The effects of shift type and consecutive shifts on U.S. hospital nurses’ occupational patterns of physical activity, sedentary behavior, and momentary fatigue

Nurses represent the largest workgroup within the health care system, and nursing work is psychologically and physically demanding. The complexity and multidimensional nature of nursing work may lead to fatigue, and previous studies have linked work factors (e.g., total working hours, shift length, night shifts) to nursing fatigue. We currently do not understand nurses’ patterns of physical activity (PA), sedentary behaviors (SB), and fatigue during a 12-hour shift. We conducted a study to examine the relationships between nurses’ work schedule characteristics, fatigue, and occupational patterns of PA and SB.

A total of 80 hospital nurses working 12-hour shifts (day and night) participated in this study. Participants’ personal, organizational, and health-related factors were surveyed at baseline. Nurses’ step count, sitting-, standing-, walking-time were measured for 14-days using an activity monitor. We used a 2-way texting platform to assess nurses' fatigue levels during a shift (0 – ‘not at all’ to 10 – ‘very’).

Nurses spent significantly more time standing and walking, and less time sitting during a day shift, compared to a night shift. Regardless of shift type, we observed a significant rise in fatigue among nurses over the course of a shift; however, the rise in nursing fatigue was significantly attenuated during day shifts, compared to night shifts. Also, our findings suggest that when nurses work day shifts, they are more physically active, and additional walking appears to increase nursing fatigue. Conversely, nurses are more sedentary during night shifts, and additional walking appears to reduce fatigue among nurses working 12-hour shifts.