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Updated: May 14, 2026

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments

Published on: August 8, 2019

Perceptions and observations of off-shift nursing.

Pamela B de Cordova¹, Ciaran S Phibbs, Patricia W Stone

¹Center for Health Outcomes and Policy Research, University of Pennsylvania, School of Nursing, Philadelphia, PA 19104-4217, USA. beckerp@nursing.upenn.edu

Journal of Nursing Management

|February 16, 2013

Summary

Registered nurses perceive challenges in off-shift hospital care due to fewer resources, despite collaboration and task completion. Management should ensure adequate staffing and support for night nurses to improve care quality.

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Last Updated: May 14, 2026

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments

Published on: August 8, 2019

Area of Science:

Nursing Care Quality
Hospital Management
Healthcare Delivery

Background:

Patients admitted during off-shifts (nights, weekends) experience poorer health outcomes.
The reasons behind worse off-shift patient outcomes remain unclear.

Purpose of the Study:

To qualitatively explore registered nurses' (RNs) perceptions of nursing care and quality during off-shifts compared to regular hours.
To understand the lived experiences of RNs working non-traditional shifts.

Main Methods:

Semi-structured interviews were conducted with 23 RNs.
Observations as participants were performed in medical-surgical and intensive care units.
Content analysis was used to identify key themes in nurse perceptions.

Main Results:

Six themes emerged: nurse collaboration, task completion, shift-specific work dynamics, staff composition, and feelings of under-appreciation.
Nurses reported working with diverse RN personnel during off-shifts.
Night nurses perceived a lack of appreciation for their work.

Conclusions:

Reduced resources on off-shifts may negatively impact the quality of hospital care.
Management should ensure sufficient ancillary staff and balanced experience levels.
Improved communication between day and night shift nurses can address feelings of under-appreciation.