Under pressure - Nursing staff's perspectives on working hours and recovery during the COVID-19 pandemic: A qualitative study

• Published in: International journal of nursing studies advances Vol. 7; p. 100225
• Main Authors: Hernandez, Isabelle, Söderström, Marie, Rudman, Ann, Dahlgren, Anna
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.12.2024; Elsevier
• Subjects: COVID-19; Fatigue; Nursing; Occupational stress; Personnel management; Shift work schedule; Sleep; Work-Life balance; COVID-19; Occupational stress; Work-Life balance; Nursing; Sleep; Shift work schedule; Personnel management; Fatigue
• ISSN: 2666-142X; 2666-142X
• DOI: 10.1016/j.ijnsa.2024.100225

The COVID-19 pandemic contributed to increased pressure on healthcare systems. During periods when the demands exceed the capacity of healthcare organizations, adaptive strategies are used to meet these demands. During the COVID-19 pandemic, working hours for nursing staff were reorganized and extended. This has posed challenges for recovery, which may be a key factor for maintaining health and safety under such conditions. The aim of the study was to bring insights into how nursing staff perceived their working hours and recovery during the COVID-19 pandemic, and if they experienced any changes in their sleep and well-being. A qualitative descriptive design was chosen, as it is suitable for gaining insight into perceptions and experiences. Qualitative semi-structured interviews were conducted using an interview guide. The interviews were analyzed using thematic analysis. Sixteen registered nurses and six certified nursing assistants from four Swedish hospitals participated in the study. The organization of working hours during the COVID-19 pandemic was considered suboptimal and resulted in more demanding working hours and poor recovery. Nursing staff experienced loss of control as they lost influence over working hours, working hours became more unpredictable and the boundaries between work and leisure became blurred. Nursing staff also experienced a decline in their health and well-being, including extreme fatigue, impaired sleep and physical/mental changes. The strategies used by healthcare organizations to meet increasing demands during the COVID-19 pandemic contributed to impaired recovery and well-being of nursing staff, which could generate negative feedback loops contributing to depletion of resources at the organizational level. What is already known•Overtime, long working hours and night work have been associated with health and safety risks.•Organizations can flex their human resources by extending working hours when under pressure.•Recovery may be a key factor for preventing adverse consequences of demanding working hours and job stressors.What this paper adds•Suboptimal organization of working hours during periods of increased pressure can lead to loss of control and negatively impact sleep and well-being among employees.•Lost control over working hours and free time can contribute to poor recovery and ill-health.•Short-term organizational-level strategies used during the COVID-19 pandemic contributed to negative consequences at the employee-level, which could have a wider system impact.