Long shifts, understaffing and working in teams with a higher proportion of unregistered staff have been linked to greater sickness absence among nurses.
The new research from the University of Southampton was based on data from four acute care hospitals in England and more than 18,000 registered nurses and nursing support staff.
“Our findings are significant because the nursing workforce is under increasing pressure”
Chiara Dall’ora
It covered an almost five-year period between April 2015 and February 2020.
The researchers, including Dr Chiara Dall’ora and Professor Peter Griffiths, wanted to see if there were any links between sickness rates and factors such as skill-mix, understaffing and shift length.
They found that registered nurses working repeated long shifts were more likely to experience sickness absence in the following week.
The research, published in the journal JAMA Network, revealed a 26% increase in the odds of a registered nurse reporting in sick when their shifts are all 12 hours or longer in the preceding seven days, when compared to nurses working no long shifts at all.
In terms of skill mix, the academics found that the higher the proportion of registered nurses on a ward, compared to nursing support staff, the lower the sickness rates among nurses.
Specifically, for every 10% increase in the proportion of registered nurses on shift, there was a 2% reduction in incidents of nurse sickness.
They also noted that registered nurse understaffing was “associated with sickness absence” among nursing support staff during the following week.
For registered nurses, the link between nurse understaffing and sickness was observed among full-time nurses but not part-time nurses.
Nursing support worker understaffing was not associated with sickness absence for any staffing group.
Interestingly, the research also suggested that having bank staff fill in staffing gaps could protect against sickness among both nurses and nursing support staff.
The researchers concluded: “This retrospective case-control study found that exposure to [registered nurse] understaffing increased the risk of sickness absence in nursing teams.
“Adverse working conditions for nurses, already known to pose a risk to patient safety, may also create risks for nurses and the possibility of further exacerbating staff shortages.”
Lead investigator Dr Dall’ora said: “Our findings are significant because the nursing workforce is under increasing pressure, with not enough nurses entering the profession, and many leaving their jobs due to stress-related sickness and burnout.
“We hope our work can help inform those in charge of planning workforce strategy and scheduling.”
Co-author Professor Griffiths added: “Increasing registered nurse staffing levels has been associated with improved outcomes for patients and could be a cost-effective strategy for improving the quality and safety of care.
“Our study adds to this body of evidence by shining a light on the additional impact on nurses’ health and wellbeing.”
