The Impact of 12-Hour Versus 8-Hour Shifts on Intensive Care Unit Nurses' Physical and Mental Well-Being and Job Satisfaction: A Systematic Review.

Authors

Ammar Othman, Danielle Najm, Edward Zimbudzi

Published in

Journal of nursing management. Volume 2026. Issue 1.

Abstract

Twelve-hour shifts have been widely implemented in intensive care units (ICUs), where nurses work in high-acuity environments requiring sustained clinical attention. However, evidence regarding the impact of shift length on ICU nurses' physical health, mental well-being, job satisfaction and patient-care outcomes remains limited and inconsistent.
To investigate the impact of 12-h compared with 8-h shifts on ICU nurses' physical health, well-being and job satisfaction.
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO (CRD420251021178).
A systematic search of CINAHL, Ovid MEDLINE and Embase was conducted in February 2025 and updated in June 2026. Additional searches of Scopus and Web of Science were undertaken in June 2026. Eligible studies included ICU nurses and compared 12-h with 8-h shifts. Risk of bias and methodological quality were assessed using design-specific Joanna Briggs Institute (JBI) critical appraisal tools and the Mixed Methods Appraisal Tool (MMAT). Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Findings were synthesised narratively due to the heterogeneity of the included studies.
Of 815 records identified, five studies met the inclusion criteria. Findings on fatigue, sleep and burnout were inconclusive across studies. Twelve-hour shifts were generally associated with greater roster satisfaction, flexibility and work-life balance, while evidence for sick leave was limited or mixed.
Evidence did not consistently favour either 12- or 8-h shifts for ICU nurses, with low to very low certainty of evidence. Shift duration should therefore be considered alongside overall roster design, staffing needs and nurses' well-being when planning ICU schedules.
Nurse managers should avoid a one-size-fits-all approach to shift duration, as evidence does not clearly favour 12- or 8-h shifts. Shift-length decisions should consider roster design, staffing needs, workload, recovery time and nurses' preferences. Managers should also monitor staff well-being, satisfaction, absenteeism, retention and patient-care outcomes when reviewing shift patterns. Given the low certainty of evidence, ongoing local evaluation is essential to ensure rosters support workforce sustainability and safe, high-quality care.

PMID:
42952228
Bibliographic data and abstract were imported from PubMed on 29 Oct 2026.

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