3.2 Impact of Extended Rotations on Sickness Absence and Attrition
The restructuring of hospital nursing rosters serves as a primary institutional response to ongoing workforce deficits and shifting patient care requirements (Butler et al., 2017). Healthcare organizations frequently modify shift patterns, staffing levels, and qualification structures to stabilize daily operational capacity across clinical wards (Butler et al., 2017). However, applying ergonomic and occupational health frameworks reveals that altering shift configurations generates contradictory outcomes for healthcare delivery and workforce sustainability. When hospital managers extend shift durations to offset staff shortages, these organizational adjustments are often perceived by both employers and employees as beneficial due to fewer shift handovers, reduced overtime demands, and potential institutional cost savings (Dall'Ora et al., 2020). Nevertheless, analytical evaluation demonstrates that the compression of working hours introduces substantial operational vulnerabilities (Dall'Ora et al., 2020). Extended clinical shift work correlates directly with heightened physical fatigue, increased risk of occupational accidents, and elevated rates of staff sickness absenteeism (Dall'Ora et al., 2020). These heightened stress levels and absenteeism figures exacerbate workforce attrition, thereby intensifying the underlying nursing shortage that prompted the shift reorganization initially (Dall'Ora et al., 2020). Furthermore, because nurse staffing configurations directly influence the overall standard of patient care and broader clinical results, unchecked workforce exhaustion poses severe risks to care quality (Butler et al., 2017). Consequently, shift restructuring fails as a durable standalone solution to nursing shortages unless roster designs systematically account for occupational recovery periods.