Healthcare Workers’ Perspectives on 24-h Shift Work in Latvia: A Cross-Sectional Study

Abstract

Highlights What are the main findings? Healthcare workers working extended shifts reported substantial fatigue, emotional exhaustion, health complaints, and perceived patient-safety concerns, while a substantial proportion still preferred to retain 24-h shifts. Frequently reported reasons for retaining 24-h shifts included financial considerations, schedule convenience, consecutive days off, and the possibility of combining employment across multiple workplaces. What are the implications of the main findings? Future work-schedule reforms should consider staffing capacity, remuneration, opportunities for recovery, schedule flexibility, and healthcare workers’ preferences. The findings support further evaluation of flexible and mixed scheduling approaches rather than immediate universal replacement of 24-h shifts. Abstract Background/Objectives: Prolonged working shifts may adversely affect healthcare workers’ health, well-being, cognitive performance, and patient safety. Nevertheless, 24-h shifts remain commonly used in Latvian healthcare. This study aimed to examine healthcare workers’ experiences of 24-h shift work, their attitudes toward revising this work schedule, and the main reported reasons underlying their preferences. Methods: A cross-sectional survey was conducted in Latvia between October 2025 and February 2026. A structured 64-item questionnaire assessed sociodemographic and professional characteristics, workload, shift patterns, health and emotional well-being, perceived patient-safety concerns, professional motivation, and attitudes toward alternative work schedules. Of 1524 submitted questionnaires, 1318 were included in the analysis. Quantitative data were summarized using descriptive statistics, while open-ended responses were examined using qualitative content analysis. Results: Most respondents regularly worked extended shifts, and 40.5% worked at more than one institution. More than half reported health changes that they perceived as potentially related to extended shift work, with 61.1% reporting emotional exhaustion and 49.2% reporting persistent fatigue. Fatigue during extended shift work had contributed to a self-reported error or perceived decline in care quality among 34.9% of respondents. Despite these concerns, a substantial proportion of participants preferred to retain 24-h shifts. Frequently reported reasons included schedule convenience, consecutive days off, financial considerations, and the ability to combine employment across multiple workplaces. Open-ended responses further highlighted preferences for flexibility, employee choice, adequate staffing, opportunities for rest, and consideration of financial consequences when revising work schedules. Conclusions: The findings demonstrate a tension between healthcare workers’ perceived health and patient-safety concerns associated with extended shift work and the practical and financial advantages associated with retaining 24-h shifts.