Problems Experienced by Health Personnel on Duty and Solution Suggestions

Year 2025, Volume: 15 Issue: 2, 164 - 177, 31.08.2025

Muhammed Fatih Ertaş

Abstract

Aim: The aim of this study is to investigate the difficulties encountered by healthcare personnel working with a shift system in training and research hospitals and to suggest solution-oriented approaches.
Material and Method: Designed as a qualitative case study, the study was conducted with 28 healthcare personnel working in research hospitals in Istanbul. Data were collected using a semistructured interview form and analyzed with MAXQDA 2020.
Results: The effects of the shift system and the proposed solutions were categorized under 10 main codes. Sleep Problems and Positive Feedback were the most emphasized subcodes for daily routines (28%). While Impact on Family Relationships (38%) was emphasized regarding family and social life, Resentment and Criticism (44%) were prominent in the perspectives of family and friends. Participants emphasized Positive Feedback in career development and job satisfaction. Health effects were dominated by Physical Health Problems such as insomnia and headache (56%). Lack of Time and Other subcodes were equally prominent problems regarding educational opportunities (32%). The difficulties experienced during shifts were mostly attributed to Relationships with Patients and Their Relatives (33%), while Self-Motivation (50%) was the most frequently mentioned coping strategy. Solution suggestions were highlighted as Shift Arrangements and Staff Increase (52%). These findings underline the extensive impact of on-call systems on healthcare professionals.
Conclusion: On-call systems affect healthcare professionals’ daily lives, family dynamics, careers and health. Improvements are essential, especially in managing physical health issues, improving patient relationships and optimizing shift arrangements.

Keywords

on-call system , healthcare management , healthcare business management , strategic management

