Shorter Shifts as a Nurse Retention Strategy

Introduction

Nurse turnover is one of the main problems in healthcare that is only growing exponentially over the years. Especially with the coronavirus pandemic hit in 2020, nurses have become even more of a valuable resource to society because they provide vital care to patients. The approach to this problem should be complex, which means one change in the system cannot improve the current state of nurses’ employment. However, reducing shift hours and employing more nurses can significantly improve the quality of the provided care and discourage nurses from changing their job.

Nursing is known for its exhausting and non-stable working schedules. Nurses often have to deal with working more hours without pay. Moreover, working conditions are stressful and life-risking because they usually treat people with infections or other contagious illnesses. Lockhart (2020) reports that 18% of “nurses change jobs or even profession within the first year after graduation” (p. 56). Moreover, one-third of American nurses leave their job within two years (Lockhart, 2020). The remaining ones may not operate at a total capacity while working with patients due to the exhaustion from stressful working conditions. Heidari et a. (2017) state that 98.9% of nurses “consider attention to requesting shifts of employees as an important psychological factor” (p. 1468). A good approach to this problem would be shift reduction to encourage the nurses to stay in the professional field.

Strengths

The SWOT analysis is implemented to measure the effectiveness and utility of the proposed change. Ball et al. (2017) conducted research that examines the relationship between shift length and nurses’ satisfaction with their job. This study helps estimate the reasons for nurses’ turnover and suggests an alternative to the traditional nurse shift schedule. The results showed that nurses who work more than twelve hours during one shift are more likely to leave care undone, which poorly affects healthcare quality (Ball et al., 2017). Moreover, these nurses were less satisfied with their work. Dissatisfaction with the job can discourage nurses from continuing their careers. Meanwhile, “the amount of self-reported poor quality of nursing care was lower amongst nurses working eight hours or less (15.9%) compared to those working longer hours (20.0 to 21.1%)” (Ball et al., 2017, p. 4). These statistics call for a change because the reduced working hours can significantly improve healthcare quality and decrease the rate of nurse turnover.

Weaknesses

However, there is not enough research on the long-term effects of reduced shift time. Ball et al. (2017) warn that their study lack objective assessment since the data was based on the surveys taken by the nurses, who could misreport the quality of their work. Moreover, a shorter shift is an unusual practice, and some nurses might be skeptical about the new change because they are used to the old schedule. Such change implies reduced costs for organizations that operate on an hour-pay system, which might even increase the number of nurses changing their job. A healthcare organization must spend considerable time researching and reconstructing the existing schedule and hiring new nurses to compensate for the deducted hours. Despite the modern care in the United States is intensive-oriented, often times patients’ health depends on the hours spent with the care. In other words, intensive treatment might not be as effective as a prolonged observation of a patient during an extended shift.

Opportunities

In the face of the COVID-19 pandemic, many educational facilities switched their teaching mode to an online format. Such change created more opportunities for people who want to study nursing but could not access a traditional form of education, such as people living in remote areas. Online learning will increase the number of registered nurses with degrees, which in turn will increase the workforce pool.

Threats

Since the reduced work shifts call for more nurse practitioners employed in an organization, the demand for nurses increases, which is an external threat. According to Carson-Newman University Online (2021), “there will be a 55,000 plus shortage of primary care physicians by 2032,” making the healthcare facilities depend on the nurses they have already employed. Therefore, introducing this change proposes a risk of hiring nurses that are not qualified for the job and may endanger patients’ lives. Moreover, an increased number of employees requires more wages, which is not economically beneficial for a medical organization. If the organization decides to hire more employees, it would have to reduce the wages. Wage reduction may discourage nurses from developing their careers; therefore, this change may negatively affect nurse retention. Among the internal threats, nurses, who will work shorter shifts, may experience additional pressure since they will have to demonstrate better results in a lesser time.

Conclusion

In conclusion, it is difficult to determine whether the change in schedules should be implemented due to the costs and workforce complications. Despite the increased quality of nursing care achieved during shorter shifts, there are few opportunities to allow a successful introduction of this change. The nursing field requires thorough research that would estimate the long-term effect of the reduced shifts on an organization’s both medical and economic aspects.

References

Ball, J., Day, T., Murrells, T., Dall’Ora, C., Rafferty, A. M., Griffiths, P., & Maben, J. (2017). A cross-sectional examination of the association between shift length and hospital nurses’ job satisfaction and nurse-reported quality measures. BMC Nursing, 16(1), 1-7. Web.

Carson-Newman University Online. (2021). 21 nursing trends we expect to see in 2021 (updated). Web.

Heidari, M., Seifi, B., & Gharebagh, Z. (2017). Nursing staff retention: Effective factors. Annals of Tropical Medicine and Public Health, 10(6), 1467-73. Web.

Lockhart, L. (2020). Strategies to reduce nursing turnover. Nursing Made Incredibly Easy, 18(2), 56. Web.

Sullivan, E. J. (2012). Effective leadership and management in nursing (8th ed.). Pearson.