New Graduate Nurses Adaptation to Shift Work: Can We Help? Collegian Vol 14 No 1 2007 23 Introduction Most new graduate nurses (NGNs) entering employment within New South Wales, experience shift work that is organised on the basis of a rapidly rotating roster system during their initial clinical year. Rapidly rotating rosters necessitate both day and evening shifts and normally include a varying number of night shifts (usually in blocks of 2-4 shifts) at frequent but irregular intervals. Although nursing rosters are frequently favourably viewed by those working in other shift working industries where life is dictated by the inexorable march of the slow rotation shift schedule and there is little opportunity for variation of rosters, working a rapid rotation roster also requires adaptation. Adaptation to a shift working lifestyle has a significant and ongoing effect on the lives of all nurses, but these effects are undoubtedly more acutely felt by the NGNs who are attempting to adjust to full time work in the health care sector whilst developing a shift working lifestyle which such a position necessitates. Previous research (Jamal & Baba, 1997) has explored the effects of shift work patterns for nurses, reporting that nurses working rapid rotating shifts - including night shifts - experience reduced states of well-being. In an earlier study (Jamal, 1982), nurses working a fixed shift schedule (no variation in shift time for weeks to months) were reported as spending more leisure time with their families, less leisure time alone and experiencing fewer physical and psycho- logical problems than nurses working rotating shifts. Rotating shift nurses have also been reported as experiencing the most job-related stress (Coffey, Skipper & Jung, 1988), followed in turn by the fixed day, afternoon, and night shift nurses. Coffey et al. (1988) found that the type of shift worked and the effect of type of shift on job- related stress remained significant over and above covariates such as nurses’ level of seniority and time in the current role. These findings are particularly interesting in light of recent changes to the organisation of nursing work within current Australian health systems. Female nurses who worked rosters that included night shifts, have also reported more stress symptoms than those working two-shift systems (morning and afternoon shifts), and nurses who routinely worked night shifts as part of rotating rosters were also less likely to enjoy their work and to exhibiting passive stress coping strategies which contributed to their experience of burnout and stress (Kandolin, 1993). New Graduate Nurses Adaptation to Shift Work: Can We Help? Sandra H. West, RN, CM, Int.Care Cert., BSc, PhD, MRCNA, Faculty of Nursing & Midwifery, University of Sydney, New South Wales Maureen Ahern, RN, BA, MHP, MRCNA, Faculty of Nursing & Midwifery, University of Sydney, New South Wales Margot Byrnes, RN, Int.Care Cert., BHlthSc, MA(Ed&Work), Faculty of Nursing and Midwifery, University of Sydney, New South Wales Lloyd Kwanten, BMedSci(Hons), Research Assistant, Faculty of Nursing & Midwifery, University of Sydney, New South Wales Shift work’s desynchronisation of physiologically determined circadian rhythms has a major effect on the psychobiology of every shift worker. It is also commonly perceived that the effects of shift work contribute to the current New Graduate Nurses (NGNs) attrition rate. NGNs must also adjust to work within the health care system as they adapt to shift work, but do the initial effects of shift work as experienced by NGNs get better with time? This study aimed to describe the adaptation of NGNs to shiftwork. Levels of general health, sleep, fatigue, circadian type, job satis- faction, levels of burnout and the coping processes of 150 final year undergraduate students were investigated in a questionnaire based longitudinal study conducted over their initial twelve months of clinical practice as NGNs. Correlational analysis indicates that whilst shift work initially seriously disturbs sleep and other variables associated with indivi- dual and situational differences some adaptation was evident by twelve months. Social dysfunction scores (GHQ28) remained significantly related with variables associated with burnout, job satisfaction, sleep disturbance and life disruption at the twelve month point. The presence of depression on pre-shift work scales was also significantly related to continuing experience of sleep disruption and increased levels of emotional exhaustion through- out the twelve month period. Further investigation is required to establish the effect of shiftwork on outcome measures such as levels of burnout and job satis- faction for NGNs. However, although it is possible that improved preparation for shift work may assist the adaptation of NGNs to shift work during their first year of practice it is clear that attention to the organisation of nursing shift work would also be timely. Key Words: shiftwork; new graduate nurse; nursing work; rosters Correspondence to: Associate Professor Sandra West swest@nursing.usyd.edu.au