avoided, efforts should be made to spread the work shifts across a longer time period allowing greater recovery between shifts.”

For example nurses, may consider spreading their shifts across a greater number of days, such as working three shifts over a 5-7 day period.

“It may be prudent for nurses to work no more than 2 shifts in a row and to allow a minimum of 2 days of recovery days off following 2 work shifts,” he says. “Where fatigue and ultimately burnout occur, is when there is an imbalance of work volume performed relative to recovery.”

For successive shifts – two or more -- one day off for recovery is likely insufficient to restore performance, which is a scenario, if routinely performed that may lead to chronic fatigue and impaired mental and physical performance on a long term basis, he warns.


1. Thompson BJ, Stock MS, Banuelas VK, et al. The Impact of a Rigorous Multiple Work Shift Schedule and Day Versus Night Shift Work on Reaction Time and Balance Performance in Female Nurses: A Repeated Measures Study. Jrl Occ Environ Med 2016;58(7):737-743.

For more on this story see the September 2016 issue of Hospital Employee Health.