Healthcare Workers' Perspectives on 24-h Shift Work in Latvia: A Cross-Sectional Study

Background/Objectives: Prolonged working shifts may adversely affect healthcare workers' health, well-being, cognitive performance, and patient safety. Nevertheless, 24-h shifts remain commonly used in Latvian healthcare. This study aimed to examine healthcare workers' experiences of 24-h shift work, their attitudes toward revising this work schedule, and the main reported reasons underlying their preferences. Methods: A cross-sectional survey was conducted in Latvia between October 2025 and February 2026. A structured 64-item questionnaire assessed sociodemographic and professional characteristics, workload, shift patterns, health and emotional well-being, perceived patient-safety concerns, professional motivation, and attitudes toward alternative work schedules. Of 1524 submitted questionnaires, 1318 were included in the analysis. Quantitative data were summarized using descriptive statistics, while open-ended responses were examined using qualitative content analysis. Results: Most respondents regularly worked extended shifts, and 40.5% worked at more than one institution. More than half reported health changes that they perceived as potentially related to extended shift work, with 61.1% reporting emotional exhaustion and 49.2% reporting persistent fatigue. Fatigue during extended shift work had contributed to a self-reported error or perceived decline in care quality among 34.9% of respondents. Despite these concerns, a substantial proportion of participants preferred to retain 24-h shifts. Frequently reported reasons included schedule convenience, consecutive days off, financial considerations, and the ability to combine employment across multiple workplaces. Open-ended responses further highlighted preferences for flexibility, employee choice, adequate staffing, opportunities for rest, and consideration of financial consequences when revising work schedules. Conclusions: The findings demonstrate a tension between healthcare workers' perceived health and patient-safety concerns associated with extended shift work and the practical and financial advantages associated with retaining 24-h shifts.