NIOSH Training for Nurses on Shift Work and Long Work Hours

Module 5. Work Organization Strategies to Promote Alertness and Health in Nurses


Employers and managers have the responsibility to set up workplace systems that reduce risks linked to fatigue. Without appropriate organization of work, nursing staff can have difficulty getting adequate sleep and recovery from work. This is due to several factors:

  • Poorly designed work schedules increase misalignment of the time available for sleep and the worker’s circadian rhythms (discussed in Module 2). As a result, nursing staff will be less able to get enough good quality sleep.
  • Inadequate time off between work shifts prevents nursing staff from getting the 7 to 8 hours of sleep each day that most people need.1
  • A poor psychological work environment causes undue work stress which interferes with sleep.

Inadequate sleep leads to poor performance on the job and other negative effects discussed in Modules 2 and 3.

The Joint Commission, the American Nurses Association, and work schedule experts advise employers and managers to implement organizational strategies to reduce the risks from shift work and long work hours.2-5 Both management strategies (discussed in this Module and Module 7) and individual worker strategies (discussed in Modules 6 to 11) are needed to reduce these risks.

Module: 5, Page 1 of 20
Page last reviewed: March 31, 2020