Influence of nursing staff working hours on the stress level during the COVID-19 pandemic: a cross-sectional online survey

Background

Working as a nurse means being responsive and highly accountable 24/7 and to be able to offer high-quality care, specifically during pandemics. Studies have shown that the average number of working hours per week is a significant predictor of stress and that the severity of the COVID-19 pandemic has increased the nurses’ stress levels.

Objective

Therefore, we investigated (1) if a change had occurred in the nurses’ working hours during the COVID-19 pandemic as compared to the hours employed and (2) the influence of the nursing staff’s working hours during COVID-19 pandemic on the perceived level of stress.

Design

We used an online survey in this Austrian cross-sectional study, distributed using a snowball sampling method.

Participants and methods

In the online survey, we asked the nurses many relevant questions, including how many hours they are employed per week and how many hours they had worked on average per week since the outbreak of COVID-19. We used the Perceived Stress scale to measure stress level among these nurses. Data were collected between mid-May and mid-July 2020.

Results

Three-quarters of the 2600 participating nurses reported changes in their working hours during the COVID-19 pandemic. The nursing staff’s hours of employment were statistically significantly associated with their average number of working hours during the COVID-19 pandemic. About two-thirds of the nurses who were employed either less than 10 hours or for 31-40 hours worked for more than 40 hours. Most of the nurses experienced a moderate level of stress. We identified a statistically significant association between increasing the number of working hours per week and the nurses’ perceived stress level. In addition, 15% of the nurses who had worked more than 40 hours reported experiencing a high level of stress. In addition, we found that nurses who worked more hours during the pandemic experienced higher stress than nurses who reduced their working hours or kept the same working hours.

Conclusions

We found a statistically significant association between an increase in the nursing staff’s working hours and their level of stress. We believe that these results reflect the negative consequences of prolonged working hours. For this reason, a (inter-)national discussion is needed on the topic of restricting the working hours of healthcare workers during such pandemics. This discussion can improve the health and safety of the health care workers, the patients, as well as members of the general population.

Tweetable Abstract

Increasing working hours of nurses during COVID-19 pandemic is increasing their level of stress.

What is already known about the topic?

• The ability of the nurse to provide high-quality care is strongly associated with the health of nursing staff

• During COVID-19 pandemic, prolonged/irregular working hours may be appearing, to ensure continuity of the healthcare system.

• Such prolonged/irregular working hours can result in increased stress among nurses.

What this paper adds

• Three-quarters of the nurses reported changes in their working hours during the COVID-19 pandemic.

• About two-thirds of the nurses who were employed either less than 10 hours or for 31–40 hours worked for more than 40 hours.

• This study showed that an increasing number of working hours per week is increasing nurses’ perceived stress level.

• It also demonstrated that 15% of the nurses who had worked more than 40 hours experienced a high level of stress.