Nurse rostering: understanding the current shift work scheduling processes, benefits, limitations, and potential...

Area of Science:

• Healthcare Management
• Occupational Health and Safety
• Nursing Practice

Background:

• Effective shift work schedules are crucial for mitigating sleep impairment and fatigue in healthcare workers.
• Organisations have a responsibility to implement measures to reduce staff fatigue and associated occupational health and safety risks.
• Assessing current nursing rostering processes is essential for identifying areas of improvement.

Purpose of the Study:

• To identify who creates nurse rosters and the processes involved.
• To evaluate the training and knowledge of rostering staff regarding sleep optimization and staff well-being.
• To determine the benefits and limitations of existing rostering practices.

Main Methods:

• Semi-structured interviews were conducted with 24 nurses responsible for rostering.
• Interviews were conducted across three sites in Victoria (metropolitan and regional/rural).
• Data analysis employed cluster coding and thematic analysis, guided by grounded theory principles.

Main Results:

• Rostering staff reported being unprepared, unaware of fatigue guidelines, and lacking formal training.
• Self-rostering was common, allowing staff to submit preferences, but concerns about fatigue persisted.
• Responsibility for managing fatigue was divided, with some believing it was up to individual staff preferences; cultural barriers to change were also identified.

Conclusions:

• Self-rostering offers flexibility but may lead to shift preferences driven by lifestyle rather than fatigue minimization and safety.
• Enhanced consideration of shift work's impact on fatigue is necessary within healthcare organizations.
• Clinical governance structures must be strengthened to minimize occupational health and safety risks for direct patient care providers.