The association between shift scheduling and burnout, insomnia, and wellbeing in critical care nurses

Critical care nurses provide patient care 24 h a day, through shift work, which can have negative effects on nurses' health and wellbeing and patient outcomes. The high-stress nature of critical care areas requires nurses to have adequate rest between shifts to ensure safe, high-quality care. Quick returns (QRs), such as returning to the next shift in less than 11 h, may not provide sufficient rest time; however, it is not yet known whether this impacts critical care nurses' health and wellbeing.

The objective of this study was to determine the association between shift scheduling and burnout, insomnia, and wellbeing in Australian critical care nurses.

A descriptive and associational study was conducted. Australian critical care nurses were invited to participate in an online survey. The survey included sociodemographic and work characteristics including shift scheduling, the Burnout Assessment Tool (BAT), and the Bergen Insomnia Scale (BIS). Mann-Whitney U-tests and t-tests were used to investigate associations between QRs and burnout, insomnia, and wellbeing. Additionally, an open-ended survey question allowed nurses to share their perceptions of QRs.

Surveys were completed by 532 critical care nurses. BAT dimension and total scores and BIS scores were significantly higher among nurses who reported QRs than in those who did not: Exhaustion mean: 3.53 vs 3.35, p = 0.003; Mental Distance: 2.91 vs 2.75, p = 0.016; Cognitive Impairment: 2.49 vs 2.34, p = 0.001; Emotional Impairment: 2.35 vs 2.19, p = 0.007; Secondary Symptoms: 3.04 vs 2.91, p = 0.039; total BAT score: 2.9 vs 2.8, p = 0.004 and BIS Insomnia symptoms: 25.51 vs 23.50, p = 0.035. Open-ended responses revealed concerns about personal health, fatigue, and risk to patient safety.

Critical care nurses are exposed to significant occupational stressors that may impair their health and wellbeing. The removal or reduction of QRs from rostering schedules may have substantial benefits for nurses and the safety and quality of patient care.