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The Impact of Multiple Care Giving Roles on Fatigue, Stress, and Work Performance Among Hospital Staff Nurses

Scott, Linda D. PhD, RN; Hwang, Wei-Ting PhD; Rogers, Ann E. PhD, RN, FAAN

JONA: The Journal of Nursing Administration: February 2006 - Volume 36 - Issue 2 - p 86-95

Objective: This study describes fatigue and stress among a random sample of full-time hospital staff nurses (n = 393) who provide care for aging family members, compares the results to nurses with and without children younger than 18 years living at home, examines differences in sleep duration, and explores the effects on work performance by care giving status during a 4-week period.

Background: Little attention has been given to the effects of care giver well-being when individuals assume dual roles as family and professional care givers.

Methods: Hospital staff nurses recorded daily information concerning their work hours, errors, sleep/wake patterns, perceptions of fatigue, alertness, and stress and periods of drowsiness and sleep episodes while on duty for 28 days.

Results: Fatigue and stress levels were significantly higher among nurses caring for both children and elders. However, nurses providing elder care at home were more fatigued, sleep-deprived, and likely to make errors at work.

Conclusions: These findings underscore the importance of restorative sleep interventions and fatigue countermeasures for hospital staff nurses involved in dual care giving roles. Limiting overtime and applying circadian principles to hospital scheduling processes would ensure a more alert workforce, minimize health risks for nurses, and maximize the safety of those in their care.

Authors' affiliations: Associate Professor and Director of the Undergraduate Program (Dr Scott), Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, Mich; Assistant Professor (Dr Hwang), Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics; Associate Professor (Dr Rogers), School of Nursing, University of Pennsylvania, Center for Sleep and Respiratory Neurobiology, University of Pennsylvania School of Medicine, Philadelphia, Pa.

Corresponding author: Linda D. Scott, PhD, RN, Kirkhof College of Nursing, Grand Valley State University, 312 Cook-Devos Center for Health Sciences, 301 Michigan Avenue NE, Grand Rapids, MI 49503 (

Financial Support for this study was provided by the Agency for Health Care Research and Quality (R01 HS11963-01).

© 2006 Lippincott Williams & Wilkins, Inc.