Choice and consistent shift patterns could improve nurses’ work-life balance

Research by the University of Southampton has found nurses value both choice and consistency in their shift patterns to help balance work with commitments in their home life. Providing a good work-life balance is one way of helping to retain nurses in the NHS to ensure safe levels of care at a time of large shortfalls in staff.

The study showed that only 50 percent are satisfied with the roster pattern they work, with the rest either dissatisfied or uncertain either way. Day shifts are associated with the most satisfaction and rotating shifts with the least. It also found that 68 percent of nurses feel their shifts are mostly or completely determined by their employer.

The comprehensive survey of over 850 nurses aimed to gain an in-depth understanding of their thoughts about working patterns.

The research was conducted between June and October 2021 across two NHS trusts and by directly appealing for participants via nursing unions and journals. It examined shift length, time, rotation, rest and days off.

Full findings are published in the Journal of Clinical Nursing.

Results from qualitative responses in the survey emphasised the importance of rotas that are consistent and predictable. Many nurses expressed they should know what they are working long in advance - preferably six weeks or more - and disliked shift patterns being dictated purely by staffing needs. Over 100 nurses raised concerns over caring for children and elderly relatives, with many suggesting that consistent rotas helped them plan.

Also, nearly 200 nurses highlighted the importance of well scheduled days off, perhaps in blocks of two or three, to allow them to recover physically and emotionally - particularly when switching between night and day shifts. Many believed their switch around time was too quick.

"We undertook a broad and deep examination of nurses’ usual way of working," comments lead author Talia Emmanuel. "We looked in detail at how long, short and rotating shifts impact nurses’ lives. The study compared the everyday reality of ward schedules with the kinds of patterns staff would prefer to be working.

"Although long and rotating shifts were the least popular, the results weren’t completely clear cut. They still held some advantages for certain groups of nurses, suggesting there is room for improvement when it comes to balancing satisfaction with shifts and the everyday needs of wards and patient care."

In fact, the research found that many nurses saw some advantages to long shifts, associating them with lower travel costs and more chances to gain paid overtime. However, they also associated shorter shifts with a healthier diet and exercise - perhaps raising the question as to whether for some, cost of living is an influencing factor in shift choice.

Study co-author, Professor Peter Griffiths , says: "Incorporating individual preferences into rotas is undoubtedly a difficult task, particularly with staffing pressures. Ward managers have to balance safety, patient care and fair consideration of requests across their workforce. However, with the aid of modern rostering software, it may be possible to provide a greater level of shift satisfaction for nurses, improving their wellbeing and work-life balance, without compromising the quality of care."

The research was funded by the NIHR Applied Research Collaboration Wessex and the lead author is supported by the UKRI Economic and Social Research Council South Coast Doctoral Training Partnership.