References

• 1. Tunçsiper Ç, Bakar A. Health expenditures within the framework of health economics: the case of Türkiye. Journal of Biga Faculty of Economics and Administrative Sciences. 2023;4(1):20–8.
• 2. T. C. Official Gazette. (2014, May 22). Regulation on job and job descriptions of healthcare professionals and other professionals working in healthcare services. Official Gazette (Issue: 29007).
• 3. THD (Turkish Nurses Association) . 7 days-24 hours at the bedside: Working conditions of nurses in Turkey. Ankara. 2008. https://www.saglikcalisanisagligi.org/brosurler/ hemsirelerincalismakosullari.doc [Updated October 10, 2012. Accessed November 16, 2024].
• 4. Değirmencioğlu M. How good is the shift work system for employees? Journal of Aviation. 2019;3(2):113–21.
• 5. Nena E, Katsaouni M, Steiropoulos P, Theodorou E, Constantinidis T, Tripsianis G. Impact of shift work on sleep, health and quality of life of healthcare workers. Indian Journal of Occupational and Environmental Medicine. 2018;22(1):29–34.
• 6. Ferri P, Guadi M, Marcheselli L, Balduzzi S, Magnani D, Di Lorenzo R. Impact of shift work on the psychological and physical health of nurses in a general hospital: A comparison between alternating night shifts and day shifts. Risk Management and Health Policy. 2016;9:203–11.
• 7. Harris R, Kavaliotis E, Drummond SPA, Wolkow PA. Sleep, mental health and physical health in new shift workers transitioning to shift work: Systematic review and meta-analysis. Sleep Medicine Reviews. 2024;75:101927.
• 8. Yeşilçiçek Çalık K, Aktaş S, Kobya Bulut H, Özdaş Anahar E. The effect of shift and on-call system on nurses. Journal of Health Sciences and Professions. 2015;2(1):33–45.
• 9. Söyük S, Erol M, Ateş M. Job satisfaction of nurses working in private hospitals in Istanbul. Journal of Health and Nursing Management. 2016;1(3):26–36.
• 10. Koyutürk A. Organizational justice and job satisfaction in health workers: The case of a public hospital [Master’s thesis]. Istanbul: Okan University, Institute of Health Sciences; 2015.
• 11. Sayılan A, Boğa SM. Determination of the Relationship Between Job Stress, Workload, Job Control and Social Support Levels of Nurses and Tendency to Medical Error. Journal of Research and Development in Nursing. 2018;20(1):11–22.
• 12. Nena E, Katsaouni M, Steiropoulos P, Theodorou E, Constantinidis TC, Tripsianis G. Effect of shift work on sleep, health, and quality of life of health-care workers. Indian journal of occupational and environmental medicine. 2018;22(1), 29–34.
• 13. Kecklund G, Axelsson J. Health consequences of shift work and inadequate sleep. BMJ. 2016;355:i5210.
• 14. Türkmenoğlu B, Sümer H. Burnout Levels of Healthcare Workers in Sivas City Center. Sivas Cumhuriyet University Health Sciences Institute Journal. 2017;2(2):24–34.
• 15. Çevik O, Özbalcı AA. The relationship between burnout levels and demographic characteristics of healthcare workers: Samsun province example. MANAS Journal of Social Research. 2020;9(3):1773–87.
• 16. Daşbilek F, Doğan Yüksekol Ö, Orhan İ. Investigation of worklife quality and work-family conflict of nurses working in shifts in terms of some variables. Journal of Health and Nursing Management. 2022;9(2):272–84.
• 17. Basatemur M, Güneş G. Evaluation of nocturnal eating habits and sleep quality in nurses;a university hospital sample. ESTÜDAM Journal of Public Health. 2021;6(3):227–36.
• 18. Sun Q, Ji X, Zhou W, Liu J. Sleep problems in shift nurses: A brief review and recommendations at both individual and institutional levels. Journal of Nursing Management. 2019;27(1):10–18.
• 19. Bagheri Hosseinabadi M, Ebrahimi MH, Khanjani N, Biganeh J, Mohammadi S, Abdolahfard M. The effects of amplitude and stability of circadian rhythm and occupational stress on burnout syndrome and job dissatisfaction among irregular shift working nurses. Journal of Clinical Nursing. 2019;28(9–10):1868–78.
• 20. Ulukan Y, Kılıç Aksoy Ş, Çiçek H. The effect of shift work on job commitment and job performance. Istanbul Commerce University Journal of Social Sciences. 2023;22(46):187–206.
• 21. Uslu F, Demir E. A qualitative data collection technique: InDepth interview. Hacettepe University Faculty of Letters Journal. 2023;40(1):289–99.
• 22. Yağar F. Determining sample size in qualitative research: data saturation. Aksaray University Journal of Social Sciences Institute. 2023;7(2):138–52.
• 23. Baltacı A. A conceptual review on sampling methods and sample size problem in qualitative research. BEU SBE Journal. 2018;7(1):231–74.
• 24. Bingöl K. Stress and coping methods among health workers: A qualitative study [Master’s thesis]. Karabük: Karabük University, Institute of Graduate Education;2023.
