Nurses' perception of the first hour of the morning shift (6.00–7.00 a.m.) in a German hospital

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Abstract
Morning shifts in Germany usually start at 6.00 a.m. Apart from the well-known effects of shiftwork on health and family/social life, the early rising time poses additional problems. Part of a study on the first hour of the morning shift is described in this paper. Thirteen nurses on a female surgical and on a male medical ward were interviewed using a semi-structured interview guide. The findings were obtained through phenomenological analysis. Seven themes emerged from the results: (a) the impact of rising early on the individual, (b) the detrimental effect of alternating shifts on well-being, (c) disturbances to personal life, (d) the rationale for early start, (e) consequences for patients, (f) suggestions for change, and (g) increased risk of leaving the job. The findings suggest that the early start puts nurses under considerable stress. Tradition rules the time-oriented and ritualized way of organizing work. Further extensive research is recommended.