Index IntroductionNurse Engagement in Nursing WorkloadImplications for Patient CareResearchResearch StrategyLiterature ReviewChoosing a Critical Appraisal ToolAnalyzing a Critical Appraisal ToolReferencesIntroductionThe purpose of this article is to to explore, analyze and evaluate an area of ​​practice that has changed and transformed the role of the nurse, the nursing commitment since I last practised, seven years ago. In this case we are talking about changes in the length of the shift, which previously consisted of half days and two hours less on the night shift compared to today, which is twelve and a half hours with an hour's break. It is important to note that in some special circumstances, flexible working hours may be granted for health reasons, childcare issues and other extenuating circumstances. To fully comply with professional guidance and the Data Protection Act (2018), confidentiality will be maintained and the information provided will not identify departments or locations (Dimond 2015; Nursing and Midwifery Council 2018). Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay Nurses' commitment to nursing workload In an effort to recognize the effect of shift work on nurses, studies have been undertaken which include a wide range of evidence (Ball J. & Pike G 2009) . By implementing flexible working methods that encompass the variety of a nurse's life, it is no surprise that shift patterns have had an effect on nurses and their retention in the workplace (Middleton 2018; Brooks, 2000). Further evidence shows that employee-friendly shifts are improving retention, encouraging recruitment, return to the profession, engagement and reducing absence. However, even with the information available, some institutions have decided to implement twelve and a half hour shifts as the basis for nurse recruitment, which seems contrary to some findings with a growing concern for the quality of care (Stimpfel A. & &). Aiken L 2013). The certain unpopularity of working longer shifts (among numerous other variables) may be an indicator for considering work-related "job satisfaction" and "well-being" in some circumstances. Working as a hospital nurse generally involves long working hours and potentially unpopular shifts, and taking a job in an area of ​​interest where long working days are considered the "norm" can become a matter of acceptance. The impetus for the change may be due to funding, as it appears that starting at 7am and finishing at 7.30pm "doesn't fit" into the unsociable hourly wage (when before the change, working a night shift and finishing at 9pm :30 would have given 1.5 hours of work). unsociable salary). The need to work longer hours changed about seven/eight years ago and it would have been interesting to investigate how many nurses had some form of complaint or resistance to the change. It would have been helpful for this document to research the amount of complaints/resignations/early retirements/etc., as specific data is not available. As stated, a previous study was undertaken to investigate shift patterns, suggesting that further improvements are needed in the well-being and effectiveness of the nursing population with effective shift work management and approach to this. This became more evident as a student returned to practice during my clinical placement and, by directly asking the question to colleagues,it appears that a longer working day is not necessarily a disadvantage for all individuals, as the opportunity to work longer shifts will benefit some nurses and for them many problems that others face may be less (Pryce, 2016). When the change occurred, some nurses may have perceived it as a lack of choice over a crucial aspect of their lives, such as not being able to work their preferred shift pattern or being rotated into an unfamiliar environment when a department was not could/wouldn't welcome them. It Could Mean Something Harmful The effects of longer shifts were more likely to negatively affect them specifically, with the influence on shift patterns being positively associated with their nursing commitment. Further research found that nurses were no more likely to increase their daily working hours or request a change in working hours if it impacted their relationships or personal lives Lin, Liao, Chen, and Fan, ( 2014). Any evidence collected should be further examined based on other variables. Meaning what. The department where the nurse worked, particular mood, events of the day, attendance time, age, health, experience and many more. Interestingly, age, or at least experience, seemed to play a role in how satisfied nurses were with working longer hours. Some senior nurses seemed more receptive to change and this may be due to a number of factors such as less family commitment (adult children), not wanting to change environments and greater satisfaction in what they are doing (Letvak, Ruhm, & Gupta, 2013 ). RCN employment surveys have been completed since 1988 and, usually with a response rate greater than fifty percent, find that longer shifts should consider the nurse's personal feelings with many nurses' job satisfaction and related shift duration. A longer shift combined with an excessive workload could decrease levels of job satisfaction, making it less likely that you will remain in your situation. It was also found that the level of independence and involvement in shift decision making was predictive of job satisfaction. This suggests that a nurse is more committed to their company or organization where they work if they have more flexibility during their shift, which in turn can lead to a rotation that allows them to choose a system that is less harmful to their health and their private lives. (RCN Nursing Employment Survey 2017). Also in the survey, the RCN found that 41.9% compared to 34.4% strongly disagree/disagree that they are able to balance their home life effectively, while, interestingly, almost 50% said they strongly agreed/agreed that they were satisfied with their choice of shift length. . There were 7,720 responses deemed usable for data analysis. It recognizes that physiological and social problems related to longer shifts could hinder efficiency and effectiveness of performance, impacting individual workers, patients and employers. These factors can influence an individual's reaction to changing jobs, with 37% considering a change, up from 31% in 2015. It has also been found that nurses tend to associate their job as "rewarding" (73 .6%) but working longer sometimes makes it 'unpleasant'. Bogossian, F., Winters-Chang, P., & Tuckett, A. (2014) imply that occupations that are perceived (potentially inaccurately)as involving unpopular working hours are rarely a first-choice occupation at any age and when nurses have the choice