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by Jessica Schlichtemeier

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3 Pronoun use
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4 Faulty subject-verb agreement
7 Wrong or missing prepositions
3 Incorrect verb forms
1 Comma misuse within clauses

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How Long Hours Affect Nurses' Mental and Physical Health

Ava Tegels

Honors English

Mrs. Schlichtemeier

February 28, 2025

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A nurse practitioner, Amy Tegels, worked in a hospital during COVID-19. This is

her story. She glanced at the clock—3:47 AM. Her shift had started over

eighteen hours ago, but no end was in sight. COVID had turned time into a blur

of PPE, exhaustion, and the constant beeping of ventilators. She pulled off her

fogged-up face shield and wiped her forehead, leaving behind a faint imprint of

the N95 mask that had dug into her skin. Her scrubs clung to her body, damp

with sweat from hours of running between patients. In the dim glow of the

nurses’ station, she saw Lisa, an ICU nurse, hunched over the charting

computer, her fingers trembling from fatigue.

“You should take a break,” Amy said softly, though she knew how empty the

words sounded. Breaks from the chaos have become a luxury. Lisa gave a tired

smile. “I’ll rest when this is over.” Amy wanted to tell her that she had been

saying the same thing for two years now. That the “over” they had been waiting

for kept moving further away like a mirage. Instead, she reached for another

patient chart and kept going. She had another patient. She braced herself

before entering. The patient had been on high-flow oxygen for days. His wife

had called earlier, begging for updates—she wasn’t allowed in the hospital, and

video calls had become their only connection. By 6 AM, her body ached in ways

she didn’t know were possible. Her phone buzzed—a text from her mother. She

stared at the message, unable to reply. How could she explain the endless cycle

of loss, the guilt of not being able to save everyone, the fear that she might

bring the virus home? Instead, she typed: I’m okay. Love you. As the morning

shift took over, Amy finally stepped outside. The first rays of sunlight hit her

face, but she felt no warmth. She sat on a bench, closed her eyes, and let

exhaustion settle in her bones. She had another shift in six hours.

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Nurses play a very important role in the healthcare profession. However, the
1
environment that they work in will significantly affect the quality of work and
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their ability to perform the duties well. Working conditions range from staffing

levels and work hours to the physical environment and organization have a very

big impact on how well the job is done by nurses. Working conditions affect

productivity and efficiency in the work that nurses do positively and negatively.

While some conditions may improve their performance, other conditions can

create roadblocks that alter the nurses' effectiveness, which can lead to

positive and negative outcomes in caring for the patients. It is important to

understand the relationship between working conditions and nurse

productivity because improving healthcare and ensuring better outcomes for

patients and professionals is essential to the overall success of the industry.

Increased physical activity is a positive way to look at long hours and shifts as a

nurse. With long hours comes more activity on your feet. This increases your

health and allows for more activity and can lead to better health.

According to an article written by M. Yao (2008), when nurses work long hours

and shifts, they adopt new opportunities. Working long hours can allow time to

show what someone can do and eventually work up to a new position. It could

also allow nurses to gain respect from coworkers in the workplace and give new

opportunities for them to take someone else's spot if they quit. If a nurse is on

a shift and someone quits because they can’t withstand the long hours, the

other nurse on duty will be able to take that position and potentially gain more

pay.

Shifts, day and night, are long and exhausting. However, when working those

shifts, nurses are opening their eyes to see what their strengths and
3 4,5
weaknesses are. A nurse that works long hours in the emergency room may gain

a perspective that they can handle the stress and fast-paced work of the

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environment. On the other hand, the nurse may determine that the long hours

make them drowsy, and they do not work as well during the night shift

compared to a day shift. The eye-opening experiences that come with shift

work show the strengths and weaknesses that each individual has. Some

healthcare workers may respect that they have strengths and weaknesses,

while others will resent the fact that they cannot do certain things.

Nurses can have a new way of looking at life after working long hours in any

environment. After working long hours, nurses interact with new patients and

experience every day. After talking with patients and getting to know their

stories, healthcare workers get a deeper understanding of life. They must

6
realize that the work that they do helps others and allows for a new view on the

nurse’s own life. Helping others creates a more loving and caring side to any

person, and the nurses now know not to take life for granted.

