# Unexplored dimension of shift work: the effects of late-early shifts on nurses and their wellbeing — a qualitative study

## TL;DR

This study explores how late-early shifts affect nurses' physical and mental health, leading to challenges in their work and personal lives.

## Contribution

The study provides new qualitative insights into the underexplored impact of late-early shifts on nurses' wellbeing in private hospitals.

## Key findings

- Late-early shifts lead to physical and mental health issues, unhealthy eating, and social challenges for nurses.
- Nurses may choose casual work or change roles to avoid late-early shifts due to their negative effects.
- Extended breaks and workload adjustments could help mitigate the negative impacts of these shifts.

## Abstract

To investigate nurses’ perceptions of the effects of late-early shifts on their overall wellbeing including physical and mental health.

Nurses work long hour shifts with short breaks in between to provide 24-hour care in a healthcare setting. Little is known about nurses’ perception of counterclockwise (CCW) rotating shifts, mainly the late-early shift. This study delves into nurses’ views on late-early shifts in three South Australian private hospitals.

An exploratory, qualitative design.

Four focus group interviews, each with five nurses from three private hospitals in South Australia, were conducted post-ethical approval. Qualitative data underwent manual thematic analysis using an inductive approach.

Participants reported impacts on physical and mental health, unhealthy food habits, and social and work environment challenges associated with late-early shifts. These effects may be mitigated through interventions like extended breaks between shifts, reduced workload, and additional support.

The late-early shift has detrimental effects on nurses’ wellbeing. This led nurses to opt for casual work, practice “quiet quitting,” or pursue nursing roles that accommodate their preferred shift schedules.

Research indicates that well-rested nurses provide quality patient care and improve health outcomes. Optimal scheduling and incentives play a vital role in enhancing nurses’ health and retention of the nursing workforce.

This paper explicitly explores the experience of nurses working late-early shifts in private hospitals in South Australia.

Not applicable.

•Shift work negatively affects nurses’ physical and mental health, leading to sleep disturbances, fatigue, and burnout.

•Fatigued nurses are more prone to errors and have diminished capacity to provide optimal patient care.

•Counterclockwise rotating shifts, such as the late-early shift, have been underexplored, particularly regarding their impact on nurses’ wellbeing.

•This study offers qualitative insights into the perceived effects of late-early (Counterclockwise rotating) shift on nurses’ physical and mental wellbeing, job satisfaction, and personal lives.

•Highlights how late-early shifts affect nurses’ shift preferences and employment decisions, helping build an evidence base for healthcare organisations aiming to address these challenges.

•Suggests possible interventions, such as longer breaks and shift scheduling adjustments, to mitigate the negative impacts of late-early shifts on nurse wellbeing.