Thesis:

Assessing the relationship between various work shifts and health status of nurses working at the Machakos level five county referral hospital, Machakos county, Kenya

Hospitals have designed shift work which comprise of irregular working hours beyond the traditional diurnal working schedules in order to meet the patients’/ clients’ demands for health care, 24 hours a day. Some of these shifts may pose challenges to the nurses, imparting negatively on patient care and also the wellbeing on the health care providers, hence the need to assess the relationship between various work shifts and health status among nurses in Machakos Level five county referral hospital. A descriptive cross-sectional study design was used to collect data from 167 respondents using a structured questionnaire. Qualitative data was also collected through focused group discussion and key informant interviews. Qualitative data was transcribed and reported verbatim. Quantitative data was entered in to the Statistical Package for the Social Sciences (SPSS) software version 27 to generate both descriptive and inferential statistics. Mean score for various responses were computed to assess the relationship between various working shifts and the respondent’ health status. Authority to collect data was sought from the Mount Kenya University Ethical Review Committee (ERC), National Commission for Science, Technology and Innovation (NACOSTI) and the Machakos level five county referral hospital management. The study results showed that the 12 hours shift had an effect on the respondents’ physical health with most respondents saying that the shift caused various illnesses like muscle strain, backache varicose veins and fatigue. Likewise, night duty and 12 hours shift affected the respondents’ mental health by causing sleep disturbances, disorientation, mental fatigue, feeling of being isolated, poor concentration to patient care and also mood disorders. Regarding the respondent’s social health, night duty and 12 hours shift had a negative effect, with most of them stating that the shifts led to marriage instabilities, being viewed by the community as promiscuous, family strains, and also being isolated by neighbours and friends. Others included being absent in some major social activities in the family / community and lack of time to interact with family members. The researcher therefore recommends that the hospital management should prioritize implementing shorter shifts (6 or 8 hours) to improve nurses’ overall wellness and performance. There is also need to ensure a fair and structured shift rotation system should be established to prevent prolonged night and 12-hour shifts, reducing burnout. There is also need Strive to recruit more nursing staff to avoid overburdening existing employees and reduce the need for extended shifts. Counseling services and stress management programs should be introduced to help nurses cope with the psychological impact of night and long-hour shifts. Also, nurses should be encouraged to communicate their preferred shifts where feasible to maintain a balance between work, family, and personal time.