The age of a healthcare worker or nurse can largely affect the amount of energy

and strength they have to get through the long hours of shifts. A twenty-five-

year-old nurse fresh out of school will be able to better withstand the long

amounts of time on their feet because they have stronger bones and are most

likely more in shape. On the other hand, a sixty-year-old nurse might have more

trouble getting around on a long shift because they are tired faster and their
7 8
physical strength weakens as one gets older.

The health of healthcare workers is very important. The nurse that is taking

care of an ill patient must be at full capacity health-wise, otherwise, the patient

may get the sickness of the nurse and cause the condition to worsen. Long

hours on night shifts and day shifts can weaken the nurses' immune systems.

Most commonly, the sicknesses that nurses contract are from the patients that

they care for. Without the full health of a nurse, the productivity of the work

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they do will lessen because they may not be able to focus on the patient's

sickness and the attention will be on their illnesses.

In the early 20th Century, there was a rise in the recognition of mental health

strains in the healthcare industry. The nursing profession began to grow rapidly

as hospitals expanded and nurses took on more responsibilities. Before long,

more and more disorders started to begin to show up. Disorders such as Sleep

Disorders, Maladaptation, Gastrointestinal problems, and insomnia began to

become more recognized.

Sleep disorders can be formed when an individual gets no sleep at all. This will
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cause them to not be able to sleep regularly or mess up the sleep schedule.

Insomnia and other sleep disorders are most commonly caused by stress,

physical distress, anxiety, depression, and many more things. Along with

Insomnia, many more sleep disorders can be developed from overworked

nurses and healthcare workers. Those disorders are sleep Apnea, Narcolepsy,

and Restless Legs Syndrome. According to an article written by Ferri (2016), all
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of these sleep disorders have the same root problem being stress and long

hours:

The sleep alterations related to shift work have been included among the

Circadian Rhythm Sleep-Wake Disorders, irregular type, of the Diagnostic and

Statistical Manual of Mental Disorders, which reports a high frequency of this

disorder among the night shift worker population (5%–10% of the workforce). A

Greek study confirms that sleep disturbance that occurs in shift work is

strongly associated with chronic fatigue. The symptoms of fatigue, including

“sleepiness and lack of energy,” “impaired concentration,” and “feelings of

discomfort,” were more severe in the nurses who worked night shifts than

others who worked during the day (p. 203).

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Maladaptation syndrome is another result of stress. It refers to a state in which

a person is not able to cope with stressors, changes, or challenges in an

environment that they are in or have been in. The main effects of maladaptation

are ineffective coping mechanisms, which can make a nurse more stressed,

failure to adjust to changes, and disruption of normal functioning. Not being

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able to adjust to changes is important because without the ability to do so, a

nurse will not be able to do simple functions. The medical field is very

unpredictable, so if a nurse cannot adapt to changes, they will not succeed in

the healthcare field. Whether a nurse were to work in a clinic or an emergency

room, the changes will be there no matter what.

An article published by the Cleveland Clinic in 2021 stated that gastrointestinal

disorders are conditions that mainly affect the digestive system in the human

body. Within the digestive system, the disorder affects the stomach, intestines,

esophagus, liver, gallbladder, and pancreas. Some gastrointestinal disorders

are temporary, while others will be chronic and require long-term management

to keep the nurses healthy. Another symptom of long hours is Irritable Bowel

Syndrome, which is a disorder that commonly affects the large intestine. The

disorder has symptoms of cramping, bloating, diarrhea, and constipation. It is

believed to be a combination of sensitivity to pain and stress. All of these

problems can be sourced from long amounts of time not using the bathroom or

stress.

J. Skargon (2021) conducted a poll where he determined the impact mental

health nurses have on the mental health and physical health of other nurses

and healthcare workers. His findings were as follows:

The findings indicate that, although mental health nurses encounter a range of

challenges in physical health management, they view it as a key component of

their clinical role. Issues that impact mental health nurses when managing

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physical health include poor integration of health services, confidence of

medical colleagues, and access to resources in terms of equipment to

undertake monitoring and time to have meaningful conversations about

physical health.

