Balancing preferences and constraints around nurses shift scheduling across healthcare organisations: a qualitative study

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Abstract

Aim

To understand how preferences and constraints of nursing staff, nurse managers and hospital directors interact and influence decisions around nurse shift patterns

Background

Globally, many nursing staff have expressed intention to leave the profession and high levels of stress and burnout. Shift patterns are often cited as a key driver of negative nurse outcomes. How preferences and constraints of staff groups involved in nurse shift scheduling interact to shape decisions remains unexplored.

Design

Qualitative study. We interviewed 17 nursing staff, 5 nurse managers and 6 hospital directors.

Methods

Staff were recruited through 5 NHS Trusts based in the North, Midlands, East and South of England. The results were analysed using inductive and deductive framework analysis.

Results

Three themes were identified that influenced nurses’ decisions for shift scheduling: 1/ Balancing Choice with Consistency, Predictability and Flexibility; 2/Adequate Rest and Recovery Between Shifts; and 3/Enjoyment and Engagement at Work. There was a meta-theme of conflicting priorities for shift scheduling between nursing staff, nurse managers and hospital directors across these three themes.

Conclusions

Different priorities for shift scheduling of nursing staff, nurse managers and hospital directors created potential or actual conflict. Solutions appeared to consist of compromises where priorities of different staff groups were simultaneously upheld to an acceptable level. This occurred through collaborative interactions across staff groups.

Implications for Practice

Nursing staff, nurse managers and hospital directors can facilitate choice and flexibility and navigate conflicts in nurse shift scheduling through collaborative approaches that enhance awareness and effective communication.

Reporting Method

Qualitative data was reported using the EQUATOR checklist COREQ. No Patient or Public Contribution

What does this paper contribute to the wider global clinical community?

Collaborative approaches can influence conflicting priorities of staff groups in relation to nurse shift scheduling.

Staff understanding other staff priorities for nurse shift scheduling enhances awareness.

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