title: Perceptions and observations of off-shift nursing.
abstract: OBJECTIVE
  The purpose of this paper is to qualitatively explore registered nurse perceptions of off-shift (e.g. nights and weekends) nursing care and quality compared with regular hours.
  
  
  BACKGROUND
  Patients admitted to hospitals on off-shifts have worse outcomes than patients admitted on more regular hours. The underlying mechanism for this association is not well understood.
  
  
  METHODS
  In-depth semi-structured interviews of 23 registered nurses and four observer-as-participant observations were conducted on both medical-surgical and intensive care units in two large (>850 beds) tertiary hospitals. Content analysis was used to identify themes.
  
  
  RESULTS
  Six themes emerged: (1) collaboration among self-reliant night nurses; (2) completing tasks; (3) taking a breather on weekend day shift; (4) new nurse requirement to work at night; (5) mixture of registered nurse personnel; and (6) night nurse perception of under-appreciation.
  
  
  CONCLUSIONS
  Although nurses collaborate, complete more tasks and work with other types of registered nurses, the decreased resources available on off-shifts may affect quality care delivered in hospitals.
  
  
  CONCLUSIONS
  These findings support the importance of management to provide sufficient resources in terms of ancillary personnel and balance less experienced staff. Facilitating communication between night and day nurses may help allay night nurses' feelings of under-appreciation.
authors: Center for Health Outcomes and Policy Research, University of Pennsylvania, School of Nursing, Philadelphia, PA 19104-4217, USA. beckerp@nursing.upenn.edu
authors: Pamela B
authors: PB
authors: de Cordova
authors: Ciaran S
authors: CS
authors: Phibbs
authors: Patricia W
authors: PW
authors: Stone
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015401:Nursing Administration Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling; D011787:Quality of Health Care; D057188:Workflow