Long working hours for nurses have a negative impact on both patient outcomes and nurses' health and job outcomes. Yet little is known about how changes in health care policy and the economy have affected trends in nurses' work schedules, particularly among newly licensed nurses.

Researchers analyzed data from four cohorts of newly licensed nurses to describe how, when, and under what circumstances new nurses in different health care settings were working. Surveys were sent to random samples of U.S. nurses who were first licensed between 2004 and 2015: from 2004 to 2005, 2007 to 2008, 2010 to 2011, and 2014 to 2015.

Average working hours were similar for all four cohorts. Overall, nurses worked a mean of 39.4 hours a week, and most worked 12-hour shifts. The authors note that 11.6% to 14.6% of nurses held more than one job, more than one-third worked nights, and 10% to 14% worked rotating shifts. Twelve percent of nurses worked weekly mandatory overtime, and 45.6% worked weekly voluntary overtime. Average weekly voluntary overtime hours were higher in the 2004 to 2005 and 2014 to 2015 cohorts than in the other two cohorts. Nurses preferred the day shift and 12-hour shifts.

The researchers didn't find evidence of meaningful changes to improve nurses' scheduling, working hours, or overtime to enhance nurse well-being or patient safety. Nurse managers and policymakers should pay attention to new nurses' scheduling and shift preferences and guard against mandatory overtime, the authors advise.

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