This descriptive pilot study was intended to evaluate negative outcomes of shift work stress in nursing. Objective analysis of waist-hip-circumference ratios (WHR) and subjective survey reports were utilized to assess whether differences existed in expressed stress, stress related health disorders, and stress associated behaviors among day shift, night shift, and rotating shift registered nurses (RNs). Statistical analysis of the WHRs indicates that no statistical difference exists in the results from this study across the three nursing shifts. Nonetheless, survey reports do suggest that variance exists between nursing shifts. For example, stress related health problems appear to be most prevalent with night shift and rotating shift nurses. Rotating shift RNs had the highest percentage of nurses with one or more health disorders, the highest percentage of bacterial or viral infections over the past 12 months, and the highest number of sick calls in the past 12 months. Rotating shift RNs also reported the highest prevalence of stress associated behaviors with the exception of motor vehicle crashes, which were reported most often from day shift nurses. The literature reviewed as well as the data collected in this study supports that expressed stress does vary among day shift, night shift, and rotating shift RNs. Although the quantifiable data supports the presence of higher stress on day shifts, the WHR tool is unfortunately affected by many variables and as such may have provided unreliable results. This tool needs to be further analyzed with a larger sample size and possibly with a better control of variables prior to accepting results of the collected WHR data. The results indicate that nurses, particularly those working rotating shifts, could benefit from stress reduction interventions. Moreover, future research should continue evaluating deleterious health effects of nursing shift work, and efficacy of stress reduction interventions in nursing. Stress reduction interventions including education and practice changes should be implemented at individual, facility, community, and federal levels to improve the health of nurses as well as the safety of patients.


Hans-Peter de Ruiter

Committee Member

Marlys Sandve

Date of Degree




Document Type



Master of Science in Nursing (MSN)


School of Nursing


Allied Health and Nursing

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Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License



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