Trauma in nursing refers to the psychological challenges that they face

performing their daily duties when they are on the clock. Nurses frequently face

high-pressure situations daily, are exposed to death, and see many different

health problems. Nurses will have trauma from hearing about or listening to

stories about patients' deaths and witnessing traumatic events. When working

in these conditions, nurses might develop anxiety, intrusive thoughts, and

emotional numbness.

The emotional toll that caring for potentially dying patients and ill patients has

a huge impact on how a nurse performs. Nurses are also sometimes exposed to

physical and verbal fighting in the workplace. If that occurrence becomes an

everyday thing, the nurse witnessing it may develop severe emotional stress

trying to figure out how to stop it or get it out of the clinic or hospital.

Working long hours and having rare, short breaks throughout a shift as a nurse
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will play a massive role in how well a nurse will cooperate and support their

patients. A nurse working long hours will care for many patients. With that

comes the chance for error or mistakes. When mistakes become more present,

the individual will begin to lose confidence in themselves and the work that

they do.

Poor access to resources in a medical setting cannot happen. In an article

written by J. Skargon (2020), many nursing students and nursing staff

experienced low support and resources coming from the hospital. Without the

appropriate resources needed to take care of patients and nurses themselves,

both patients and nurses will be exposed to viruses and illnesses. Along with

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that, nurses won’t get the correct amount of training necessary for them to be
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able to correctly help the patients. This causes stress and doesn’t allow for

nurses to work at their full potential.

The long hours of shift work in an emergency setting compared to a clinic is a

big one. A nurse working in a hospital will be significantly more worried about

getting to patients on time and caring for as many patients as they have. The

long hours have a big impact on nurses in a way of giving nurses worry and

making them second guess their work.

The workload of nurses who are working shifts is great in a hospital setting. A

nurse will have to work with all of the patients and make sure all are feeling not

ill as well as keeping up with all of the paperwork required for each patient,

also called charts in a medical setting.

The emergencies that come along with nursing are very common. While working

long hours in a hospital, emergencies are a very common occurrence, although,

if working in a clinic, the occurrence of emergencies is a lot less. The number of

emergencies that come in a day in a hospital will cause severe stress and will
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not allow for the nurse to work at the highest potential.
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There are many consequences of long term exhaustion in nursing shifts. When

working shifts, they can consist of night, day, or even middle day to morning

shifts. All of these shifts will cause difficulty in sleeping patterns. When

working different shifts, there is no set sleep schedule, which messes with the

body's systems. With irregular sleeping patterns come trouble sleeping and

fatigue. Another side effect that comes with long-term exhaustion is a lack of

recovery time. When working shifts, there is always a go, go, go mentality. This
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leaves very little room to recover from no sleep or sleep deprivation the night or

day before the shift occurs. When nurses are working shifts, there is no time for

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rest, which will potentially lead to burnout, increasing the risk of long-term

exhaustion, which leads to exhaustion and errors made in the workplace.

Depression in nursing is an issue that will impact a lot of nurses' mental health

and the quality of patient care that they provide. Nurses, due to high-stress

situations in work, long and tiring shifts, emotional strain, and witnessing
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traumatic situations, are at a higher risk for getting depression. Recognizing the

signs of depression and giving resources for support is important to improve

nurses' well-being and make sure that there is a safe, compassionate patient

care system.

The CoronaVirus, also known as COVID-19, was a pandemic that occurred in

2019. The 2019 virus strains were acute respiratory syndromes that were

spread by touch, cough, and many more things. The most common symptoms of

COVID-19 are cough, fever and chills, sore throat, and loss of taste and smell.

The virus is attempted to be prevented by masking in public, keeping six feet of

distance from others, and getting vaccinated regularly to keep up with the

different strains. Nurses were hugely affected by the COVID-19 pandemic, both
19
professionally and personally. They were on the front of the crisis, they would

work long hours under lots of pressure while facing numerous challenges. Some

of the challenges they faced were increased workload, staff shortages, high
20
stress levels, trauma, burnout, and exposure to the sickness themselves.