• 25. Çolak Yılmazer Y, Buldukoğlu K. Investigation of professional satisfaction, burnout and compassion fatigue levels of nurses: A university hospital example. HUHEMFAD. 2021;8(2):144–50.
• 26. Hinderer KA, VonRueden KT, Friedmann E, McQuillan KA, Gilmore R, Kramer B, Murray M. Burnout, compassion fatigue, compassion satisfaction, and secondary traumatic stress in trauma nurses. J Trauma Nurs. 2014;21(4):160–69.
• 27. Özvurmaz S, Öncü A. The effects of shift and watch system working order on nurses. Adnan Menderes University Faculty of Health Sciences Journal. 2018;2(1):39–46.
• 28. Uzdil Z, Kaya S. The effect of sleep patterns on nutritional status of nurses working with a shift system. Samsun Journal of Health Sciences. 2022;7(3):823–34.
• 29. Uzunbacak HH. A qualitative study on the effect of working hours on the quality of family life. Hitit University Social Sciences Institute Journal. 2017;10(2):1235–56.
• 30. Yıldırım A, Şimşek H. Qualitative research methods in social sciences. Ankara: Seçkin Publishing; 2008.
• 31. Yıldırım A, Şimşek H. Qualitative research methods in social sciences (9th Expanded Edition) . Ankara: Seçkin Publishing House; 2013.
• 32. Miles MB, Huberman AM. Qualitative data analysis: An expanded sourcebook. Sage: USA; 1994. Kafkas J Med Sci 2025; 15(2):164–177177
• 33. Ekici G, Demirbaş M. Investigation of the relationship between role-activity balance and quality of life in female nurses working in shifts. Journal of Occupational Therapy and Rehabilitation. 2020;8(2):91–8.
• 34. Orhaner E, Mutlu S. The effect of job satisfaction on motivation of health personnel. International Journal of Health Management and Strategies Research. 2018;4(1):74–93.
• 35. Güzel Özdemir P, Ökmen AC, Yılmaz O. Shift work disorder and mental and physical effects of shift work. Current Approaches in Psychiatry. 2018;10(1):71–83.
• 36. McDowall K, Murphy E, Anderson K. The impact of shift work on sleep quality among nurses. Occupational Health. 2017;67(8):621–25.
• 37. Books C, Coody LC, Kauffman R, Abraham S. Night shift work and its health effects on nurses. The Health Care Manager. 2020;39(3):122–27.
• 38. Khan S, Malik BH, Gupta D, Rutkofsky I. The role of circadian misalignment due to insomnia, lack of sleep, and shift work in increasing the risk of cardiac diseases: A systematic review. Cureus. 2020;12(1):e6616.
• 39. Geniş B, Cosar B, Taner ME. Factors affecting mental status in health care workers and the effects of shift work system. Journal of Psychiatric Nursing. 2020;11(4):275–83.
• 40. Farías R, Sepúlveda A, Chamorro R. Impact of shift work on the eating pattern, physical activity and daytime sleepiness among Chilean healthcare workers. Safety and Health at Work. 2020;11(3):367–71.
• 41. Pulat Demir H, Elkin N, Barut AY, Bayram HM, Averi S. Evaluation of sleep duration and nutritional status of health personnel working in shifts. IGUSABDER. 2017;2:89–107.
• 42. Kesgin M, Kubilay G. Evaluation of health problems caused by life habits and working conditions of nurses working in a private hospital. Journal of Nursing, Faculty of Health Sciences. 2011;18(1):41–9.
• 43. Demirçi T. Comparison of eating behaviors and sleep quality of shift and non-shift health personnel working in a foundation hospital [Master’s thesis]. Istanbul: Biruni University, Institute of Health Sciences; 2017.
• 44. Yılmaz D, Günay MA. Health communication in Turkey: A research on health professionals. Inonu University Faculty of Communication Electronic Journal (INIF E-Dergi). 2022;7(1):75–91.
• 45. Başol E. Communication problems between patients and health professionals (doctor and nurse) and solution suggestions. International Anatolia Academic Online Journal of Social Sciences. 2018;4(1):76–93.
• 46. Günaydın N. Sleep quality and its effect on the general mental status of nurses working in a state hospital. Journal of Psychiatric Nursing. 2014;5(1):33–40.
• 47. Shen S-H, Yen M, Yang S-L, Lee CY. Insomnia, anxiety, and heart rate variability among nurses working different shift systems in Taiwan. Nursing & Health Sciences. 2016;18(2):223–29.
• 48. Radovan, M. Workplace flexibility and participation in adult learning. Sustainability. 2024;16:5950.
• 49. Chaker R, Hajj-Hassan M, Ozanne S. The effects of online continuing education for healthcare professionals: A systematic scoping review. Open Education Studies. 2024;6(1):20220226.
• 50. Salvado M, Marques DL, Pires IM, Silva NM. Mindfulnessbased interventions to reduce burnout in primary healthcare professionals: A systematic review and meta-analysis. Healthcare. 2021;9(10):1342.
• 51. Wang Q, Wang F, Zhang S, Liu C, Feng Y, Chen J. Effects of a mindfulness-based interventions on stress, burnout in nurses: a systematic review and meta-analysis. Front Psychiatry. 2023;14:1218340.