of different shift patterns that corresponded to their family responsibilities stress levels occurred (although this is not so unexpected as working in a hospital environment would logically be “challenging” anyway) making their attitude and commitment to longer shifts more favorable. Implications for Patient Care As a nurse who used to work half days, but now works twelve and a half hour shifts, it would be fair to say that tiredness is a factor and one should ask whether a longer shift, combined with additional fatigue, is really a way to provide patients with effective care. It stands to reason that a patient will view their care negatively if a nurse is irritable and tired, and the impact on the patient's health may be compromised by an overworked or exhausted nurse. Studies have been undertaken to examine the relationship between longer working hours and its impact on patient care and mortality rates, many of which have found a link between longer shifts and quality of care (Griffiths P, Dall' Ora C, Simon M, et al, 2014). ). In their European study, it was found that there was more nurse fatigue, patient safety was compromised and more work was left undone as working longer hours would appear to be detrimental to care outcomes. Since fatigue is common on longer shifts, it would be helpful to find a way around this, such as not working more than two long days at a time or switching straight from long days to successive nights, for example. It would be assumed that the nurses' shift would be sensible as it would not consist of three long days immediately followed by nights as it could be argued that this would exhaust a nurse and have potential implications for - the only 'positive' would be continuity of care. There may be examples of annual leave where the nurse would like to 'condense' a working week to have an extended holiday, where it may be a matter of 'getting through it' just to achieve this, but again this leads to the situation anticipating the implications for the patient. You would at least expect the department manager to question this and consider how this would promote 'safe practice' as patient care should be at the heart of any shift decisions. Having a reduced and longer number of shifts would result in fewer handovers and decreased overlap between shifts and, from the manager's perspective, this could be seen as a 'positive' in terms of patient care , with greater continuity of care and much fewer "new faces" for the patient to get used to. From an employment perspective, working more days would give the nurse (theoretically) more days off and perhaps less travel expenses. Working longer shifts could lead to a problem with a loss of concentration which could lead to medication errors putting the patient at risk – obviously, errors are made anyway, but a fatigued and stressed nurse may have the potential to make more errors. Add to all this the fact that a tired nurse working long hours may not be entirely complicit when it comes to observing all the correct procedures when dealing with issues such as infection control policy or sharps, which once again puts the patient at risk. These are speculative "matters", with many variables such as the individual attitude of the nurse, the number of sick patients to be treated - but they could allhave a major factor when longer working hours and fatigue enter the equation. ResearchResearch is an important part of nursing as it makes a difference to the quality of education, care and practitioners should adhere to evidence-based practice. How to search for information that is "relevant" and of a "good standard" is very important as certainly not all articles are worthy and, especially on the Internet, can be very biased especially if a product is being introduced or attempting to be sold. You need to check the limitations and weaknesses of many articles with the ability to search, read and review important clinical research documents. Examination of an item involves a balanced judgment of its values ​​and merits. It should not be thought of as "focusing" on the negative aspects of the item, but rather as recognizing and deciding on its qualities and shortcomings. Search strategy The search was carried out using databases such as Cochrane (although this returned a small number of results with the chosen search criteria), Google Scholar and Cinahl (using the free trial). The university library was also accessed to collect relevant literature. Some examples of keywords used during the search were “nurse(s)/nurses/shift length/hours of work/patient care.” Additionally, some reference books were used, but the books date quickly. The overall search yielded limited results with a search period ranging from 2015 to 2019. It was decided that while the search should be as current as possible, a larger time frame was needed. The search was then extended to 2009 – 2019. Further search methods consisted of a manual exercise of viewing journals such as Journal of Advanced Nursing, Nursing Standard etc. Extending the search to the World Wide Web using Google Scholar as the search engine revealed the search targeting, among others, health issues related to nursing and hard shifts were indexed under several hundred authors and related to social issues /household, depression, injuries, impact of patient care, and job retention/satisfaction. Once you have “narrowed” your search, it is even beyond the scope of this article to review all available literature. Literature Review A literature review examines and summarizes articles on a chosen topic; this is an essential step in any research process. It should be done to find out what has already been written and researched on the chosen topic, this way the research will not be repeated unnecessarily. Some articles were researched using a quantitative method, while other articles took a qualitative approach. It has been established that there are many topics regarding qualitative and quantitative research and that one research method is not superior to the other, what is of great importance is that the chosen research method is appropriate for the purpose of the study. The articles reviewed had a clear title structure that addressed the chosen research area. The titles indicated that they were all relevant to the research area, while the authors of the literature reviewed held a range of qualifications ranging from PhD, MSc and BSc and associated with medical and/or business/management. Some authors provided evidence that influence on shift patterns and realization of the preferred shift pattern were positively associated with nursing commitment, although not all evidence reviewed was considered 'strong' - Participant inclusion in some studies may be distorted as it might be assumed that the-007487