The sustained long hours, pressure to do great things, and the emotionally
21
taxing nature of the job of nursing, eventually causes nurses to grow a feeling of

burnout. Burnout also affected many other healthcare workers. Burnout will

cause physical exhaustion, mental exhaustion, and a feeling of detachment

22
from patients because of the attention being turned towards themselves.

Nurses face an overwhelming number of patients every day, which only

increased during the pandemic in 2019. Hospitals and clinics were stretched

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thin on healthcare workers, especially nurses. Many of them would work longer

hours and overtime or take on other people's shifts to handle the extra number

of patients coming in to seek healthcare and medicine. The constant pressure

of taking care of critically ill patients, like the ones suffering from COVID-19,

added even more stress to nurses' plates. Nurses were not only dealing with

the physical or mental demands of their work but also with the emotional toll of

seeing patients die and struggle from the virus strains.

According to an article written by R. Kunkle (2024), nurses worked closely with

23
the patients who had been infected by the virus. They were at very high risk of

eventually adopting the sickness themselves. Despite the use of personal

24
protective equipment, the risk of getting the sickness was still extremely high,

and many nurses did eventually get sick. Nurses also faced the fear of

spreading the virus to their families and loved ones. This created psychological

issues, as many nurses took precautions such as self-isolation to keep the

sickness away from their families. The emotional and physical toll of the strains

also affected other relationships. Some nurses experience stress at home due

to being overworked or having a heavy workload. This leads to challenges in

balancing home life with the life at home with their families.

During COVID-19, nurses faced a lot of hazardous conditions while working at

the front of healthcare. These conditions put their physical health at risk, as

well as their mental health. The risks that nurses encounter are exposure to the

virus, personal protective equipment shortages, physical and mental

exhaustion, and psychological stress. Nurses, by the nature of the job, are in

contact with infected patients, giving them a higher risk of adopting COVID-19.

Despite the personal protective equipment, the virus is very contagious,

especially in the early stages of the pandemic, making it very difficult to stay

away from the risk. Furthermore, nurses often spent extended periods with

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patients who had severe symptoms. This increases the likelihood of getting the

virus, especially if the patients were not diagnosed with it yet.

In the early stages of the pandemic, there was a shortage of personal protective
25
equipment. Nurses often have to reuse the personal protective equipment,
26
which makes the risk for exposure increasingly higher. Even when the personal

protective equipment was available, it was uncomfortable to wear for long

hours, leading to physical issues like skin irritation. This made it even more

difficult to perform at the highest level for long shifts.

Due to staff shortages and a crazy number of patients, nurses were required to

work extended shifts, which could sometimes be more than 12 hours. This

constant pressure led to physical fatigue and even, sometimes, burnout.

Nurses had to perform demanding tasks such as lifting or repositioning a

patient, all while under extreme exhaustion and physical fatigue. The pandemic

also took a toll on nurses emotionally. They were forced to witness patients

suffering and dying, often without the family present. This led to burnout,

stress, and trauma. This affected nurses specifically in end-of-life care.

27
Often, nurses had to make difficult decisions regarding a patient and their care.

Many faced moral distress when they had to decide which patients would

receive treatment and which wouldn't. Nurses also lived with the constant fear

of contracting the virus themselves or even transmitting it to family and

friends. This was compounded by their not knowing that the virus would spread

and the potential for asymptomatic carriers.

Nurses played a crucial role during the COVID-19 pandemic. Risking their lives

daily to care for those affected by the illness. Their dedication was seen as they

worked on the frontlines, often under difficult and dangerous conditions.

In conclusion, the long hours and challenging working conditions experienced

by nurses, especially during the COVID-19 pandemic, have had a big impact on

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their physical, emotional, and mental well-being. The constant pressure of

extended shifts, high patient volumes, and low resources led to increased

burnout, physical exhaustion, and emotional strain. Nurses have had to

navigate both the physical discomfort of personal protective use and the

psychological toll of witnessing patient suffering and death. These conditions

not only compromise the health of nurses but also highlight the urgent need for

changes within the system to improve the environment, ensure better support,

and promote their well-being. The dedication shown by nurses throughout

these challenges shows their crucial role in healthcare and addresses these

issues to prevent long-term difficulties for their health and the quality of care

nurses provide.

