The independent and interactive effects of changes in overtime and night shifts during the COVID-19 pandemic on burnout among nurses: a longitudinal study

Jul 6, 2024Scandinavian journal of work, environment & health

How changes in overtime and night shifts during COVID-19 relate to nurse burnout over time

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Abstract

Nurses in the high overtime group reported 4.33 points higher emotional exhaustion compared to those with stable low overtime.

High overtime is linked to elevated levels of emotional exhaustion, depersonalization, and reduced personal accomplishment among nurses.
Nurses who increased night shifts reported lower emotional exhaustion compared to those with no night shifts, but this effect was only seen in those with stable low overtime.
Increases in night shifts are associated with higher depersonalization and poor personal accomplishment in nurses already experiencing high overtime.
Findings suggest that high overtime is an independent risk factor for burnout, indicating a need for targeted interventions.

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OBJECTIVES: This study aimed to evaluate the independent and interactive effects of changes in overtime and night shifts on burnout among nurses during the COVID-19 pandemic.

METHODS: Nurses working in an Italian university hospital (N=317) completed the Maslach Burnout Inventory in September 2019 and again in December 2020. Based on hospital administrative data, changes in overtime and night shifts in the same years were categorized into three groups each. Linear regressions were used to estimate 2020 burnout differences between exposure groups, controlling for 2019 burnout levels, demographic and work-related characteristics, and to test the interaction between the two exposures.

RESULTS: Nurses in the onset of high overtime group had higher emotional exhaustion [4.33, 95% confidence interval (CI) 1.74-6.92], depersonalization (2.10, 95% CI 0.49-3.71), and poor personal accomplishment (2.64, 95% CI 0.55-4.74) compared to stable low overtime nurses. Nurses in the increase in night shifts group had lower emotional exhaustion (-4.49, 95% CI -7.46- -1.52) compared to no night shift nurses. Interaction analyses revealed that this apparently paradoxical effect was limited to stable low overtime nurses only. Moreover, increases in night shifts were associated with higher depersonalization and poor personal accomplishment in nurses in the stable high overtime group.

CONCLUSIONS: Increase in overtime is an independent risk factor for burnout among nurses, highlighting the need for specific regulations and actions to address it. Long-standing guidelines for the assignment of night shifts might have contributed to attenuate the impact of their increase on nurses' mental health.

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The independent and interactive effects of changes in overtime and night shifts during the COVID-19 pandemic on burnout among nurses: a longitudinal study

Abstract

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