Content area
Full Text
Almost 3 million registered nurses (RNs) practice in the United States, representing the backbone of the American health care system (U.S. Department of Health and Human Services, Health Resources and Services Administration, 2010 ). In the hospital setting, RNs, or staff nurses, provide direct care to patients on a 24-hour basis. As such, staff nurses typically work long hours with infrequent meal periods or rest breaks, frequently resulting in fatigued providers (Rogers, Hwang, & Scott, 2004 ; Rogers, Hwang, Scott, Aiken, & Dinges, 2004 ; Scott, Rogers, Hwang, & Zhang, 2006 ; Trinkoff, Geiger-Brown, Brady, Lipscomb, & Muntaner, 2006 ). The purpose of this article is to describe the current trends in nurses' work hours, meal periods, and rest breaks in the hospital setting and, using an occupational health nursing lens, to explore measures that could improve the quality of nurses' work environments. Because occupational health nurses are often charged with addressing complex health and safety issues that affect employees, nurses represent a unique group of clinicians who can deliver care to hospital-based RNs.
Nurses' Work Hours and Schedules
Most nurses in the United States are employed in hospitals (U.S. Department of Health and Human Services, Health Resources and Services Administration, 2010 ) and are directly responsible for the safety of their patients (Kane, Shamliyan, Mueller, Duval, & Wilt, 2007 ). To supply this around-the-clock care, staff nurses traditionally rotated among three 8-hour shifts (i.e., day, evening, night). A nursing shortage in the late 1970s and early 1980s prompted a change in shifts to 10 or 12 hours (Josten, Ng-A-Tham, & Thierry, 2003 ). Today, the 12-hour shift is most common, generally starting at 7 (a.m. or p.m.) and ending at 7 (p.m. or a.m.). A 2009 American Nurses Association (ANA) poll of more than 14,000 nurses indicated that 59.4% of the nurses worked 12-hour shifts, with 20.7% working straight 12-hour nights (ANA, 2009 ).
The data regarding nurses' working hours are limited; however, available statistics indicate that nurses work long hours, with few breaks or meals, and frequently do not have enough time to rest between consecutive shifts (Rogers, Hwang, & Scott, 2004 ; Scott et al., 2006 ; Trinkoff et al., 2006 ). The Nurses...