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References

Bachmann, A. O., Cohen, C., Abt, M., Gilles, I., Delmas, P., & Claudia, O. B. (2024).

“The leadership shown by nurses gave me such a boost”: health resources used

by nurses who experienced COVID-19 pandemic stressors. International Journal

of Qualitative Studies on Health and Well-being, 19(1)

https://doi.org/10.1080/17482631.2024.2432687

Cleveland clinic. (2021). Access Anytime Anywhere | Cleveland Clinic. Cleveland

Clinic. https://my.clevelandclinic.org

Ferri, P., Guadi, M., Marcheselli, L., Balduzzi, S., Magnani, D., & Di Lorenzo, R.

(2016). The impact of shift work on the psychological and physical health of

nurses in a general hospital: a comparison between rotating night shifts and

day shifts. Risk Management and Healthcare Policy, 9(9), 203–211.

https://doi.org/10.2147/rmhp.s115326
28
Kunkle, R., Xu, H., Thomas, L. E., Webb, L. E., O'Brien, E.,C., & Carol, R. G. (2024).

Nursing Home Workers' Experience During the COVID-19 Pandemic. Research in

Gerontological Nursing, 17(3), 131-140. https://doi.org/10.3928/19404921-

20240423-02

Skargon, J. (2020). Exploring the Attitudes of Mental Health Nurses and Mental
29
Health Nursing Students Toward the Physical Health of Service Users: a Mixed

Methods Study (Order No. 29423174). Available from ProQuest One Academic.

(2699037949). https://nwulibrary.idm.oclc.org/login?

url=https://www.proquest.com/dissertations-theses/exploring-attitudes-

mental-health-nurses-nursing/docview/2699037949/se-2
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Yao, M. (2008). The relationships among work related stress, health status, and

physical activity participation of nurses in teaching hospitals in Taipei, Taiwan

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(Order No. 3305879). Available from ProQuest One Academic, 102-115.

(304833781). https://nwulibrary.idm.oclc.org/login?

url=https://www.proquest.com/dissertations-theses/relationships-among-

work-related-stress-health/docview/304833781/se-2

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1. their work Pronoun use Correctness

2. the duties → their duties Determiner use (a/an/the/this, etc.) Correctness

3. A nurse → Nurses Confused words Correctness

4. that works → who works Pronoun use Correctness

5. works → work Faulty subject-verb agreement Correctness

6. on → of Wrong or missing prepositions Correctness

7. one → they Pronoun use Correctness

8. gets → get Faulty subject-verb agreement Correctness

9. the sleep → their sleep Determiner use (a/an/the/this, etc.) Correctness

10. being Incorrect verb forms Correctness

11. , without Comma misuse within clauses Correctness

12. will cooperate → Incorrect verb forms Correctness

cooperates

13. support → supports Faulty subject-verb agreement Correctness

14. for Wrong or missing prepositions Correctness

15. for Wrong or missing prepositions Correctness

16. long term → long-term Misspelled words Correctness

17. no Misuse of quantifiers Correctness

18. for → of Wrong or missing prepositions Correctness

19. on → at Wrong or missing prepositions Correctness

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20. high stress → high-stress Misspelled words Correctness

21. causes → cause Faulty subject-verb agreement Correctness

22. towards → toward Wrong or missing prepositions Correctness

23. the patients Determiner use (a/an/the/this, etc.) Correctness

24. the sickness → sick Misuse of modifiers Correctness

25. the personal Determiner use (a/an/the/this, etc.) Correctness

26. for → of Wrong or missing prepositions Correctness

27. had → have Incorrect verb forms Correctness

28. , C. Improper formatting Correctness

29. a Mixed → A mixed Confused words Correctness

30. work related → work-related Misspelled words Correctness

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